Burak KÜÇÜK, Gökhan ARICAN, Damla GÜLDEREN, Hacer UĞURLU, Kezban Tülay YALÇINKAYA, Murat ARAL

Kahramanmaraş Sütçü İmam Üniversitesi Sağlık Uygulama ve Araştırma Hastanesi’nde Kan Kültürlerinden İzole Edilen Mikroorganizmalar ve Antibiyotik Duyarlılıkları

Kahramanmaraş Sütçü İmam Üniversitesi Sağlık Uygulama ve Araştırma Hastanesi’nde kan kültürlerinden izole edilen mikroorganizmalar ve antibiyotik duyarlılıkları ÖZET Amaç: Kan dolaşımı enfeksiyonları, mortalite ve morbiditenin önde gelen nedenlerinden biridir. Çalışmamızın amacı kan kültürlerinde en sık belirlenen enfeksiyon etkenlerini ve antibiyotik duyarlılıklarını saptamaktır. Gereç ve Yöntem: 3719 izolat çalışmaya dahil edilmiştir. Kan kültürü örnekleri BACT/ALERT 3D otomatize sistemi ile inkübe edilmiştir. Üreyen mikroorganizmaların identifikasyonu ve antibiyotik duyarlılıkları Phoenix otomatize sistem ile yapılmıştır. Bulgular: En sık izole edilen Gram negatif bakteriler Escherichia coli 227 (%36.37), Klebsiella pneumoniae 126 (%20.19) olarak bulunmuştur. Gram pozitif bakterilerin 2245’inin koagülaz negatif Staphylococcus türleri, 251’inin (%8.8) Enterococcus spp., 194’ünün (%6.87) Staphylococcus aureus olduğu saptanmıştır. Gram negatif bakterilere en etkili antibiyotikler karbapenemler, aminoglikozidler ve tigesiklin olarak bulunmuştur. Tüm Acinetobacter izolatları karbapenemlere dirençli bulunmuştur. Staphylococcus aureus izolatlarında vankomisin direnci saptanmazken metisilin direnci %55, koagülaz negatif Staphylococcus izolatlarında metisilin direnci %84 olarak bulunmuştur. Enterococcus spp. izolatlarında vankomisin direnci %9.7 olarak bulunmuştur. Sonuç: Sonuç olarak bakterilerin direnç oranlarının bu denli yüksek olması enfeksiyon kontrol önlemlerinin artırılması gerektiğini düşündürmektedir. Anahtar kelimeler : Antibiyotik direnci; kan kültürü; kan dolaşımı enfeksiyonu; mikroorganizma Microorganism isolated from blood culture and their antimicrobial susceptibilities obtained at Kahramanmaraş Sütçü Imam University Health Practice and Research Hospital ABSTRACT Objective: Blood stream infections remain a major cause of morbidity and mortality. The aim of this study is to determine the types of microorganisms and antibiotic susceptibility isolated from blood cultures. Materials and Methods: 3719 isolates identified included in the study. Blood culture samples were incubated in BACT/ALERT 3D automated system. Identification and antibiotic susceptibility of microorganisms were done with Phoenix automated system. Results: The most frequent Gram negative bacteria were Escherichia coli 227 (36.3%), Klebsiella pneumoniae 126 (20.1%). The most frequent Gram positive bacteria were 2245 (79.5%) coagulase negative Staphylococcus, 251 (8.8%) Enterococcus spp., 194 (6.87%) Staphylococcus aureus. Carbapenems, aminoglycosides and tigecycline were most effective antibiotics against all Gram negatives. All Acinetobacter isolates were resistant to carbapenems. No resistance to vancomycin was detected Staphylococcus aureus. Methicilin resistance was 55% to Staphylococcus aureus, 84% to coagulase negative Staphylococcus. Vancomycin resistance was 9.7% to Enterococcus spp.. Conclusion: As a result, the high resistance rates of bacteria suggest that infection control measures should be increased. Key words : Antibiotic resistance; blood culture; blood stream infection; microorganism

Anahtar Kelimeler:

