Alt solunum yolu infeksiyonu nedeniyle yatan hastalarda nonspesifik kültür antibiyogram sonuçları ve ampirik tedavi yaklaşımları
Küçük Resim Yok
Tarih
2014
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada alt solunum yolu infeksiyonu (ASYİ) ile göğüs kliniğine yatan olguların nonspesifik kültür sonuçlarında üreyen etkenlere karşı antibiyotiklerin direnç profilini belirlenmesi ve bu olgulardaki ampirik tedavi yaklaşımlarını incelenmesi amaçlandı. Yöntem: Seksen dört olgudan nonspesifik kültür istendi. Üreme olan 41 olgu değerlendirmeye alındı. Bulgular : Olguların 35’i erkek, 6’sı kadın olup, yaş ortalamaları 61.4 ± 16.1 idi. Nonspesifik kültürlerin 16’sında (%39) Streptococcus pneumoniae, 8’inde (%19.5) Pseudomonas aureginosa, 13’ünde (%31.7) Klebsiella pneumonia üredi. Streptococcus pneumoniae’ye karşı %13 penisilin, %14 ampisilin -sulbaktam, %7 siprofloksasin, %58 sefuroksim, %29 klaritromisin, %7 levofloksasin direnci vardı. Seftriakson ve moksifloksasin direnci yoktu. Klebsiella pneum onia’ya karşı %33 seftriakson, %36 seftazidim, %30 sefepim, %10 imipenem, %9 amikasin direnci vardı. Siprofloksasine direnç saptanmadı. Pseudomonas aureginosa’ya karşı, %12 imipenem, %12 siprofloksasin, %37 seftazidim, %20 sefepim direnci vardı. Amikasin v e gentamisine direnç yoktu. Olguların ampirik tedavilerinde en çok tercih edilen antibiyotikler 11 kişide (%27) ampisilin -sulbaktam, 8 kişide (%20) seftriakson + klaritromisin, 7 kişide (%17) sefuroksim + klaritromisin şeklinde idi. Bulgularımız, yatan olg uların ampirik olarak alt solunum yolu enfeksiyonlarının tedavisinde kullanılan birçok antibiyotiğe önemli oranda direnç olduğunu göstermektedir. Sonuç : Bu tür olgularda her merkezin etyolojide en sık rastlanan etkenleri ve bu etkenlerin belirli direnç paternlerini bilerek ampirik tedavi başlanması tedavi başarısında anahtar rol oynayacaktır.
Objective : In this study, we aimed to determine the resistance profile of antibiotics to the microorganisms that were reproduced from nonspecific cultures of hospital ized patients at chest disease clinic because of lower respiratory tract infection (LRTI), and to investigate empiric treatment approach. Method : Nonspecific cultures were obtained from 84 patients. Forty -one cases (35 men and 6 women, mean age: 61.4 ± 16. 1) who had reproduced cultures are evaluated. Results : Culture results revealed 16 (39%) Streptococcus pneumonia, 8 (19.5%) Pseudomonas aureginosa, and 13 (31.7%) Klebsiella pneumonia. Of the grown Streptococcus pneumonia, 13% was resistant to penicillin, 14% to ampicillin -sulbactam, 7% to ciprofloxacin, 58% to cefuroxime, 29% to clarithromycine, and 7% to levofloxacin. Resistance to ceftriaxon and moxifloxacin was not observed. Resistance to ceftriaxon by Klebsiella pneumonia was 33%, to ceftazidim was 36% , to cefepim was 30%, to imipenem was 10%, to amicasin was 9%, and it was found to be sensitive to ciprofloxasin. Resistance for Pseudomonos aureginosa was 12% to imipenem, 12% to ciprofloxasine, 37% to ceftazidim, and 20% to cefepim. Amicasine and gentami cin was found to be sensitive for Pseudomonos aureginosa. During the process of therapy, the most preferred antibiotics were ampicillin -sulbactam at 11 cases (27%), ceftriaxon + clarithromycine at eight cases (20%), and cefuroxim + clarithromycine at seven cases (17%). Our results showed that the cases hospitalized because of LRTI have a significant resistance to most of the antibiotics. Conclusion : We conclude that empiric treatment must be started according to the resistance profile and most suuscebtable bacteria of each center to have more successful results.
Objective : In this study, we aimed to determine the resistance profile of antibiotics to the microorganisms that were reproduced from nonspecific cultures of hospital ized patients at chest disease clinic because of lower respiratory tract infection (LRTI), and to investigate empiric treatment approach. Method : Nonspecific cultures were obtained from 84 patients. Forty -one cases (35 men and 6 women, mean age: 61.4 ± 16. 1) who had reproduced cultures are evaluated. Results : Culture results revealed 16 (39%) Streptococcus pneumonia, 8 (19.5%) Pseudomonas aureginosa, and 13 (31.7%) Klebsiella pneumonia. Of the grown Streptococcus pneumonia, 13% was resistant to penicillin, 14% to ampicillin -sulbactam, 7% to ciprofloxacin, 58% to cefuroxime, 29% to clarithromycine, and 7% to levofloxacin. Resistance to ceftriaxon and moxifloxacin was not observed. Resistance to ceftriaxon by Klebsiella pneumonia was 33%, to ceftazidim was 36% , to cefepim was 30%, to imipenem was 10%, to amicasin was 9%, and it was found to be sensitive to ciprofloxasin. Resistance for Pseudomonos aureginosa was 12% to imipenem, 12% to ciprofloxasine, 37% to ceftazidim, and 20% to cefepim. Amicasine and gentami cin was found to be sensitive for Pseudomonos aureginosa. During the process of therapy, the most preferred antibiotics were ampicillin -sulbactam at 11 cases (27%), ceftriaxon + clarithromycine at eight cases (20%), and cefuroxim + clarithromycine at seven cases (17%). Our results showed that the cases hospitalized because of LRTI have a significant resistance to most of the antibiotics. Conclusion : We conclude that empiric treatment must be started according to the resistance profile and most suuscebtable bacteria of each center to have more successful results.
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Cerrahi
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3
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1
