Abstract
Amaç: Hastane kaynaklı enfeksiyonlar arasında yer alan yara enfeksiyonları az gelişmiş ve gelişmekte olan ülkeler için büyük bir sağlık sorunudur. Çalışmamızda yara enfeksiyonuna neden olan etkenler ve bu etkenlerin antibakteriyel duyarlılığının belirlenmesi amaçlanmıştır.
Gereç ve Yöntem: Retrospektif olarak 1290 yara sürüntü örneği değerlendirildi. Etken olarak düşündüğümüz mikroorganizmaların tür düzeyinde tanımlanmaları, antibakteriyel duyarlılıkları konvansiyonel ve VITEK-2 otomatize sistem ile çalışıldı.
Bulgular: Örneklerin 505’inde bakteriler, 16’sında mantarlar etken olarak izole edildi. İzole edilen bakteriyel etkenlerin; %60’ını Gram negatif bakteriler, %40’ını Gram pozitif bakteriler oluşturuyordu. Bakteriyel etkenler içinde en sık izole edilen bakteri 143 (%28.31) örnekle Staphylococcus aureus bunu 121 (%24) örnekle Escherichia coli, 47 (%9.30) örnekle Acinetobacter baumannii, 46 (%9.10) örnekle Pseudomonas aeruginosa takip etti. Bu mikroorganizmaların en sık izole edildikleri servislere göre dağılımı ise; Staphylococcus aureus polikliniklerden, Escherichia coli ve Pseudomonas aeruginosa yatan hasta servislerinden, Acinetobacter baumanii yoğun bakım ünitelerinden saptandı. Staphylococcus aureus’ların 61 (%42.65)’i metisiline dirençli bulunurken tigesiklin, vankomisin ve linezolid’e direnç saptanmadı. Escherichia coli’de en fazla direnç 111 (%91.73) hasta ile ampisiline karşı görüldü, 118 (%97.52) hasta ile imipenem ve meropenem en duyarlı oldukları antibakteriyeller olarak saptandı. Acinetobacter baumanii’ye karşı antibakteriyellerin hepsinde yüksek direnç saptanırken kolistine karşı direnç saptanmadı. Pseudomonas aeruginosa’da en fazla direnç sefepim ve imipeneme karşı 14 (%29.78) hastada saptanırken, kolistine karşı direnç saptanmadı.
Sonuç: İzole edilen mikroorganizmaların ve antibiyotik duyarlılıklarının belirlenmesi, ampirik tedavilere yön verebilmek, hekimlerin kontrollü ve akılcı antibiyotik kullanımı konusunda bilinçlenmesini sağlayacaktır.
Keywords
References
- Dryden MS. Complicated skin and soft tissue infection. J Antimicrob Chemother. 2010; 65(Suppl 3): iii35-44.
- Gündem NS, Çıkman A.Yara kültürlerinden izole edilen mikroorganizmalar ve antibiyotik duyarlılıkları. ANKEM; 2012;26(4):165-70.
- Bilgehan H. Klinik Mikrobiyolojik Tanı. 5.Baskı. İzmir: Barış Yayınları; 2009.
- Oladeinde BH, Omoregie R, Olley M, Anunibe JA, Onifade AA. A 5 -year surveillance of wound infections at a rural tertiary hospital in Nigeria. African Health Sciences 2013;13(2):351-6.
- Owens CD, Stoessel K. Surgical site infections: Epidemiology, microbiology and prevention. Journal of Hospital Infection. 2008;70(Suppl 2): 3-10.
- Muluye D, Wondimeneh Y, Ferede G, Nega T, Adane K, Biadgo B, et al. Bacterial isolates and their antibiotic susceptibility patterns among patients with pus and/or wound discharge at Gondar university hospital. BMC Res Notes. 2014;7:619. doi: 10.1186/1756-0500-7-619.
- Citil MU, Mete E, Oğuz EO, Abban GM, Şahin B , Kaleli İ. Investigation of the effect of ibuprofen on wound healing in experimental Staphylococcus aureus soft tissue infections. Mikrobiyoloji bulteni. 2015; 49(2): 166-80.
- Wong SY, Manikam R, Muniandy S. Prevalence and antibiotic susceptibility of bacteria from acute and chronic wounds in Malaysian subjects. J Infect Dev Ctries 2015; 9(9):936-44. https://doi.org/10.3855/jidc.5882
- Yıldırım AM, Çarkçı HA,Yılmaz M, Toraman ZA. Yanık ve yara örneklerinden izole edilen mikroorganizma türlerinin belirlenmesi ve antimikrobiyal duyarlılıklarının araştırılması. Kocatepe Tıp Dergisi Kocatepe Medical Journal 2019; 20:26-32.
