Mikrobiyolojik Örneklerden İzole Edilen PseudomonasAeruginosaSuşlarının Antibiyotik Direnç Modelleri

Yıl 2023, , 152 - 159, 30.08.2023

Duygu Kübra Tuna

https://doi.org/10.52976/vansaglik.1220794

Öz

Amaç: İnsan katılımcıların verilerini içeren bu tek merkezli retrospektif çalışma, mikrobiyoloji laboratuvarı tarafından dört yıl boyunca toplanan örneklerden izole edilen Pseudomonas aeruginosa suşlarının antibiyotik direnç oranlarını belirlemeyi amaçlamıştır.
Yöntem: 2017-2021 yılları arasında servis, yoğun bakım ve poliklinik servislerinde yatan 789 hastadan izole edilen yara, kan, trakeal aspirat, apse, vajina, beyin omurilik sıvısı, balgam ve idrar kültürü örnekleri Pseudomonas türleri açısından retrospektif olarak değerlendirildi. .
Bulgular: Kültürlerin çoğu idrar (%42.7) ve balgam kültürleriydi (%20.4). Servise başvuran hastaların çoğu göğüs hastalıkları bölümünden (%38,6), üroloji bölümünden (%14,3) ya da palyatif bakım ünitesinden (%12,5) nakledildi. En yüksek direnç oranları sefuroksim, levofloksasin ve netilmisine karşı; en düşük direnç oranı amikasine karşıydı. Aztreonam, sefepim ve gentamisin'e karşı dirençler yıllar içinde önemli ölçüde azalırken (sırasıyla P=0.0321, 0.0038 ve 0.0004), kolistin ve levofloksasine karşı dirençler önemli ölçüde arttı (sırasıyla P<0.0001 ve P=0.0407). Yıllar içinde sefepim, seftazidim ve siprofloksasine karşı dirençlerde önemli düşüşler gözlendi (sırasıyla P=0.0321, 0.0038 ve 0.0004). Yıllar içinde sadece sefepim için idrar kültüründen izole edilen suşların direncinde önemli bir azalma gözlendi (P=0.0003). Balgam, idrar ve solunum sekresyon kültürlerinden izole edilen suşların levofloksasine karşı direnci 2019 yılında önemli ölçüde artarken, 2020 yılında yara kültürünün direnci artmıştır (P=0.0145).
Sonuç: Antimikrobiyallerin sıklıkla çeşitli kullanımları nedeniyle hastalarda antibiyotik direnç profilinde yıllar içinde değişiklikler tespit edildi. Etkili tedavi protokollerini seçmek için her hastane için mikroorganizmaları ve antibiyotik dirençlerini düzenli olarak belirlemek gerekir.

Anahtar Kelimeler

Pseudomonas aeruginosa, antibiyotik direnç, suş, kültür

The Antibiotic Resistance Patterns of Pseudomonas Aeruginosa Strains Isolated from Microbiological Specimens

Öz

Purpose: This single-center retrospective study involving the data of human participants aimed to determine the antibiotic resistance rates of Pseudomonas aeruginosa strains isolated from samples collected by the microbiology laboratory for four years.
Methods: The samples of wound, blood, tracheal aspirate, abscess, vagina, cerebrospinal fluid, sputum, and urine culture isolated from 789 patients who were hospitalized in the service, intensive care and outpatient services between 2017-2021 were evaluated retrospectively for Pseudomonas species.
Results: Most of culture were urine (42.7%) and sputum cultures (20.4%). Most patients applied to the service were transferred from department of chest diseases (38.6%) or from department of urology (14.3%) or palliative care unit (12.5%). The highest rates of resistances were against cefuroxime, levofloxacin and netilmicin; lowest rate of resistance was against amikacin. The resistances against aztreonam, cefepime and gentamicin significantly reduced over years (P=0.0321, 0.0038 and 0.0004, respectively) while resistances against colistin and levofloxacin considerably increased (P<0.0001 and P=0.0407, respectively). Significant decreases were observed in resistances against cefepime, ceftazidime and ciprofloxacin over years (P=0.0321, 0.0038 and 0.0004, respectively). A significant decrease in resistance of strains isolated from urine culture was only observed for cefepime over years (P=0.0003). The resistance of strains isolated from cultures of sputum, urine and respiratory secretions against levofloxacin significantly increased in 2019 while those of wound culture increased in 2020 (P=0.0145).
Conclusion: Alterations in the antibiotic resistance profile were detected in patients over years due to frequently varied use of antimicrobials. To select effective treatment protocols, it is necessary to regularly determine the microorganisms and their antibiotic resistance for each hospital

Anahtar Kelimeler

antibiotic resistance, pseudomonas aeruginosa, strain, culture

Kaynakça

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