Hastane kökenli Acinetobacter baumannii izolatlarının antibiyotik duyarlılıkları ve imipenem dirençli izolatların genotiplemesi
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Tarih
2008
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info:eu-repo/semantics/openAccess
Özet
Hastane infeksiyonları mortalite ve morbidite oranlarını, ayrıca hastanede kalış süresini ve tedavi maliyetini önemli oranda arttırdığı için, önemli bir sağlık problemi olmaya devam etmektedir. Bu çalışmada, Trakya Üniversitesi Eğitim Araştırma Uygulama Hastanesi'nde 2004?2006 yılları arasında kandan izole edilen 92 A. baumannii kökeninde antibiyotik duyarlılıklarındaki değişimlerin araştırılması, imipenem dirençli A. baumannii kökenlerinin Pulsed-Field Gel Electrophoresis ile genotiplemesinin yapılması amaçlandı. Reanimasyon ve nöroloji servislerinin sırasıyla 51 köken (%56) ve 13 köken (%14) ile A. baumannii'nin en fazla izole edilen birimler olduğu saptandı. İmipenem dirençli olduğu saptanan 59 bakterinin sırasıyla 35'i ve 10'nu yine bu iki servisteki hastalardan izole edildi. Denenen bakterilerin tümünde en etkili antibiyotik %90,2 duyarlılık oranı ile minosiklin idi, bunu doksisiklin %70,6, imipenem %45,7 duyarlılık oranı ile takip etmekteydi. Mezlosilin ve sefotaksim için direnç oranı %100 bulundu. Diğer antibiyotiklere de direnç oranı oldukça yüksek olup %68,4-94,5 arasında saptandı. İmipeneme dirençli çıkan grupta minosiklin %100 duyarlı bulundu. Doksisiklin burada da ikinci sırada duyarlı (%55,9) bulundu. Ampisilin/sulbaktama %17, amikasine ise %10,2, gentamisine %1,7 ve tobramisine %3,4 duyarlılık bulundu. Denenen diğer tüm antibiyotiklere %100 direnç saptandı. Pulsed-Field Gel Electrophoresis'e göre tüm kökenler monoklonal bulundu.
Hospital infections continue to be an important health problem since they seriously increase the rate of mortality and morbidity as well as hospital care period and treatment costs. In this study, it was aimed to explore the changes in antibiotics sensitivities on the 92 A. baumannii strains isolated from blood between 2004 and 2006 in Trakya University Education, Research and Application Hospital and to genotype the imipenem resistant A. baumannii strains by using Pulsed-Field Gel Electrophoresis. Reanimation and neurology were determined to be the units where A. baumannii was the most frequently isolated, with the amounts as 51 strains (56%) and 13 strains (14%) respectively. 59 bacteria, which were determined to be imipenem resistant, were also isolated from the patients of these two units, with the amounts as 35 and 10 respectively. Among the tested bacteria, it was found that minosiklin was the most effective antibiotic with the sensitivity rate of 90.2%, the second was doksisilin with the rate of 70.6% and the third was imipenem with the rate of 45.7%. The resistance rates of Mezlosilin and sefotaksim was found as 100%. The resistance rates to the other antibiotics were also found to be relatively high with values between 68.4% and 94.5%. In the group found to be resistant to imipenem, minosiklin was determined to be sensitive with the rate of 100%. Doksisiklin was found to be again in the second order in sensitivity (55.9%). Sensitivity to Ampisilin/sulbaktam was found to be as 17%, amikasin as 10.2%, gentamisin as 1.7% and tobramisin as 3.4%. A-100% sensitivity was determined to all other tested antibiotics. All strains were found to be monoklonal according to Pulsed-Field Gel Electrophoresis.
Hospital infections continue to be an important health problem since they seriously increase the rate of mortality and morbidity as well as hospital care period and treatment costs. In this study, it was aimed to explore the changes in antibiotics sensitivities on the 92 A. baumannii strains isolated from blood between 2004 and 2006 in Trakya University Education, Research and Application Hospital and to genotype the imipenem resistant A. baumannii strains by using Pulsed-Field Gel Electrophoresis. Reanimation and neurology were determined to be the units where A. baumannii was the most frequently isolated, with the amounts as 51 strains (56%) and 13 strains (14%) respectively. 59 bacteria, which were determined to be imipenem resistant, were also isolated from the patients of these two units, with the amounts as 35 and 10 respectively. Among the tested bacteria, it was found that minosiklin was the most effective antibiotic with the sensitivity rate of 90.2%, the second was doksisilin with the rate of 70.6% and the third was imipenem with the rate of 45.7%. The resistance rates of Mezlosilin and sefotaksim was found as 100%. The resistance rates to the other antibiotics were also found to be relatively high with values between 68.4% and 94.5%. In the group found to be resistant to imipenem, minosiklin was determined to be sensitive with the rate of 100%. Doksisiklin was found to be again in the second order in sensitivity (55.9%). Sensitivity to Ampisilin/sulbaktam was found to be as 17%, amikasin as 10.2%, gentamisin as 1.7% and tobramisin as 3.4%. A-100% sensitivity was determined to all other tested antibiotics. All strains were found to be monoklonal according to Pulsed-Field Gel Electrophoresis.
Açıklama
Anahtar Kelimeler
Mikrobiyoloji, Microbiology
