A surveillance study of antimicrobial resistance of Gram-negative bacteria isolated from intensive care units in eight hospitals in Turkey

Abstract

This study was carried out with the participation of eight hospitals in Turkey to determine the frequency of gram-negative bacteria isolated in intensive care units (ICU) and to compare their resistance rates to selected antibiotics. Aerobic gram-negative bacteria isolated from ICUs during 1996 were studied. Antibiotic susceptibilities to imipenem, ceftazidime, ceftazidime-clavulanate, ceftriaxone, cefotaxime, cefepime, cefodizime, cefuroxime, piperacillin/tazobactam, amoxycillin-clavulanate, gentamicin, amikacin and ciprofloxacin were determined by Etest. A total of 748 isolates were obtained from 547 patients. The majority of organisms were isolated from the respiratory (38.8%) and urinary tracts (30.9%). Pseudomonas spp. were the most frequently isolated gram-negative species (26.8%), followed by Klebsiella spp. (26.2%). Escherichia coli, Acinetobacter spp. and Enterobacter spp. were the other commonly isolated organisms. High resistance rates were observed for all antibiotics studied. Imipenem appeared to be the most active agent against the majority of isolates. Although resistance rates exceeded 50%, ciprofloxacin, cefepime and amikacin were found to be relatively effective. Extended-spectrum beta-lactamase (ESBL) production appeared to be a major mechanism of resistance to beta-lactam antibiotics. In contrast to ceftazidime-clavulanate, piperacillin/tazobactam showed poor activity against organisms thought to produce ESBL, suggesting the presence of an enzyme resistant to tazobactam action. This study has yielded high rates of resistance in aerobic gram-negative isolates from ICUs in Turkey. High resistance rates to all the other antibacterials studied leave imipenem as the only reliable agent for the empirical treatment of ICU infections in Turkey.

Antimicrobial susceptibility patterns among bacteria isolated from intensive care units of the largest teaching hospital at the northwest of Iran

“…Respiratory pathogens are responsible for about one-third of ICU infections (Garner et al, 1998;Flanders, Collard, Saint, 2006). In the present study, the most common site of infection was the respiratory tract (51.7 %); this result is in agreement with other studies conducted indifferent countries including Turkey (38.8 %) (Gunseren et al, 1999), India (29.7%) (Orrett, 2002), Oman (65%) (Al-Lawati, Crouch, Elhag, 2000), Italy (91%) (Bassetti et …”

“…Moreover, the resistance rate to cephalosporins (79.5%-87.8%) was comparable to that in Iran (Hadadiet al, 2008), but higher than reported in foreign studies (Gunseren et al, 1999;Al-Lawati, Crouch, Elhag, 2000;Glupczynski et al, 2001;Patzer, Dzierzanowska,Turner, 2002;Gonlugur et al, 2004;Karlowsky et al, 2003;Meric et al, 2005). C u r r e n t r e s u l t s a l s o s h o w e d t h a t 2 5 .…”

“…The overall resistance rate of antimicrobials was higher in the current study than in other reports (Gunseren et al, 1999;Mendes et al, 2005;Styers et al, 2006;Patzer, Dzierzanowska, Turner, 2002;Gonlugur et al, 2004;Karlowsky et al, 2003). Moreover, the resistance rate to cephalosporins (79.5%-87.8%) was comparable to that in Iran (Hadadiet al, 2008), but higher than reported in foreign studies (Gunseren et al, 1999;Al-Lawati, Crouch, Elhag, 2000;Glupczynski et al, 2001;Patzer, Dzierzanowska,Turner, 2002;Gonlugur et al, 2004;Karlowsky et al, 2003;Meric et al, 2005).…”

“Isolation and Characterization of Lactose and Non- Lactose Fermenting Bacteria From Tertiary Care Hospital and Their Antimicrobial Susceptibility Test”

“…These microorganisms have survived for thousands of years by their ability to adapt to antimicrobial agents [10].…”

A Study on the Prevalence and Microbiological Profile of Nosocomial Infections in the ICU of a Tertiary Care Hospital in Eastern India

“…(Shehabi et al, (1996), Ducel et al,(2002), Krishna et al,) Critically ill Intensive care unit (ICU) patients are most vulnerable for developing these infections . Compared with an average patient, an ICU patient has five to seven folds higher risk of nosocomial infection and ICU infections contributes to 20% to 25% of all nosocomial infections in a hospital (Günserena et al, 1999). Factors like increasing use of invasive devices, immunosuppressive drugs and status as well as irrational use of antibiotic therapy in ICUs are all contributing for the same.…”