Klinik örneklerden izole edilen gram-negatif çomaklarda genişlemiş spektrumlu beta-laktamaz sıklığı ve antibiyotik duyarlılığı
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Dosyalar
Tarih
2003
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmanın amacı, Gram-negatif çomaklarda genişlemiş spektrumlu beta-laktamaz (GSBL) varlığını araştırmak ve GSBL içeren çomaklarda antibiyotik duyarlılığını saptamak idi. Klinik örneklerden izole edilen toplam 222 Gram-negatif çomakta GSBL varlığı çift disk sinerji testi ile araştırılmıştır. Çalışmaya alınan E. coli, Klebsieila spp., Proteus spp., Enterobacter spp., Pseudomonas aeruginosa suşlarında GSBL varlığı sırası ile %19.4, %15.9, %13.7, %26,7, %16.7 olarak saptanmıştır. GSBL pozitif saptanan suşların 16 (%38)'sı poliklinik, 26 (%62)'sı servis kökeni olarak belirlenmiştir. GSBL varlığı açısından servis ve poliklinik hastalarından izole edilen suşlar arasında anlamlı fark gözlenmiştir (p=0.012). GSBL pozitifliği saptanan kökenlerde imipenem, gentamisin, amikasin, siprofloksasin, ve sefepim duyarlılığı sırasıyla %95.3, %78.5, %97.6, %80.9, %92.8 olarak bulunmuştur. Sonuç olarak; nozokomiyal infeksiyonlardan izole edilen Gram-negatif bakterilerde GSBL varlığının rutin olarak değerlendirilmesi gerekir. GSBL pozitif kökenlerde karbapenem, amikasin ve sefepiminin en etkili antibiyotikler olarak görülmüştür.
The purpose of the present study was to determine the presence of extended spectrum beta-lactamase (ESBL) in clinical isolates of Gram-negative bacilli and also the jn-vitro antibiotic susceptibility of the strains found to carry ESBL. Totally 222 clinical isolates were screened with double disk synergy test. ESBL production was positive in Escherchia coli, Klebsiella spp., Proteus spp., Enterobacter spp., Pseudomonas aeruginosa isolates as 19.4%, 15.9%, 13.7%, 26.7%, 16.7%, respectively. Of the ESBL producing isolates 16 (38%) were isolated from outpatients and 26 (62%) from hospitalised patients. The difference between these grups was significant (p=0.012). The susceptibility to imipenem, gentamycin, amikacin, ciprofloxacin and cefepime were 95.3%, 78.5%, 97.6%, 80.9% and 92.8%, respectively, among the ESBL producing isolates. It is suggested that ESBL must be evaluated routinely in Gram-negative bacilli isolated from nosocomial infections. Carbapenem, amikacin and cefepim were found as the most effective antibiotics against ESBL producing isolates.
The purpose of the present study was to determine the presence of extended spectrum beta-lactamase (ESBL) in clinical isolates of Gram-negative bacilli and also the jn-vitro antibiotic susceptibility of the strains found to carry ESBL. Totally 222 clinical isolates were screened with double disk synergy test. ESBL production was positive in Escherchia coli, Klebsiella spp., Proteus spp., Enterobacter spp., Pseudomonas aeruginosa isolates as 19.4%, 15.9%, 13.7%, 26.7%, 16.7%, respectively. Of the ESBL producing isolates 16 (38%) were isolated from outpatients and 26 (62%) from hospitalised patients. The difference between these grups was significant (p=0.012). The susceptibility to imipenem, gentamycin, amikacin, ciprofloxacin and cefepime were 95.3%, 78.5%, 97.6%, 80.9% and 92.8%, respectively, among the ESBL producing isolates. It is suggested that ESBL must be evaluated routinely in Gram-negative bacilli isolated from nosocomial infections. Carbapenem, amikacin and cefepim were found as the most effective antibiotics against ESBL producing isolates.
Açıklama
Anahtar Kelimeler
Gram-Negatif Basiller, Genifllemifl Spektrumlu Beta Laktamazlar, Çift Disk Sinerji Testi, Gram-Negative Bacilli, Extended Spectrum Beta Lactamases, Double Disk Synergy Test
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İnfeksiyon Dergisi
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Cilt
17
Sayı
1
