Caskurlu Hulya, Davarci Ismail, Kocoglu Mucahide Esra, Cag Yasemin
Istanbul Medeniyet University, Faculty of Medicine, Göztepe Training Hospital, Department of Clinical Microbiology and Infectious Disease, Istanbul, Turkey.
Trakya University, Faculty of Medicine, Department of Clinical Microbiology, Edirne, Turkey.
Medeni Med J. 2020;35(2):128-135. doi: 10.5222/MMJ.2020.89138. Epub 2020 Jun 30.
Majority of nosocomial infections are seen in intensive care units (ICUs) and they course with higher rates of mortality, and morbidity rates. In this study, we aimed to investigate the distribution of microorganisms isolated from the tracheal aspirate and blood cultures of ICU hospitalized patients, and their antibiotic resistance profiles.
Tracheal aspirate and blood cultures sent from ICU patients were evaluated retrospectively between 2014-2018. Antimicrobial susceptibility tests were performed on microorganism cultures that were identified by conventional methods and using an automated system.
A total of 23.275 samples were accepted during the study period. The microorganisms isolated from tracheal aspirate cultures were Gram-negative (89.7%), Gram-positive (9.3%) and yeasts (1%). The most common Gram (-) microorganisms were A.baumannii (%25.7). The rates of meropenem resistance were documented as 98.3% for A.baumannii in 2014, 95.7% in 2018, 69.2% for P.aeruginosa. in 2014, and 35.6% in 2018, 45.55 for K.pneumoniae in 2014, and 5.8% in 2018 and 8% for E.coli in 2014, and 2% in 2018. The rates of methicillin resistance in S.aureus were documented as 28.0% in 2018, and 67.7% in 2015. The rates of penicillin resistance for S. pneumonia was documented as 76.8% in 2018, and 13.4% in 2015. The microorganisms isolated from blood culture were Gram (-) (31.4%), Gram (+) (57.9%) and yeasts (10.6%). The most frequently isolated Gram (-) bacteria were K.pneumonia (9.3%) and A.baumannii (8.8%). The rates of meropenem resistance were documented as 97.3% for A.baumannii. in 2014 and 79.2% in 2018, as 76.9% for K.pneumoniae in 2014 and 37.3% in 2018 and 79.2% for P.aeruginosa in 2014 and 26.1% in 2018. The artes of methicillin resistance were documented as 89.2% in 2018, and 78.5% for CNS in 2015, and 42.6% in 2018 while it was 92.4% for S. aureus in 2015.
Our study showcased a drop throughout the year in rates of carbapenem resistance against Gram (-) microorganisms and methicillin resistance in S.aureus. However, the persistently high carbapanem resistance in A.baumannii isolates demonstrates the crucial need to continue with infection control measures.
大多数医院感染发生在重症监护病房（ICU），其死亡率和发病率较高。在本研究中，我们旨在调查从ICU住院患者的气管吸出物和血培养物中分离出的微生物分布及其抗生素耐药谱。
回顾性评估2014年至2018年间从ICU患者送来的气管吸出物和血培养物。对通过传统方法和自动化系统鉴定的微生物培养物进行药敏试验。
研究期间共接受了23275份样本。从气管吸出物培养物中分离出的微生物为革兰氏阴性菌（89.7%）、革兰氏阳性菌（9.3%）和酵母菌（1%）。最常见的革兰氏阴性微生物是鲍曼不动杆菌（25.7%）。2014年鲍曼不动杆菌对美罗培南的耐药率记录为98.3%，2018年为95.7%；2014年铜绿假单胞菌对美罗培南的耐药率为69.2%，2018年为35.6%；2014年肺炎克雷伯菌对美罗培南的耐药率为45.5%，2018年为5.8%；2014年大肠杆菌对美罗培南的耐药率为8%，2018年为2%。2018年金黄色葡萄球菌对甲氧西林的耐药率记录为28.0%，2015年为67.7%。2018年肺炎链球菌对青霉素的耐药率记录为76.8%，2015年为13.4%。从血培养物中分离出的微生物为革兰氏阴性菌（31.4%）、革兰氏阳性菌（57.9%）和酵母菌（10.6%）。最常分离出的革兰氏阴性菌是肺炎克雷伯菌（9.3%）和鲍曼不动杆菌（8.8%）。2014年鲍曼不动杆菌对美罗培南的耐药率记录为97.3%，2018年为79.2%；2014年肺炎克雷伯菌对美罗培南的耐药率为76.9%，2018年为37.3%；2014年铜绿假单胞菌对美罗培南的耐药率为79.2%，2018年为26.1%。2018年甲氧西林耐药率记录为89.2%，2015年凝固酶阴性葡萄球菌对甲氧西林的耐药率为78.5%，2018年为42.6%，而2015年金黄色葡萄球菌对甲氧西林的耐药率为92.4%。
我们的研究表明，全年革兰氏阴性微生物对碳青霉烯类的耐药率以及金黄色葡萄球菌对甲氧西林的耐药率有所下降。然而，鲍曼不动杆菌分离株中持续较高的碳青霉烯类耐药率表明，继续采取感染控制措施至关重要。
