Kronik Obstrüktif Akciğer Hastalığının Akut Alevlenmelerinde Balgamdan İzole Edilen Moraxella Catarrhalıs Sıklığı Ve Antibiyotik Duyarlılığı
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2014
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Abstract
Kronik obstrüktif akciğer hastalığı (KOAH), morbidite ve mortaliteye neden olan progresif , kronik seyirli ve akut alev- lenmelerle seyreden bir hastalıktır. Çalışmamızda KOAH alevlenmelerinde sık görülen etkenlerden olan Moraxella catarrhalisin izolasyon oranı, beta-laktamaz aktivitesi ve antibiyotik duyarlılıkları araştırılmıştır. Çalışmaya, Ekim 2009- Mart 2010 tarihleri arasında Abant İzzet Baysal Üniversitesi Tıp Fakültesi ve İzzet Baysal Devlet Hastanesi Göğüs Hastalıkları ve Tüberküloz Bölümüne başvuran, KOAH alevlenmesi tanısı alan 124 gönüllü hasta alınmıştır. Hastalardan alınan balgam örneklerinde üreyen bakteriler konvansiyonel mikrobiyolojik yöntemler ve API NH test kiti ile tanımlanmıştır. Antibiyotik duyarlılık testleri için agar dilüsyon testi ve E-test yöntemi, beta-laktamaz aktivitesi için nitrosef in testi kullanıl- mıştır. Kültürü yapılan 98 balgam örneğinin 50sinde patojen kabul edilen 51 mikroorganizma üremiştir. Bu bakterilerin % 15i Streptococcus pneumoniae (n:15), % 11.2si Pseudomonas aeruginosa (n:11), % 10.2si Moraxella catarrhalis (n:10), % 6.1i Haemophilus inf luenzae (n:6), % 3ü Escherichia coli (n:3), % 3ü Klebsiellae pneumoniae (n:3) ve, % 3ü Haemophilus parainf luenzae (n:3) olarak bulunmuştur. Bir hastanın balgam kültüründe patojen olarak bilinen iki bakteri (M.catarrhalis ve H.inf luenzae) birlikte üretilmiştir. İzole edilen on M.catarrhalis suşlarının dokuzunda beta-laktamaz testi pozitif olarak sap- tanmıştır. Eritromisin, tetrasiklin, siprof loksasin, sef uroksim ve sef triaksona karşı direnç görülmemiştir. Trimetoprim- sülf a- metoksazol direnci % 10, ampisilin direnci % 90 olarak belirlenmiştir. Elde edilen sonuçlar dünya ve ülkemiz verileri ile uyumlu bulunmuştur.
Chronic obstructive pulmonary disease (COPD) is a progressive chronic disease that can lead to morbidity and morta- lity which also can have acute exacerbations. In our study, the isolation rate, beta lactamase activity and antibiotic suscepti- bility of Moraxella catarrhalis, one of the most common agents causing COPD exacerbations, is assessed. A hundred and twenty-f our voluntary COPD patients diagnosed with acute exacerbation who were ref erred to Pulmonary Disease and Tuberculosis Department of Izzet Baysal Research Hospital and Abant Izzet Baysal University Medical Faculty during the time period of October 2009 to March 2010 were included the study. Bacteria isolated f rom sputum cultures were identif ied by conventional microbiological methods and API NH test kit. Agar dilution test and E-test method were used f or antibiotic susceptibility testing and nitrocephin test was used f or testing beta-lactamase production. In 50 of the 98 cultured sputum specimens, 51 pathogenic microorganisms were detected. Fif teen percent % of these bacteria were Streptococcus pneumoniae (n:15), 11.2 % were Pseudomonas aeruginosa (n:11), 10.2 % were Moraxella catarrhalis (n:10), 6.1 % were Haemophilus inf luenzae (n:6), 3 % were Escherichia coli (n:3) 3 % were Klebsiella pneumoniae (n:3) and 3 % were Haemophilus parainf - luenzae (n:3). In one patients sputum culture, two pathogenic bacteria were isolated (M.catarrhalis and H.inf luenzae). Beta- lactamase test was positive in nine of the 10 M.catarrhalis strains. No resistance was detected aganist erythromycin, tetracy- cline, ciprof loxacin, cef uroxime and cef triaxone. Resistance aganist trimethoprim-sulf amethoxazole was 10 % and the resis- tance aganist ampicillin was 90 %. Results obtained were in correlation with the data reported f rom the world and Turkey.
Chronic obstructive pulmonary disease (COPD) is a progressive chronic disease that can lead to morbidity and morta- lity which also can have acute exacerbations. In our study, the isolation rate, beta lactamase activity and antibiotic suscepti- bility of Moraxella catarrhalis, one of the most common agents causing COPD exacerbations, is assessed. A hundred and twenty-f our voluntary COPD patients diagnosed with acute exacerbation who were ref erred to Pulmonary Disease and Tuberculosis Department of Izzet Baysal Research Hospital and Abant Izzet Baysal University Medical Faculty during the time period of October 2009 to March 2010 were included the study. Bacteria isolated f rom sputum cultures were identif ied by conventional microbiological methods and API NH test kit. Agar dilution test and E-test method were used f or antibiotic susceptibility testing and nitrocephin test was used f or testing beta-lactamase production. In 50 of the 98 cultured sputum specimens, 51 pathogenic microorganisms were detected. Fif teen percent % of these bacteria were Streptococcus pneumoniae (n:15), 11.2 % were Pseudomonas aeruginosa (n:11), 10.2 % were Moraxella catarrhalis (n:10), 6.1 % were Haemophilus inf luenzae (n:6), 3 % were Escherichia coli (n:3) 3 % were Klebsiella pneumoniae (n:3) and 3 % were Haemophilus parainf - luenzae (n:3). In one patients sputum culture, two pathogenic bacteria were isolated (M.catarrhalis and H.inf luenzae). Beta- lactamase test was positive in nine of the 10 M.catarrhalis strains. No resistance was detected aganist erythromycin, tetracy- cline, ciprof loxacin, cef uroxime and cef triaxone. Resistance aganist trimethoprim-sulf amethoxazole was 10 % and the resis- tance aganist ampicillin was 90 %. Results obtained were in correlation with the data reported f rom the world and Turkey.
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Farmakoloji ve Eczacılık
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Volume
28
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2