Antibiyotik direnci, kan kültürü, kan dolaşımı enfeksiyonu, mikroorganizma

PDF

___

1. Bastuğ A, Akıncı E, Aypak A, Kanyılmaz D, Aslaner H, But A, et al. The Evaluation of Healthcare Associated Bloodstream Infections at a Tertiary Care Hospital Between 2011 and 2015: Epidemiology and Mortality Risk Factors. Kafkas Journal of Medical Sciences. 2017;7(1):1-6.
2. Goto M, Al-Hasan MN. Overall burden of bloodstream infection and nosocomial bloodstream infection in North America and Europe. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 2013;19(6):501-9.
3. Rodríguez-Baño J, López-Prieto MD, Portillo MM, Retamar P, Natera C, Nuño E, et al. Epidemiology and clinical features of community-acquired, healthcare-associated and nosocomial bloodstream infections in tertiary-care and community hospitals. Clinical Microbiology and Infection. 2010;16(9):1408-13.
4. Tabah A, Koulenti D, Laupland K, Misset B, Valles J, Bruzzi de Carvalho F, et al. Characteristics and determinants of outcome of hospital-acquired bloodstream infections in intensive care units: the EUROBACT International Cohort Study. Intensive Care Med. 2012;38(12):1930-45.
5. Er H, AŞIk G, YoldaŞ Ö, DemİR C, KeŞLİ R. Kan Kültürlerinde İzole Edilerek Tanımlanan Mikroorganizmaların ve Antibiyotik Direnç Oranlarının Belirlenmesi. Türk Mikrobiyoloji Cemiyeti Dergisi. 2015.
6. Keihanian F, Saeidinia A, Abbasi K, Keihanian F. Epidemiology of antibiotic resistance of blood culture in educational hospitals in Rasht, North of Iran. Infection and drug resistance. 2018;11:1723-8.
7. Özkaya E, Tümer S, Kirişci Ö, Çalışkan A, Erdoğmuş P. Evaluation of microorganisms isolated from blood cultures and antibiotic sensitivity obtained at Kahramanmaraş Necip Fazıl City Hospital in the last two years. Turkish Bulletin of Hygiene and Experimental Biology. 2015;72(2):115-22.
8. Bolukçu S, Başaran S, Çağatay A, Özsüt H, Eraksoy H. Klinik Mikrobiyoloji Laboratuvarına Gönderilen Kan Kültürlerinin Prospektif Olarak Değerlendirilmesi. Klimik Dergisi. 2018;31(2):120-4.
9. Canzoneri CN, Akhavan BJ, Tosur Z, Andrade PEA, Aisenberg GM. Follow-up blood cultures in Gram-negative bacteremia: Are they needed? Clinical Infectious Diseases. 2017;65(11):1776-9.
10. Ergul AB, Isik H, Altintop YA, Torun YA. A retrospective evaluation of blood cultures in a pediatric intensive care unit: a three year evaluation. Turk pediatri arsivi. 2017;52(3):154-61.
11. Gundogdu A, Kilic H, Ulu-Kilic A, Aydin G, Alp E. Epidemiological Features of Nosocomial Bloodstream Infections in Pediatric Patients. Klimik Dergisi/Klimik Journal. 2016;29(1):29-35.
12. Opota O, Croxatto A, Prod'hom G, Greub G. Blood culture-based diagnosis of bacteraemia: state of the art. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 2015;21(4):313-22.
13. Safak B, Kilinc O. Microorganisms Isolated From Blood Cultures During 2010-2015 and Their Antimicrobial Susceptibilities. Klimik Dergisi/Klimik Journal. 2016;29(2):61-5.
14. Gandra S, Mojica N, Klein EY, Ashok A, Nerurkar V, Kumari M, et al. Trends in antibiotic resistance among major bacterial pathogens isolated from blood cultures tested at a large private laboratory network in India, 2008-2014. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. 2016;50:75-82.
15. Organization WH. Antimicrobial resistance global report on surveillance: 2014 summary. World Health Organization, 2014.
16. Küçükateş E, Gültekin N. Antimicrobial Susceptibility and Microorganisms Isolated from Blood Cultures of Hospitalized Patients in Intensive Care Units. Haseki Tıp Bülteni. 2016;54(2):97-102.
17. Nazik S, Cingöz E, Şahin AR, Güler S. Kan kültürlerinden izole edilen Staphylococcus aureus suşlarında metisilin direncinin yıllara göre değişimi. Kocaeli Tıp Dergisi. 2018;7(1):32-6.
18. Ödemiş İ, Köse Ş, Ersan G, Çelik D, Akbulut İ. Evaluation of antibiotic susceptibilities of enterococcus strains isolated from clinical samples of hospitalized patients. Turkish Bulletin of Hygiene and Experimental Biology. 2018;75(4):345-52.
19. Ozer Balin S, Aktas Senol A. Evaluation of Hospital Infections in Intensive Care Unit. Klimik Dergisi/Klimik Journal. 2017;30(3):108-13.
20. Barış A, Bulut ME, Öncül A, Bayraktar B. Distribution of Clinical Isolates at Species Level and Their Antibiotic Susceptibilities in Intensive Care Units Patients. Türk Yoğun Bakım Derneği Dergisi. 2017;15(1):21-7.
21. Şirin MC, Ağuş N, Yılmaz N, Derici YK, Hancı SY, Bayram A, et al. The change of antibiotic resistance profiles over the years in Pseudomonas aeruginosa and Acinetobacter baumannii strains isolated from intensive care units. Journal of Clinical and Experimental Investigations. 2015;6(3).
22. Aydin M, Kasikcioglu C, Nargiz Kosucu S, Timurkaynak F, Arslan H. Bloodstream Infections: Etiologic Agents and Their Antibiotic Resistance Rates. Klimik Dergisi/Klimik Journal. 2016;29(2):83-6.