Antibacterial Resistance in Healthcare-AssociatedGram-negative Infections: What Changed in thePast Two Decades?
Yıl: 2021 Cilt: 26 Sayı: 4 Sayfa Aralığı: 704 - 712 Metin Dili: İngilizce DOI: 10.5578/flora.20219616 İndeks Tarihi: 17-05-2022
Antibacterial Resistance in Healthcare-AssociatedGram-negative Infections: What Changed in thePast Two Decades?
Öz: Introduction: Antimicrobial resistance in healthcare-associated gram-negative microorganisms is rising. Monitoring antimicrobial resis tance is crucial for determining infection control programs and planning empirical treatment of patients. In this study, it was aimed todetermine the distribution of the causative gram-negative bacteria and monitor the antibiotic susceptibility changes of Pseudomonasaeruginosa, Acinetobacter baumanni, Klebsiella spp. and Escherichia coli. Materials and Methods: An active and targeted surveillance of healthcare-associated infections is conducted by the Infection ControlCommittee in high-risk and intensive care units of our hospital. In this study, these surveillance data were used to compare the distri bution and antimicrobial susceptibility patterns of gram-negative microorganisms causing healthcare-associated infection in followingperiods: January-July 1998, January-December 2008 and January-December 2019. Results: A total of 1635 gram-negative isolates were analyzed, of which 251 were in 1998, 888 in 2008 and 496 in 2019. The mostfrequent gram-negative bacteria were Acinetobacter baumanni, E. coli, Pseudomonas spp. and Klebsiella spp.. Prevalence of E. coliand Pseudomonas spp. decreased while the prevalence of Klebsiella spp. and Stenotrophomonas maltophilia increased over years.Antimicrobial susceptibilities of beta-lactams, quinolones and aminoglycosides among P. aeruginosa increased over years, only the sus ceptibility of piperacillin-tazobactam decreased. Among Klebsiella spp., beta-lactams and quinolones had a significant susceptibility lossduring the study period. While all Klebsiella isolates were susceptible to meropenem in 1998, only 60% were susceptible in 2019. Therewas a significant decrease in susceptibility of ceftazidime, ciprofloxacin and meropenem among E. coli isolates. All tested antibiotics lostsignificant susceptibility for A. baumanii isolates, especially from 1998 to 2008.Conclusion: Antimicrobial resistance has had an increasing trend for healthcare-associated isolates of Klebsiella spp., E. coli andAcinetobacter spp. during the last 20 years. Rising carbapenem resistance in Klebsiella spp. has become a major threat to patients inhealthcare setting.
Anahtar Kelime: Sağlık Bakımı İlişkili İnfeksiyona Yol Açan Gram-negatif Bakterilerde Direnç:Son 20 Yılda Ne Değişti?
Öz: Giriş: Sağlık hizmeti ilişkili infeksiyona neden olan gram-negatif bakterilere karşı gelişen direnç oranları her geçen gün artmaktadır.Direnç profillerinin takip edilmesi, yatan hastalarda gelişen infeksiyonlarda ampirik antimikrobiyal tedavilerin planlanması ve infeksiyonkontrol programlarının belirlenmesinde önem taşımaktadır. Bu çalışmada, sağlık bakımıyla ilişkili infeksiyona neden olan gram-negatifbakterilerin dağılımının belirlenmesi ve en sık karşılaşılan dört mikroorganizma olan Pseudomonas aeruginosa, Acinetobacter baumanni,Klebsiella spp. ve Escherichia coli’nin duyarlılıklarındaki değişimlerin izlenmesi amaçlanmıştır. Materyal ve Metod: Hastanemizin yüksek riskli ve yoğun bakım ünitelerinde sağlık bakımı ilişkili infeksiyonların aktif ve hedefe yöneliksürveyansı İnfeksiyon Kontrol Komitesi tarafından yürütülmektedir. Çalışmamızda, bu sürveyans verileri kullanılarak Ocak-Temmuz1998, Ocak-Aralık 2008 ve Ocak-Aralık 2019 dönemlerinde sağlık bakımı ilişkili infeksiyona neden olan gram-negatif mikroorganizma ların dağılımı ve antimikrobiyal duyarlılık değişimleri incelenmiştir.Bulgular: Çalışmada, 251’i 1998 yılına, 888’i 2008 yılına ve 496’sı 2019 yılına ait olmak üzere toplam 1635 gram-negatif bakteriincelenmiş olup en sık izole edilen bakteriler yıldan yıla değişen sıklıkta A. baumanni, E. coli, Pseudomonas spp. ve Klebsiella spp.’dir.Yıllar içinde E. coli ve Pseudomonas spp. sıklığı azalırken Klebsiella spp. ve Stenotrophomonas maltophilia sıklığında artış izlenmiştir.Pseudomona spp.’ye karşı piperasilin-tazobaktam dışında diğer tüm antimikrobiyallerin duyarlılıklarında artış gözlenmiştir. Klebsiellaspp. suşlarında beta-laktam antibiyotikler ve kinolonlara karşı belirgin duyarlılık kaybı gözlenmiştir. 