Akademik Veri Yönetim Sistemi
Turk Hijyen ve Deneysel Biyoloji Dergisi, cilt.74, sa.1, ss.55-70, 2017 (Scopus, TRDizin)
Objective: Bloodstream infections are the most common nosocomial infections and significant reasons for mortality and morbidity. Early diagnosis and treatment are of vital importance in terms of patient prognosis. Blood culture is the most reliable method for the diagnosis of bacteremia and sepsis. The aim of this study was to identify the microorganisms isolated from the blood cultures sent to medical microbiology laboratory from various clinics between January 2011 and December 2014 and to determine antibiotic resistance profiles of these microorganisms. Methods: Blood cultures were studied by the BACTEC 9120 (Becton-Dickinson Diagnostic Instrument Systems, USA) automation system. The identification of the microorganisms was carried out by using both conventional methods and BD Phoenix Automized Microbiology Identification System (Becton Dickinson and Company, Sparks, USA). Antibiotic susceptibility of the bacteria was studied with Kirby-Bauer disc diffusion method and evaluated as regards the criteria of Clinical Laboratory Standards Institute (CLSI). Results: One A total of 50.850 blood cultures taken from 22.366 patients were examined in this study and reproduction was detected in 7.510 (14.7%) of the cultures. 4.894 (67.5%) of the reproduced microorganisms were Gram positive cocci (71% plasma coagulase negative staphylococci, 9% Staphylococcus aureus, %9 Enterococcus sp., and %6 Streptococcus sp.), 181 (2.4%) were Gram positive bacillus, 2105 (28%) were Gram negative Bacillus (32.9% E. coli, 23.9% Klebsiella sp., 16% Pseudomonas aeruginosa, 13% Acinetobacter sp., and 5.8% Enterobacter sp.), 21 (0.27%) were anaerobe bacteria and 305 (4%) were fungus type (96.7% Candida sp.). Methicillin resistance was detected as 34% in plasma coagulase negative staphylococci and 20.9% in S. aureus. Vancomycin resistance in enterococcus was determined as 13%. Broad spectrum beta lactamase formation was found as 34% in E. coli and 50% in Klebsiella sp. Carbapenemase production was detected as 8% in E.coli and 17% in Klebsiella sp. Resistance rates of E.coli and Klebsiella sp. to ampicillin was respectively as 44.7% and 100%, to gentamicin 26% and 27%, to amicasin 15% and 17%, to amoxicillin+clavulanate acid 30% and 35%, cefuroxime 41% and 51%, to cefepime 35% and 50%, to ceftazidime and cefotaxime 36% and 50%, and to ciprofloxacin 39.5% and 31.8%. Resistance rates of Acinetobacter sp. and P. aeruginosa to ceftazidime was respectively 78% and 22%, to ciprofloxacin 64% and 12.6%, to imipenem 63.6% and 26.5%, to gentamicin 56% and 11.8%, to amicasin 53% and 7%, to piperacillin + tazobactam 58% and 12%, to cefepime 61% and 16.6%, to cefotaxime 74.7% and 22%, and to cefoperazone + sulbactam 56.7% and 11%. Conclusion: It is understood that staphylococci resistant to methicillin, which is a significant problem in our hospital, bacteria like E. coli and Klebsiella sp., and bacteria like Pseudomonas and Acinetobacter genus are multiple-drug resistant and that this resistance has undergone a change over time.