Acinetobacter-Associated nosocomial infections in Cumhuriyet University Medical Faculty Research Hospital; Three years’ experience

Abstract

Nosocomial infections have high mortality and morbidity. Acinetobacter is a Gram-negative bacilli and an important nosocomial pathogen. The number of nosocomial infections caused by antibiotic resistant-Acinetobacter strains has increased in recent years. Monitoring these bacterial infections which are difficult to treat, and antibiotic susceptibility, is very important for the appropriate treatment of patients. In this study, nosocomial infections caused by Acinetobacter in the hospital of Cumhuriyet University Medical Faculty during 2014-2016 were investigated. Method: Acinetobacter-associated nosocomial infections and their rate of antibiotic resistance in patients hospitalizing in the Cumhuriyet University Medical Faculty Research Hospital between January 2014 and December 2016 were retrospectively investigated. The data of this study are the surveillance data of the infection control committee and were obtained from the 3 years data registered in the infline software. Results: The rate of infection was 3.81% in the hospital, however, it was 30.86% in the Anesthesiology intensive care unit (ICU). In 2016, the rate of infection was lower in the hospital, whereas, it was higher in the Anesthesiology ICU. The number of Acinetobacter strains as a causative agent in the nosocomial infections were higher in 2016, too. In 7.16% of the nosocomial infections, Acinetobacter species were detected as the causative agent; Acinetobacter baumannii constituting 94.5%. Only two cases of colistin resistance were seen. Tigecycline resistance was detected in one strain. Meropenem and imipenem resistance were 91.1% and 93.8% for A. baumannii, respectively. Ventilator-associated pneumonia was the most common nosocomial infection due to Acinetobacter baumannii. Conclusions: Acinetobacter strains are among the most important nosocomial pathogens in our hospital. At the same time, the antibiotic resistance is increasing among Acinetobacter strains. Regular monitoring of these bacterial infections and in vitro susceptibility profiles of them is necessary to ensure an appropriate empirical treatment of Acinetobactermediated nosocomial infections.

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

“…Yapılan çalışmalarda en sık izole edilen materyal türünün trakeal aspirat olduğu görülmektedir (5,19,20 Ülkemizde yapılan birçok çalışmada bu etkenlerin, YBÜ'ler arasında en sık anestezi YBÜ'de saptandığı bildirilirken, bu çalışmada Acinetobacter baumannii suşlarının %37'si, Pseudomonas aeruginosa suşlarının %39'u genel YBÜ'den izole edilmiştir (19,21,22). Hastanemizde birçok hastaneden farklı olarak genel YBÜ bulunmakta ve bu birimde sıklıkla diğer birimlerde yer bulunamayan hastaların tedavisi sürdürülmektedir.…”

“…Ulusal Antimikrobiyal Direnç Sürveyans Sistemi (UAMDSS) 2015 raporunda ise Türkiye genelinde karbapenemlere %68,39 direnç saptanmıştır (28). Ülkemizde yapılan birçok çalışmada karbapenemlere direnç %90'ın üzerinde bildirilmektedir (21,29,30). Bu raporlar ve çalışmalar son yıllarda bakteride karbapenem direnç artışını çarpıcı bir şekilde göstermektedir.…”

“…Kolistin çoğul dirençli Acinetobacter baumannii enfeksiyonlarının tedavisinde sıklıkla tercih edilmektedir ve henüz bu antibiyotiğe karşı direnç gelişimi çok düşük oranlardadır. Ülkemizde yapılan çeşitli çalışmalarda Acinetobacter baumannii izolatlarında kolistine direnç ya saptanmamış ya da nadiren saptanmış ve kolistin en duyarlı antibiyotik olarak bulunmuştur (21,34). Bu çalışmada da Acinetobacter baumannii izolatlarının en duyarlı olduğu antibiyotik kolistin olarak tespit edilmiştir.…”

Antioxidant, Antimicrobial Properties and In Silico Study of a N,N'-(ethane-1,2-diyl)bis(1-(9H-fluoren-2-yl)methanimine)

“…It is seen that blood is the sample type from which A. baumannii isolates in the second most frequency, while urine is the sample type from which P. aeruginosa strains are isolated in the second frequency. While many studies conducted in our country reported that these agents were detected most frequently in the anesthesia department among ICUs, 37% of A. baumannii strains and 39% of P. aeruginosa strains used in our study were isolated from the general ICU [40,41,42].…”