Three Year Resistance Profile of <i>Acinetobacter baumannii</i> and <i>Pseudomonas aeruginosa</i> Strains Isolated from Intensive Care Units

Abstract

ÖZ Amaç: Bu çalışmada, yoğun bakım ünitesi (YBÜ) örneklerinden izole edilen Pseudomonas aeruginosa ve Acinetobacter baumannii suşlarının üç yıllık antibiyotik duyarlılıklarının incelenerek direnç oranlarındaki değişimin araştırılması amaçlanmıştır. Gereç ve Yöntem: Ocak 2015-2018 arasında YBÜ örneklerinden izole edilen Pseudomonas aeruginosa ve Acinetobacter baumannii suşlarının direnç profilleri retrospektif olarak incelendi ve yıllık direnç oranları değerlendirildi. Bulgular: Üç yıllık süre içinde YBÜ örneklerinin 609'unda Acinetobacter baumannii, 420'sinde Pseudomonas aeruginosa izole edilmiştir. İzolatların en sık Genel YBÜ'den izole edildiği saptanmıştır. Acinetobacter baumanni'nin kolistin, amikasin, gentamisin, imipenem, meropenem, siprofloksasin, seftazidim, piperasilin/tazobaktama 3 yıllık ortalama direnci sırasıyla %0,5, %79, %86, %96, %96, %97, %98, %99, Pseudomonas aeruginosa'nın ise sırasıyla %5, %21, %25, %35, %38, %40, %42, %45, %49, %53 olarak tespit edilmiştir. Acinetobacter baumannii ve Pseudomonas aeruginosa suşlarında en etkili antibiyotiklerin sırasıyla kolistin (%99,5, %95) ve amikasin (%21, %79) olduğu görülmüştür. Sonuç: Hastanemiz YBÜ'lerinden izole edilen Acinetobacter baumannii izolatlarının birçok antibiyotiğe dirençli olduğu, Pseudomonas aeruginosa izolatlarının daha duyarlı olduğu saptanmıştır. Bu veriler, Acinetobacter baumannii kaynaklı enfeksiyonların tedavisinde yeni antibiyotiklere ihtiyaç duyulduğunun kanıtı niteliğindedir. Her hastanenin kendi direnç oranlarındaki değişimleri takip etmesi ve ampirik tedavi ilkelerinin güncellemesinin uygun olacaktır. Anahtar Kelimeler: Acinetobacter baumannii, Pseudomonas aeruginosa, antimikrobiyal direnç, yoğun bakım ünitesi ABSTRACT Objective: The objective of the study was to investigate the three-year antibiotic susceptibility of Pseudomonas aeruginosa and Acinetobacter baumannii strains isolated from intensive care unit (ICU) specimens and to evaluate the changes in resistance rates. Materials and Methods: The resistance profiles of Pseudomonas aeruginosa and Acinetobacter baumannii strains isolated from ICU specimens between January 2015-2018 were analyzed retrospectively and the annual resistance rates were evaluated. Results: Acinetobacter baumannii was isolated in 609 and Pseudomonas aeruginosa was isolated in 420 of the ICU specimens over a three-year period. Strains were most frequently isolated from general ICU. The three-year mean resistance of Acinetobacter baumannii and Pseudomonas aeruginosa to colistin, amikacin, gentamycin, imipenem, meropenem, ciprofloxacin, ceftazidime, piperacillin / tazobactam was 0.5%, 79%, 86%, 96%, 96%, 97% 98%, 99% and 5%, 21%, 25%, 35%, 38%, 40%, 42%, 45%, 49% and 53%, respectively. The most effective antibiotics were for Acinetobacter baumannii and Pseudomonas aeruginosa were colistin (99.5% vs 95%) and amikacin (21% vs 79%), respectively. Conclusion: It was found that Acinetobacter baumannii strains isolated from ICUs were resistant to many antibiotics and that Pseudomonas aeruginosa isolates were ...

Investigation of Virulence Factors and Antibiotic Resistance of Pseudomonas aeruginosa Isolated from A Range of Clinical Samples

“…29 In a more recent study, colistin resistance was reported at a very low rate of 5% in 420 P. aeruginosa isolated from ICUs. 33 In the present study, the colistin resistance rate was 11.7% in isolates from ICU patients. Among the reasons why colistin resistance was found to be higher in our sample group may be the inclusion of recently collected samples (2018-2021).…”

“…Therefore, colistin resistance has become an important issue, as shown by the many recent studies. 29,33,35 In a surveillance study conducted with data from many regions between 1997 and 2016, P. aeruginosa was one of the most common pathogenic bacterial species. It ranked first in Europe, the Asia Pacific region, and Latin America.…”

Clinical Characteristics, Antibiotic Resistance Profiles, and Factors Affecting Mortality in Patients Isolated Acinetobacter Baumannii in Intensive Care Unit: Retrospective Tertiary Center Analysis

“…Studies from Turkey reported that it was isolated from respiratory tract samples (tracheal aspirate and sputum) at a rate of 65-72.7% and from blood cultures at a rate of 3.6-21%. [5,8,18] In our study, it was most commonly isolated from respiratory tract samples (59.2%) and blood cultures (23.2%).…”

“…It has been reported that the APACHE-2 score is significantly higher in patients who died from A. baumannii bacteremia patients followed in the ICU. [5,8,9] Another study stated that an APACHE-2 score of >16 could predict mortality. [14] Our study's median APACHE-2 score was 25 in patients who died, while 21 in patients who survived.…”

“…[1][2][3] A. baumannii can frequently cause nosocomial infections due to the increase in the number of patients followed in ICUs and can remain alive for a long time in the hospital environment due to their resistance to external environmental conditions. [4,5] The fact that A. baumannii strains are naturally resistant to many antibiotics and can develop resistance quickly can be a severe problem by limiting the antimicrobials to be used in the treatment against this infection, which can cause severe mortality. [6] In addition, A. baumannii infections in ICUs cause prolonged hospital stays, increasing ICU occupancy rates and hospital costs.…”