ABSTRACT Objective: The aim of the study is to determine which bacteria are the causative agents and the antibiotic resistance rates in the respiratory tract secretions of patients who have diagnosed with COVID-19 and to compare these results with before the pandemic. Method: This study is a retrospective study comparing bacteria grown in bronchoalveolar lavage (BAL) fluid and endotracheal aspirate(ETA) fluids coming from adult clinical services and intensive care units and their antibiotic resistance profiles between January 2019 and December 2019 before the pandemic, with the results between January 2020 and December 2020 during the pandemic period. Results: A total of 900 culture results were examined in 2019; Acinetobacter baumannii was detected in 36%, Klebsiella pneumoniae in 23%, Pseudomonas aeruginosa in 14%, and Staphylococcus aureus in 8%. In 2020, during the pandemic, 660 culture results were examined, and same bacteria was detected in 43%, 23%,16% and 5%, respectively. K.pneumoniae's 3rd generation cephalosporin resistance, A. baumannii's resistance to tigecycline, gentamycin, tobramycin and P. aeruginosa's resistance to ceftazidime were found to have increased significantly during the pandemic compared to the pre-pandemic period. Conclusion: In hospitalized patients with COVID-19, secondary bacterial agents are mostly multidrug-resistant Gram-negative bacteria. For this reason,in patients with COVID-19 disease, appropriate empirical treatment should be selected by knowing the local bacterial agents and antibiotic resistance profiles.
Amaç: Pandemi öncesi (PÖ) ve pandemi dönemi (PD) yara enfeksiyon etkenleri ve antibiyotik direnç profillerini karşılaştırmak. Gereç ve Yöntemler: Ocak 2019-Aralık 2021 tarihleri arasında yara sürüntü örneklerinde üreyen bakteriler ve antibiyotik direnç oranları retrospektif olarak kaydedilmiştir. Bu sonuçlar PÖ (Ocak 2019 -Haziran 2020; n = 684) ve PD (Haziran 2020- Aralık 2021; n = 255) arasında karşılaştırılmıştır. Bulgular: Yara yeri enfeksiyonlarının kliniklere göre dağılımı şu şekildeydi: PÖ grubunda %27 ile yoğun bakımlar, %15 genel cerrahi servisi ve %13 enfeksiyon kliniği; PD grubunda %29 yoğun bakımlar, %24 COVID servisi ve %12 genel cerrahi servisi. Patojen sıklıkları, PÖ grubunda %19 E.coli, %16 S.aureus, %12 P.aeruginosa, %11 K.pneumoniae ve %10 A.baumannii iken, PD grubunda ise sırasıyla %22, %19, %9, %14, %10 olmuştur. PÖ grubunda S.aureus suşlarının %28’i metisilin dirençli iken, PD grubunda bu oran %35 olmuştur (p = 0,328). Meropeneme dirençli K.pneumoniae sıklığı PÖ'de %47’den PD'de %53’e yükselmiştir (p = 0,693). Sonuç: COVID-19 PD’de yara enfeksiyonlarında etken olan bakteri tiplerinin değişmediği, ama bazı antibiyotiklere direnç oranlarının hafif düzeyde arttığı gözlenmiştir. Pandemide antibiyotiklerin gereğinden çok ve uygunsuz kullanımı, çoklu ilaç direcine sahip gram negatif bakterilerin artışının sebebi olabilir. Aim: to compare the infectious agents and antibiotic resistance profiles of wound samples obtained during the pre-pandemic period (PP) and pandemic period (PD). Materials and Methods: We retrospectively recorded the rates of bacteria grown in wound swab samples and antibiotic resistance between January 2019 and December 2021. These results were compared between the PP (January 2019 - June 2020; n=684) and PD (June 2020 - December 2021; n=255) periods. Results: The distribution of wound infections according to clinics was as follows: in the PP, 27% were in intensive care units (ICU), 15% were in general surgery, and 13% were in infection clinics; in the PD, 29% were in ICU, 24% were in COVID service, and 12% were in general surgery. The pathogen frequencies were 19% for E.coli, 16% for S.aureus, 12% for P.aeruginosa, 11% for K.pneumoniae, and 10% for A baumannii in the PP, while they were 22%, 19%, 9%, 14%, and 10%, respectively, in the PD. While 28% of S aureus strains were methicillin-resistant in the PP, it was 35% in the PD (p=0.328). The incidence of meropenem-resistant K.pneumoniae increased from 47% in the PP to 53% in the PD (p=0.693). Conclusion: Our study showed that the types of bacteria causing wound infections did not change significantly during the COVID-19 pandemic period, but there was a slight increase in resistance rates to some antibiotics. The increase in multi-drug resistant gram-negative bacteria may be attributed to the excessive and inappropriate use of antibiotics during the pandemic.
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