Niyousha Matloobi AGHDAM, Gülseren AKTAŞ

HASTANE ENFEKSİYONU ARAŞTIRMA LABORATUVARINDA SAPTANAN RETROSPEKTİF SONUÇLARIN DEĞERLENDİRİLMESİ

Amaç: Hastaneler, sağlık hizmeti sunumu sırasında potansiyel enfeksiyon riski kaynağıdırlar. Vankomisine dirençli enterokoklar (VRE) ve karbapenemaz üreten Gram-negatif çomaklar, kalıcı kolonizasyona ve çok ilaca dirençli bakteriyel enfeksiyonlara neden olduğundan hastane enfeksiyonlarında önemlidirler. Bu çalışmada, 1 Ocak 2020 / 31 Aralık 2020 tarihleri arasında kliniklerde yatan hastaların rektal sürüntü örneklerinin hastane enfeksiyonu etkeni olan VRE ve karbapenem-dirençli (KD) Gram-negatif çomaklar açısından retrospektif olarak değerlendirmesi amaçlanmıştır. Gereç ve Yöntem: Hastanede yatan hastaların Hastane enfeksiyon Araştırma Laboratuvarı’na gönderilen rektal sürüntü örneklerinden KD Gram-negatif çomaklar ve VRE’yi izole etmek ve tanımlamak için standart klinik laboratuvar yöntemleri kullanılmıştır. Bulgular: İncelenen 2688 örneğin 777’sinde (%28,9) üreme olmuştur. Üreyen bakterilerin 627’si (%80,7) VRE ve 150’si (%19,3) KD Gram-negatif çomaklar olarak tanımlanmıştır. Bunlardan 75’i KD K. pneumonia; 7’si KD K. oxytoca; 26’sı KD Enterobacter türleri; 2’si KD E. coli; ve 40 suş KD Acinetobacter türü olarak belirlenmiştir. Vankomisine dirençli enterokoklar en sıklıkla dahiliye servisinde (%56,3 - 353/627) ve pediatrik yoğun bakım-yenidoğan servisinde (%37,6 - 236/627) tespit edilmiştir. Pediatri servislerinde toplam 296 bakterinin 146’sı VRE olarak tanımlanmıştır. Sonuç: Hastane enfeksiyonlarının kontrolünde yapılan sürveyans çalışmaları ile her sağlık kuruluşu kendi hastane florasını oluşturan mikroorganizmaları, direnç durumlarını ve dağılımlarını belirlemektedir. Elde edilen verilerin hastanelerin enfeksiyon kontrol süreçlerinde katkı sağlayacağı düşünülmektedir.

Anahtar Kelimeler:

Hastane enfeksiyonu, vankomisine dirençli enterokoklar, karbapeneme dirençli bakteriler, enfeksiyon kontrol önlemleri.

AN EVALUATION OF RETROSPECTIVE RESULTS DETECTED IN THE HOSPITAL INFECTION RESEARCH LABORATORY

Objective: Hospitals are a potential source of infection risk during healthcare delivery. Since vancomycin-resistant enterococci (VRE) and carbapenemase producing Gram-negative rods cause persistent colonization and multi-drug resistant bacterial infections, they are important in nosocomial infections. In this study, we aimed to retrospectively evaluate rectal swab samples of patients hospitalized in the clinics in terms of VRE and carbapenem- resistant (CR) Gram-negative rods as nosocomial infection agents between 1st January 2020 and 31st December 2020. Materials and Methods: Standard clinical laboratory methods were used to isolate and identify CR Gram-negative rods and VRE from rectal swab samples of hospitalized patients sent to our Hospital Infection Research Laboratory. Results: There was growth in 777 (28.9%) of 2688 samples examined. Of the bacteria that grew, 627 (80.7%) were defined as VRE, and 150 (19.3%) as Gram-negative rods resistant to carbapenem. Seventy-five of these were defined as CR K. pneumoniae: 7 as CR K. oxytoca: 26 as CR Enterobacter species: 2 as CR E. coli: and 40 as CR Acinetobacter species. Vancomycin-resistant enterococci were detected most frequently in the internal medicine ward (56.3% - 353/627) and pediatric intensive care-neonatal ward (37.6% - 236/627). In pediatric services, 146 of total 296 bacteria isolated were identified as VRE. Conclusion: With the surveillance studies carried out in the control of hospital infections, each health institution determines the microorganisms that make up its own hospital flora, their resistance status and their distribution. It is thought that the data we obtain will contribute to the infection control processes of the hospitals.

Keywords:

Nosocomial infection vancomycin-resistant enterococci, , carbapenem-resistant bacteria, infection control measures,

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