Türk Yoğun Bakim Derneği Dergisi (Apr 2017)
Distribution of Clinical Isolates at Species Level and Their Antibiotic Susceptibilities in Intensive Care Units Patients
Abstract
Objective: Intensive care units are a hospital’s section where hospital infections and resistant microorganisms are most commonly seen. In this study it was aimed to determine the microorganisms which were isolated from various clinical specimens of the patients in intensive care units for a year and antibiotic susceptibility of the microorganisms. Materials and Methods: MALDI TOF MS and BD Phoenix system were used for the identification of bacteria, antibiotic sensitivities were evaluated by Kirby-Bauer disk diffusion method and BD Phoenix system in accordance with the Clinical and Laboratory Standards Institute recommendations. Results: In this study, a total of 1163 microorganisms were obtained; 575 (49.4%) gram-negative bacteria (GNB), 556 (47.8%) gram-positive bacteria (GPB) and 32 Candida spp. (2.7%). Strains were produced from blood (488), urine (233), respiratory tract (224), sterile body fluid (88), wounds (68) and catheter samples (62). The most frequently isolated GNBs were found to be Acinetobacter baumannii 131 (11.2%), Klebsiella pneumoniae 109 (9.3%), Escherichia coli 91 (7.8%) in order of frequency. Extended-spectrum beta-lactamase production was observed in 16 E. coli, 29 Klebsiella spp. Carbapenem resistance was identified in 132 Acinetobacter spp., 27 Pseudomonas spp., 14 K. pneumoniae, 1 E. coli. For Pseudomonas strains, ciprofloxacin and amikacin; for Acinetobacter strains, amikacin and colistin; for Escherichia and Klebsiella strains, amikacin and imipenem were determined as the most effective antibiotics. The most frequently isolated GPBs were 351 (30%) coagulase-negative staphylococci (CNS) (192 S. epidermidis), 111 (9.5%) Enterococcus spp. (67 Enterococcus faecalis), 55 Staphylococcus aureus, respectively. While Methicillin resistance was determined in 7 S. aureus and 191 CNS; vancomycin resistance was detected in 3 Enterococcus faecium strains. The most effective antibiotics against S. aureus and Enterococcus spp. strains were identified as linezolid, vancomycin, and teicoplanin. Conclusion: It will be useful if every center arranges the treatment protocols according to their microorganism distribution and resistance profiles to fight against resistant microorganisms.
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