- Bjarnsholt T, Kirketerp-Møller K, Jensen PØ, Madsen KG, Phipps R, Krogfelt K, et al. Why chronic wounds will not heal: a novel hypothesis. Wound Repair Regen. 2008;16(1):2-10. doi: 10.1111/j.1524-475X.2007.00283.x.
- Copeland-Halperin LR, Kaminsky AJ, Bluefeld N, Miraliakbari R. Sample procurement for cultures of infected wounds: a systematic review. J Wound Care 2016; 25(4):4-6, 8-10. https://doi.org/10.12968 .
- York MK, Sharp SE, Bowler PG, Church DL. Wound/abscess and soft tissue cultures, “LynneShore G, Isenberg HD (eds). Clinical Microbiology Procedures Handbook, 3. baskı” kitabında s. 3.13.1, ASM Press, Washington. 2007.
- Al-Khawlany RS, Edrees WH, AL-Jaufy W, Nasher A, Al-shehari M, Alariqi W et al. Prevalence of methicillinresistant Staphylococcus aureus and antibacterial susceptibility among patients with skin and soft tissue infection at Ibb City Yemen. PSM Microbiol. 2021; 6(1):1-11.
- Turhanoğlu MN, Koyuncu E, Bayındır-Bilman F. Yara kültürlerinden izole edilen mikroorganizmalar ve antibiyotik dirençleri 2010-2015. Turk Hij Den Biyol Derg, 2018; 75(2): 183-194.
- Avcıoğlu F, Behçet M, Karabörk Ş , Kurtoğlu MG.Yara Örneklerinden İzole Edilen Mikroorganizmaların Antimikrobiyal Direnç Oranları - Üç Yıllık Değerlendirme .Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi / DÜ Sağlık Bil Enst Derg Journal of Duzce University Health Sciences Institute / J DU Health Sci Inst ISSN: 2146-443X sbedergi@duzce.edu.tr 2019; 9(3): 110-114 doi: https://dx.doi.org/10.33631/duzcesbed.538681
- Yerlikaya H, Kirişci Ö, Çilburunoğlu M, Uğurlu H , Aral M, Muratdağı G Yara Kültürlerinden İzole Edilen Mikroorganizmalar ve Antibiyotik Duyarlılıkları Sakarya Tıp Dergisi 2021;11(1):170-176.
- Davarcı İ, Koçoğlu ME, Barlas N, Samastı M. Yara Kültürlerinden İzole Edilen Bakterilerin Antimikrobiyal Duyarlılıkları : Üç Yıllık Değerlendirme. ANKEM Derg 2018;32(2):53-61.
- Bahceci I. Microorganisms that Reproduce in Wound Cultures in Rize Region and Their Antimicrobial Susceptibility. Middle Black Sea Journal of Health Science, 2020; 6(3):358-368.
- Serra R, Grande R, Butrico L, Rossi A, Settimio UF, Caroleo B, et al. Chronic wound infections: the role of Pseudomonas aeruginosa and Staphylococcus aureus. Expert Rev Anti Infect Ther 2015; 13: 605– 13. https://doi.org/10.1586/14787210.2015.1023291
- Bessa LJ, Fazii P, Di Giulio M, Cellini L. Bacterial isolates from infected wounds and their antibiotic susceptibility pattern: some remarks about wound infection. Int Wound J 2015; 12: 47–52. https://doi.org/ 10.1111/iwj.12049
- Queiroz-Telles F, Fahal AH, Falci DR, Caceres DH, Chiller T, Pasqualotto AC. Neglected endemic mycoses. Lancet Infect Dis 2017; 17: e367–77. https://doi.org/10.1016/S1473-3099(17)30306-7
- Kumburu HH, Sonda T, Mmbaga BT, Alifrangis M, Lund O, Kibiki G, et al. Patterns of infections, aetiological agents and antimicrobial resistance at a tertiary care hospital in northern Tanzania. Trop Med Int Health 2017; 22: 454–64. https://doi.org/10.1111/tmi.12836 .
