Erişkin yoğun bakım ünitesindeki hastaların alt solunum yolu örneklerindeki bakteriler ve antibiyotik duyarlılıkları
Küçük Resim Yok
Tarih
2026
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada amaç Düzce Üniversitesi Tıp Fakültesi Erişkin Yoğun Bakım Ünitesi'nde izlenen hastaların alt solunum yolları kültürlerinde üreyen bakterilerin antibiyotik duyarlılıklarını belirlemektir. Gereç ve Yöntemler: 10 Ocak 2024-10 Ocak 2025 tarihleri arasında Düzce Üniversitesi Tıp Fakültesi Tıbbi Mikrobiyoloji Laboratuvarı'na hastanemizin Dahili ve Cerrahi Yoğun Bakım Üniteleri'nden gönderilen bronkoalveolar lavaj (BAL), derin trakeal aspirat (DTA) örneklerinden izole edilen bakteriler ve antibiyotik duyarlılıkları değerlendirildi. Hastane Bilgi Yönetim Sistemi (HBYS)'ne kaydedilmiş hasta verileri kullanılarak retrospektif olarak veriler incelendi. Üreyen suşların identifikasyonu için ve antibiyotik duyarlılığının belirlenmesinde konvansiyonel yöntemler ve VITEK 2 otomatize sistemi (bioMérieux, Fransa) kullanıldı. Kolistin duyarlılığı sıvı mikrodilüsyon yöntemiyle belirlendi. Suşların antibiyotik duyarlılığı, European Committee on Antimicrobial Susceptibility Testing (EUCAST) kriterlerine göre değerlendirildi. Bulgular: Çalışmanın yapıldığı dönemde anlamlı üreme saptanan 321 Derin trakeal aspirat (DTA), 12 bronkoalveolar lavaj (BAL) kültüründen toplam 350 bakteri suşu izole edildi. Araştırmada saptanan etkenlerin %29'u K. pneumoniae, %25'i A. baumanii, %12'si S. aureus, %11'i E. coli, %9'u P. aeruginosa olarak bulundu. MDR K. pneumoniae izolatlarının %30'u seftazidim-avibaktam (CZA) ve %15'i kolistin dirençli bulundu. A.baumanii izolatlarında %97.7 karbapenem direnci ve %1.3 oranında kolistin direnci bulundu. İzole edilen S. aureus izolatlarının %32'si MRSA olarak belirlendi. Sonuç: Çoklu direnci olan Gram negatif bakterilerde, kolistin ve CZA'nın alternatif tedavi seçeneği olabileceği görüldü. YBÜ'de ampirik antibiyotik tedavisinin doğru zamanda ve doğru dozda verilebilmesi için sürveyans çalışmalarının yapılmasının önemli olduğu düşünüldü.
Aim: The aim of this study is to determine the antibiotic susceptibility of bacteria isolated from lower respiratory tract cultures of patients monitored at the Adult Intensive Care Unit of Düzce University Faculty of Medicine. Material and Methods: Between January 10, 2024, and January 10, 2025, bacteria isolated from bronchoalveolar lavage (BAL) and deep tracheal aspirate (DTA) samples sent to the Medical Microbiology Laboratory of Düzce University Faculty of Medicine from our hospital's Internal Medicine and Surgical Intensive Care Units and their antibiotic susceptibility were evaluated. Data were retrospectively reviewed using patient data recorded in the Hospital Information Management System (HIMS). Conventional methods and the VITEK 2 automated system (bioMérieux, France) were used for the identification of the growing strains and the determination of antibiotic susceptibility. Colistin susceptibility was determined by the liquid microdilution method. The antibiotic susceptibility of the strains was evaluated according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria. Results: A total of 350 bacterial strains were isolated from 321 DTA and 12 BAL cultures with significant growth over a one-year period. Of the agents detected in this study, 29% were K. pneumoniae, 25% were A. baumanii, 12% were S. aureus, 11% were E. coli, and 9% were P. aeruginosa. Thirty percent of MDR K. pneumoniae isolates were resistant to ceftazidime-avibactam and 15% were resistant to colistin. Ninety-seven point seven percent of A. baumanii isolates were resistant to . carbapenems and 1.3% were resistant to colistin. Thirty-two percent of the isolated Staphylococcus aureus isolates were identified as MRSA (Methicillin-Resistant Staphylococcus Aureus). Conclusion: Colistin and CZA may be alternative treatment options for gram-negative bacteria with multidrug resistance. Surveillance studies are considered important to ensure that empirical antibiotic treatment in the ICU is administered at the right time and in the right dose. Keywords: Respiratory tract infections, ventilator-associated pneumonia, Klebsiella pneumoniae, Acinetobacter baumanii, antibiotic resistance.
Aim: The aim of this study is to determine the antibiotic susceptibility of bacteria isolated from lower respiratory tract cultures of patients monitored at the Adult Intensive Care Unit of Düzce University Faculty of Medicine. Material and Methods: Between January 10, 2024, and January 10, 2025, bacteria isolated from bronchoalveolar lavage (BAL) and deep tracheal aspirate (DTA) samples sent to the Medical Microbiology Laboratory of Düzce University Faculty of Medicine from our hospital's Internal Medicine and Surgical Intensive Care Units and their antibiotic susceptibility were evaluated. Data were retrospectively reviewed using patient data recorded in the Hospital Information Management System (HIMS). Conventional methods and the VITEK 2 automated system (bioMérieux, France) were used for the identification of the growing strains and the determination of antibiotic susceptibility. Colistin susceptibility was determined by the liquid microdilution method. The antibiotic susceptibility of the strains was evaluated according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria. Results: A total of 350 bacterial strains were isolated from 321 DTA and 12 BAL cultures with significant growth over a one-year period. Of the agents detected in this study, 29% were K. pneumoniae, 25% were A. baumanii, 12% were S. aureus, 11% were E. coli, and 9% were P. aeruginosa. Thirty percent of MDR K. pneumoniae isolates were resistant to ceftazidime-avibactam and 15% were resistant to colistin. Ninety-seven point seven percent of A. baumanii isolates were resistant to . carbapenems and 1.3% were resistant to colistin. Thirty-two percent of the isolated Staphylococcus aureus isolates were identified as MRSA (Methicillin-Resistant Staphylococcus Aureus). Conclusion: Colistin and CZA may be alternative treatment options for gram-negative bacteria with multidrug resistance. Surveillance studies are considered important to ensure that empirical antibiotic treatment in the ICU is administered at the right time and in the right dose. Keywords: Respiratory tract infections, ventilator-associated pneumonia, Klebsiella pneumoniae, Acinetobacter baumanii, antibiotic resistance.
Açıklama
Anahtar Kelimeler
Mikrobiyoloji
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Kayman, H. (2026). Erişkin Yoğun Bakım Ünitesindeki Hastaların Alt Solunum Yolu Örneklerindeki Bakteriler Ve Antibiyotik Duyarlılıkları (Tez No. 996672) [Tıpta Uzmanlık Tezi, Düzce Üniversitesi].
