Yasemin TORUN ALTUNER, Yasemin ALTINTOP AY, Halit IŞIK, Ayşe Betül ERGÜL

Bir çocuk yoğun bakım biriminde kan kültürlerinin geriye dönük değerlendirilmesi: üç yıllık sonuçlar

Amaç: Bu çalışmada bir çocuk yoğun bakım biriminde yatan hastaların kan kültürlerinde saptanan mikroorganizmaların sıklığının ve antibiyotik dirençlerinin geriye dönük olarak değerlendirilmesi amaçlandı. Gereç ve Yöntemler: Çocuk yoğun bakım biriminde yatan hastalardan mikrobiyoloji laboratuvarına 2013-2016 yılları arasında gönderilen tüm kan kültürleri çalışmaya alındı. Kan kültürlerinden saptanan mikroorganizmalar ve antibiyotik duyarlılıkları belirlendi. Bulgular: Belirtilen sürede toplam 4 239 kan kültürü gönderilmişti. Kültürlerin 324'ünde (%7,6) üreme olduğu saptandı. Saptanan mikroorganizmaların 195'ini (%60,2) gram pozitif bakteriler, 107'sini (%33) gram negatif bakteriler, 22'sini (%6,8) ise mantarlar oluşturmakta idi. En sık saptanan mikroorganizma Koagulaz negatif stafilokok (%45,1) iken, bunu sırasıyla Klebsiella pneumoniae (%14,5), Enterococcus faecalis (%6,5) izlemekte idi. Mantar üremeleri arasında Candida albicans (%59,1) ilk sırada yer alırken, bunu Candida parapsilosis (%27,3) ve Candida tropicalis (%13,6) izlemekteydi. Metisilin direnci Koagulaz negatif stafilokok'ta %89,9, S.aureus'da %66 olarak saptandı. Enterokok spp.'de vankomisin direnci %3,6 idi. Gram pozitif mikroorganizmalarda linezolid direncine rastlanmadı. Klebsiella spp.'de genişletilmiş spektrumlu beta laktamaz pozitifliği %61,2, Esherichia Coli'de %100 olarak saptandı. Gram negatif bakterilerde karbapenem direnci %44,9 idi. Acinetobecter baumanii enfeksiyonlarında ise karbapenem direnci %100 olarak saptandı. Candida albicans'ta Amfoterisin-B direnci %61,5, vorikonazol direnci %7,7 idi. Çıkarımlar: Yoğun bakım birimlerinde hastane enfeksiyonlarına karşı etkin antibiyotik tedavisinin planlanması için her ünitenin kendi florasının özelliklerini bilmesi gerekmektedir.

A retrospective evaluation of blood cultures in a pediatric intensive care unit: A three year evaluation

Aim: In this study, it was aimed to retrospectively assess the frequency and antibiotic resistance of microorganisms isolated from blood cultures of patients in a pediatric intensive care unit. Material and Methods: The study was conducted on blood culture tests obtained from patients in a pediatric intensive care unit and sent to a microbiology laboratory between 2013 and 2016. The species and antibiotic susceptibilities were assessed in microorganisms isolated from the blood cultures. Results: Overall, 4239 blood cultures were obtained. Growth was detected in 324 blood cultures (7.6%). Of the microorganisms isolated, 195 (60.2%) were Gram-positive bacteria, and 107 (33.0%) were Gram-negative bacteria; 22 (6.8%) were fungi. The most commonly isolated microorganisms were Coagulase-negative staphylococci (45.1%), followed by Klebsiella pneumonia (14.5%), and Enterococcus faecalis (6.5%). Among the fungi, the most common was Candida albicans (59.1%), followed by Candida parapsilosis. The resistance rate against methicillin was 89.9% in coagulase-negative staphylococci, and 66% in S. aureus strains. The resistance rate against vancomycin was 3.6% in Enterococci spp. There was no resistance against linezolid in Gram-positive microorganisms. The rate of extended-spectrum beta lactamase positivity was found as 34% in Klebsiella spp. and 100% in Escherichia coli. The resistance rate against carbapenem was 44.9% in Gram-negative bacteriae. The resistance rate against carbapenem was 100% in Acinetobacter baumanii. In Candida albicans, resistance to amphotericine B was 61.5%, and resistance to voriconazole was 7.7%.Conclusions: To plan effective empiric antibiotic therapy against nosocomial infections in intensive care units, all units should have information about the characteristics of their own flora.

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