- Edrees W, Banafa, A, Al-Awar M. Antibacterial Susceptibility of Isolated Bacteria from Wound Infection Patients Presenting at some Government Hospitals in Sana’a City, Yemen. Al-Razi University Journal for Medical Sciences. 2021;5(1). https://doi.org/10.51610/rujms5.1.2021.99
- Utlu Y, Başak O, Bozkurt-Kozan F, Ertuğrul MB. Diyabetik Ayak İnfeksiyonu Etkenleri ve Çoğul İlaç Direnci Klimik Derg. 2019; 32(1): 84-9.
- Bozok T., Öztürk A. Niğde ilinde üçüncü basamak bir hastaneden izole edilen bakterilerin tür dağılımı ve antibiyotik duyarlılıkları: üç yıllık değerlendirme. Mersin Üniversitesi Sağlık Bilimleri Dergisi, 2023, 16.1: 22-39.
- Akkaya O. Pandemi Dönemindeki Yara Enfeksiyon Etkenlerinin ve Antibiyotik Duyarlılıklarının Pandemi Öncesi ile Karşılaştırılması. Sakarya Med J 2023 ;13(2):321-328 DOI: 10.31832/smj.1266829
- Krumkamp R, Oppong K, Hogan B, Strauss R, Frickmann H, Wiafe-Akenten C, et al. Spectrum of antibiotic resistant bacteria and fungi isolated from chronically infected wounds in a rural district hospital in Ghana. PLoS ONE.2020;15(8): e0237263. https://doi.org/10.1371/ journal.pone.0237263 .
- Ahmadkhosravi N, Khosravi AD, Asareh Zadegan Dezfuli A, Hashemzadeh M, Saki M, Mehr FJ, Izadpour F. Study of aerobic and anaerobic bacterial profile of nosocomial infections and their antibiotic resistance in a referral center, Southwest Iran: A three year cross-sectional study. PLoS One. 2021;16(11):e0259512. doi: 10.1371/journal.pone.0259512.
- Chelkeba L, Melaku T, Mega TA.,Gram-Negative Bacteria Isolates and Their Antibiotic-Resistance Patterns in Patients with Wound Infection in Ethiopia: A Systematic Review and Meta-Analysis Infection and Drug Resistance 2021;14 277–302 .
- Şenol FF, Bahçeci İ, Aytaç Ö, Öner P, Toraman ZA. Çeşitli klinik örneklerden izole edilen gram negatif gsbl pozitif bakterilerin antibiyotiklere direnç oranları. Turk J Clin Lab 2021; 4: 451-457.
Abstract
Objective: Wound infections are hospital-acquired infections and major health problem for underdeveloped and developing countries. In our study, it was aimed to determine the causative agents of wound infection and the antibacterial susceptibility of these agents.
Materials and Methods: Retrospectively, 1290 wound swab samples were evaluated. Identification, antibacterial susceptibilities of microorganisms, which we consider as causative agent, were studied with conventional methods and VITEK-2 automated system.
Results: Bacteria were isolated in 505 samples and fungi were isolated in 16 samples. Of the isolated bacterial agents, 60% were Gram-negative bacteria and 40% were Gram-positive bacteria. Staphylococcus aureus with 143 (28.31%) samples was the most frequently isolated bacteria among bacterial agents, followed by Escherichia coli with 121 (24%), Acinetobacter baumannii with 47 (9.30%), and Pseudomonas aeruginosa with 46 (9.10) samples. The distribution of these microorganisms according to the wards, where they were most frequently isolated; Staphylococcus aureus from outpatient clinics, E. coli and P. aeruginosa from inpatient services, and A. baumanii from intensive care units. While 61 (42.65%) of S. aureus were found to be resistant to methicillin, no resistance was found to tigecycline, vancomycin and linezolid. E. coli had the highest resistance to ampicillin in 111 (91.73%) patients, and imipenem and meropenem were the antibacterials to which they were most sensitive in 118 (97.52%) patients. While high resistance was detected in all antibacterials against A. baumanii, no resistance was found against colistin. In P. aeruginosa, the highest resistance was detected against cefepime and imipenem in 14 (29.78%) patients, while no resistance was detected against colistin.
Conclusion: Determining the isolated microorganisms and their antibiotic susceptibilities will enable to guide empirical treatments and raise the awareness of physicians about the controlled and rational use of antibiotics.
Keywords
References
- Dryden MS. Complicated skin and soft tissue infection. J Antimicrob Chemother. 2010; 65(Suppl 3): iii35-44.
