Nonfermentative gram-negative microorganisms isolated from intensive care units and their resistance profiles in a training and research hospital

Abstract

The aim of this study was to determine the pathogenic agents, which have been isolated in ICUs and determine their antimicrobial susceptibility in the first two years of our hospital. Methods: A total 368 strains (194 Pseudomonas aeruginosa, and 174 Acinetobacter baumannii) that were considered as an infectious agent and isolated from different clinical samples of hospitalized patients in intensive care units between January 2011 and December 2012 were included in the study. Conventional methods and automatized system were used for the identification and antibiotic susceptibility of the isolates with according to guidelines of Clinical and Laboratory Standarts Institute (CLSI). Imipenem and meropenem resistance has been confirmed by the E test method and interpreted according to CLSI. Results: Resistance rates of P.aeruginosa strains were as follows: Meropenem 35%, imipenem 36%, cefepim 21%, ceftazidim and ciprofloxacin 29%, gentamicin 33%, piperacilin/tazobactam 35%, amikacin 37%. Resistance rates of A.baumannii strains were as follows: Meropenem 85%, imipenem 87%, amikacin 22%, trimethoprim/sulfamethoxazole 25%, gentamicin 46%, piperacilin/tazobactam 54%, ampicilin/sulbactam 59%, cefepim 64%, ciprofloxacin 71%, ceftazidim 83%. Conclusion: Increased carbapenem resistance in our ICUs demonstrates importance of antimicrobial susceptibility tests. The antibiotic susceptibility tests should be surveyed continuously to avoid the spread of intensive care unit isolates carrying high level antibiotic resistance for better achievement of treatment regimens.

Nosocomial infections and risk factors in intensive care unit of a university hospital

“…In a study conducted in the ICUs of a training and research hospital, Bilman et al reported carbapenem resistance rates as 85% (meropenem) and 87% (imipenem) for Acinetobacter spp. and, 35% (meropenem) and 36% (imipenem) for P.aeruginosa [20]. In another study conducted by Yolbaş et al carbapenem resistance rate for Acinetobacter spp.…”

The change of antibiotic resistance profiles over the years in Pseudomonas aeruginosa and Acinetobacter baumannii strains isolated from intensive care units

“…A. baumannii suşlarında saptanan trimetoprim-sulfametoksazol direnç oranı yurt içi ve yurt dışında yapılan farklı çalışmalarda %13,6-%100 arasında değişmektedir [7][8][9]18,20,21,[29][30][31]. Çalışmamızda trimetoprim-sulfametoksazol direnç oranı 2011 yılında %77,6 iken, 2012'de %61,6'ya ve 2013'de %46'ya kadar düşmüştür.…”

“…Son yıllarda P. aeruginosa ve A. baumannii suşlarında görülen karbapenemaz üretimindeki artış, bu antibiyotiklere karşı direnci de beraberinde taşımaktadır [4,5]. Ülkemizde ve yurt dışında yapılan farklı çalışmalarda; P. aeruginosa izolatlarında imipenem direnci %15,5-78,8 ve meropenem direnci %7,5-71,3 arasında, A. baumannii izolatlarında imipenem direnci %10,4-98,9 ve meropenem direnci %7,6-98,9 arasında değişmektedir [4,5,8,[15][16][17][18][19][26][27][28][29][30][31]. Çalışmamızda P. aeruginosa suşlarında 2011 ve 2014 yıllarında imipenem direnci sırasıyla %45,4 ve %50, meropenem direnci sırasıyla %44,5 ve % %50,9 olarak saptanmış olup yıllar içinde istatistiksel olarak anlamlı bir değişiklik saptanmamıştır.…”