1998 yılında %100 olan meropenemduyarlılığı 2019 yılında %60’a gerilemiştir. E. coli için seftazidim ve siprofloksasin duyarlılığında belirgin azalma saptanırken meropenemduyarlılığı 1998’de %98.7’den 2019’da %91.6’ya gerilemiştir. A. baumanni için tüm antimikrobiyallerde özellikle 2008 yılında 1998’egöre belirgin duyarlılık azalması saptanmıştır. Sonuç: Son 20 yılda sağlık bakımı ilişkili infeksiyona yol açan Klebsiella spp., E. coli ve Acinetobacter spp.’ye karşı oluşan antibiyotikdirençleri artış eğilimindedir. Klebsiella spp. izolatlarında artan karbapenem direnci, hastanede yatan hastalar için büyük bir tehdithaline gelmiştir.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | AYSERT-YILDIZ P, GUZEL TUNCCAN O, Dizbay M (2021). Antibacterial Resistance in Healthcare-AssociatedGram-negative Infections: What Changed in thePast Two Decades?. , 704 - 712. 10.5578/flora.20219616 |
| Chicago | AYSERT-YILDIZ PINAR,GUZEL TUNCCAN OZLEM,Dizbay Murat Antibacterial Resistance in Healthcare-AssociatedGram-negative Infections: What Changed in thePast Two Decades?. (2021): 704 - 712. 10.5578/flora.20219616 |
| MLA | AYSERT-YILDIZ PINAR,GUZEL TUNCCAN OZLEM,Dizbay Murat Antibacterial Resistance in Healthcare-AssociatedGram-negative Infections: What Changed in thePast Two Decades?. , 2021, ss.704 - 712. 10.5578/flora.20219616 |
| AMA | AYSERT-YILDIZ P,GUZEL TUNCCAN O,Dizbay M Antibacterial Resistance in Healthcare-AssociatedGram-negative Infections: What Changed in thePast Two Decades?. . 2021; 704 - 712. 10.5578/flora.20219616 |
| Vancouver | AYSERT-YILDIZ P,GUZEL TUNCCAN O,Dizbay M Antibacterial Resistance in Healthcare-AssociatedGram-negative Infections: What Changed in thePast Two Decades?. . 2021; 704 - 712. 10.5578/flora.20219616 |
| IEEE | AYSERT-YILDIZ P,GUZEL TUNCCAN O,Dizbay M "Antibacterial Resistance in Healthcare-AssociatedGram-negative Infections: What Changed in thePast Two Decades?." , ss.704 - 712, 2021. 10.5578/flora.20219616 |
| ISNAD | AYSERT-YILDIZ, PINAR vd. "Antibacterial Resistance in Healthcare-AssociatedGram-negative Infections: What Changed in thePast Two Decades?". (2021), 704-712. https://doi.org/10.5578/flora.20219616 |
| APA | AYSERT-YILDIZ P, GUZEL TUNCCAN O, Dizbay M (2021). Antibacterial Resistance in Healthcare-AssociatedGram-negative Infections: What Changed in thePast Two Decades?. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi, 26(4), 704 - 712. 10.5578/flora.20219616 |
| Chicago | AYSERT-YILDIZ PINAR,GUZEL TUNCCAN OZLEM,Dizbay Murat Antibacterial Resistance in Healthcare-AssociatedGram-negative Infections: What Changed in thePast Two Decades?. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi 26, no.4 (2021): 704 - 712. 10.5578/flora.20219616 |
| MLA | AYSERT-YILDIZ PINAR,GUZEL TUNCCAN OZLEM,Dizbay Murat Antibacterial Resistance in Healthcare-AssociatedGram-negative Infections: What Changed in thePast Two Decades?. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi, vol.26, no.4, 2021, ss.704 - 712. 10.5578/flora.20219616 |
| AMA | AYSERT-YILDIZ P,GUZEL TUNCCAN O,Dizbay M Antibacterial Resistance in Healthcare-AssociatedGram-negative Infections: What Changed in thePast Two Decades?. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi. 2021; 26(4): 704 - 712. 10.5578/flora.20219616 |
| Vancouver | AYSERT-YILDIZ P,GUZEL TUNCCAN O,Dizbay M Antibacterial Resistance in Healthcare-AssociatedGram-negative Infections: What Changed in thePast Two Decades?. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi. 2021; 26(4): 704 - 712. 10.5578/flora.20219616 |
| IEEE | AYSERT-YILDIZ P,GUZEL TUNCCAN O,Dizbay M "Antibacterial Resistance in Healthcare-AssociatedGram-negative Infections: What Changed in thePast Two Decades?." Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi, 26, ss.704 - 712, 2021. 10.5578/flora.20219616 |
| ISNAD | AYSERT-YILDIZ, PINAR vd. "Antibacterial Resistance in Healthcare-AssociatedGram-negative Infections: What Changed in thePast Two Decades?". Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi 26/4 (2021), 704-712. https://doi.org/10.5578/flora.20219616 |