- Gündem NS, Çıkman A.Yara kültürlerinden izole edilen mikroorganizmalar ve antibiyotik duyarlılıkları. ANKEM; 2012;26(4):165-70.
- Bilgehan H. Klinik Mikrobiyolojik Tanı. 5.Baskı. İzmir: Barış Yayınları; 2009.
- Oladeinde BH, Omoregie R, Olley M, Anunibe JA, Onifade AA. A 5 -year surveillance of wound infections at a rural tertiary hospital in Nigeria. African Health Sciences 2013;13(2):351-6.
- Owens CD, Stoessel K. Surgical site infections: Epidemiology, microbiology and prevention. Journal of Hospital Infection. 2008;70(Suppl 2): 3-10.
- Muluye D, Wondimeneh Y, Ferede G, Nega T, Adane K, Biadgo B, et al. Bacterial isolates and their antibiotic susceptibility patterns among patients with pus and/or wound discharge at Gondar university hospital. BMC Res Notes. 2014;7:619. doi: 10.1186/1756-0500-7-619.
- Citil MU, Mete E, Oğuz EO, Abban GM, Şahin B , Kaleli İ. Investigation of the effect of ibuprofen on wound healing in experimental Staphylococcus aureus soft tissue infections. Mikrobiyoloji bulteni. 2015; 49(2): 166-80.
- Wong SY, Manikam R, Muniandy S. Prevalence and antibiotic susceptibility of bacteria from acute and chronic wounds in Malaysian subjects. J Infect Dev Ctries 2015; 9(9):936-44. https://doi.org/10.3855/jidc.5882
- Yıldırım AM, Çarkçı HA,Yılmaz M, Toraman ZA. Yanık ve yara örneklerinden izole edilen mikroorganizma türlerinin belirlenmesi ve antimikrobiyal duyarlılıklarının araştırılması. Kocatepe Tıp Dergisi Kocatepe Medical Journal 2019; 20:26-32.
- Bjarnsholt T, Kirketerp-Møller K, Jensen PØ, Madsen KG, Phipps R, Krogfelt K, et al. Why chronic wounds will not heal: a novel hypothesis. Wound Repair Regen. 2008;16(1):2-10. doi: 10.1111/j.1524-475X.2007.00283.x.
- Copeland-Halperin LR, Kaminsky AJ, Bluefeld N, Miraliakbari R. Sample procurement for cultures of infected wounds: a systematic review. J Wound Care 2016; 25(4):4-6, 8-10. https://doi.org/10.12968 .
- York MK, Sharp SE, Bowler PG, Church DL. Wound/abscess and soft tissue cultures, “LynneShore G, Isenberg HD (eds). Clinical Microbiology Procedures Handbook, 3. baskı” kitabında s. 3.13.1, ASM Press, Washington. 2007.
- Al-Khawlany RS, Edrees WH, AL-Jaufy W, Nasher A, Al-shehari M, Alariqi W et al. Prevalence of methicillinresistant Staphylococcus aureus and antibacterial susceptibility among patients with skin and soft tissue infection at Ibb City Yemen. PSM Microbiol. 2021; 6(1):1-11.
- Turhanoğlu MN, Koyuncu E, Bayındır-Bilman F. Yara kültürlerinden izole edilen mikroorganizmalar ve antibiyotik dirençleri 2010-2015. Turk Hij Den Biyol Derg, 2018; 75(2): 183-194.
- Avcıoğlu F, Behçet M, Karabörk Ş , Kurtoğlu MG.Yara Örneklerinden İzole Edilen Mikroorganizmaların Antimikrobiyal Direnç Oranları - Üç Yıllık Değerlendirme .Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi / DÜ Sağlık Bil Enst Derg Journal of Duzce University Health Sciences Institute / J DU Health Sci Inst ISSN: 2146-443X sbedergi@duzce.edu.tr 2019; 9(3): 110-114 doi: https://dx.doi.org/10.33631/duzcesbed.538681
- Yerlikaya H, Kirişci Ö, Çilburunoğlu M, Uğurlu H , Aral M, Muratdağı G Yara Kültürlerinden İzole Edilen Mikroorganizmalar ve Antibiyotik Duyarlılıkları Sakarya Tıp Dergisi 2021;11(1):170-176.
- Davarcı İ, Koçoğlu ME, Barlas N, Samastı M. Yara Kültürlerinden İzole Edilen Bakterilerin Antimikrobiyal Duyarlılıkları : Üç Yıllık Değerlendirme. ANKEM Derg 2018;32(2):53-61.
- Bahceci I. Microorganisms that Reproduce in Wound Cultures in Rize Region and Their Antimicrobial Susceptibility. Middle Black Sea Journal of Health Science, 2020; 6(3):358-368.
- Serra R, Grande R, Butrico L, Rossi A, Settimio UF, Caroleo B, et al. Chronic wound infections: the role of Pseudomonas aeruginosa and Staphylococcus aureus. Expert Rev Anti Infect Ther 2015; 13: 605– 13. https://doi.org/10.1586/14787210.2015.1023291
- Bessa LJ, Fazii P, Di Giulio M, Cellini L. Bacterial isolates from infected wounds and their antibiotic susceptibility pattern: some remarks about wound infection. Int Wound J 2015; 12: 47–52. https://doi.org/ 10.1111/iwj.12049
- Queiroz-Telles F, Fahal AH, Falci DR, Caceres DH, Chiller T, Pasqualotto AC. Neglected endemic mycoses. Lancet Infect Dis 2017; 17: e367–77. https://doi.org/10.1016/S1473-3099(17)30306-7
- Kumburu HH, Sonda T, Mmbaga BT, Alifrangis M, Lund O, Kibiki G, et al. Patterns of infections, aetiological agents and antimicrobial resistance at a tertiary care hospital in northern Tanzania. Trop Med Int Health 2017; 22: 454–64. https://doi.org/10.1111/tmi.12836 .
- Edrees W, Banafa, A, Al-Awar M. Antibacterial Susceptibility of Isolated Bacteria from Wound Infection Patients Presenting at some Government Hospitals in Sana’a City, Yemen. Al-Razi University Journal for Medical Sciences. 2021;5(1). https://doi.org/10.51610/rujms5.1.2021.99
- Utlu Y, Başak O, Bozkurt-Kozan F, Ertuğrul MB. Diyabetik Ayak İnfeksiyonu Etkenleri ve Çoğul İlaç Direnci Klimik Derg. 2019; 32(1): 84-9.
- Bozok T., Öztürk A. Niğde ilinde üçüncü basamak bir hastaneden izole edilen bakterilerin tür dağılımı ve antibiyotik duyarlılıkları: üç yıllık değerlendirme. Mersin Üniversitesi Sağlık Bilimleri Dergisi, 2023, 16.1: 22-39.
- Akkaya O. Pandemi Dönemindeki Yara Enfeksiyon Etkenlerinin ve Antibiyotik Duyarlılıklarının Pandemi Öncesi ile Karşılaştırılması. Sakarya Med J 2023 ;13(2):321-328 DOI: 10.31832/smj.1266829
- Krumkamp R, Oppong K, Hogan B, Strauss R, Frickmann H, Wiafe-Akenten C, et al. Spectrum of antibiotic resistant bacteria and fungi isolated from chronically infected wounds in a rural district hospital in Ghana. PLoS ONE.2020;15(8): e0237263. https://doi.org/10.1371/ journal.pone.0237263 .
- Ahmadkhosravi N, Khosravi AD, Asareh Zadegan Dezfuli A, Hashemzadeh M, Saki M, Mehr FJ, Izadpour F. Study of aerobic and anaerobic bacterial profile of nosocomial infections and their antibiotic resistance in a referral center, Southwest Iran: A three year cross-sectional study. PLoS One. 2021;16(11):e0259512. doi: 10.1371/journal.pone.0259512.
- Chelkeba L, Melaku T, Mega TA.,Gram-Negative Bacteria Isolates and Their Antibiotic-Resistance Patterns in Patients with Wound Infection in Ethiopia: A Systematic Review and Meta-Analysis Infection and Drug Resistance 2021;14 277–302 .
- Şenol FF, Bahçeci İ, Aytaç Ö, Öner P, Toraman ZA. Çeşitli klinik örneklerden izole edilen gram negatif gsbl pozitif bakterilerin antibiyotiklere direnç oranları. Turk J Clin Lab 2021; 4: 451-457.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Medical Microbiology |
| Journal Section | Research Articles |
| Authors | |
| Early Pub Date | October 24, 2023 |
| Publication Date | November 1, 2023 |
| Submission Date | May 10, 2023 |
| Acceptance Date | July 20, 2023 |
| Published in Issue | Year 2023 Volume: 5 Issue: 3 |
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