Microorganisms Isolated from Blood Cultures of Intensive Care Patients and Follow-up of Antibiotic Susceptibilities in the Last Five Years
Öz
Objective: This study aimed to determine the antimicrobial resistance profiles of microorganisms isolated from blood cultures of patients hospitalized in intensive care units of a secondary-level state hospital.Materials and Methods: Samples sent to the Microbiology Laboratory between 2018 and 2022 from patients receiving treatment in intensive care units of Nevşehir State Hospital were studied with conventional methods and automated system, and the results of the samples for which identification and antimicrobial susceptibility tests were performed were evaluated retrospectively.Results: Gram-negative bacteria growth was detected in 54.5% of all samples, gram-positive bacteria growth was detected in 40.7%, and yeast growth was detected in 4.8%; Among gram-negative bacteria, Acinetobacter baumanniwith a maximum of 28% (n = 47); Enterococcus faecaliswas isolated as gram-positive bacteria with a maximum of 20.3% (n = 34). The rate of methicillin resistance in CNSs was found to be 92.8% (26/28), and in Staphylococcus aureus,it was 33% (2/6). Extended-spectrum beta-lactamase (ESBL) positivity was detected in 72% (13/18) and 80% (20/25) of Escherichia coliand Klebsiella pneumoniaisolates, respectively. Carbapenem resistance was observed in all A.baumaniiisolates (100%). The antibiotics E. coliand K. pneumoniawere most sensitive to, and they were imipenem, meropenem (100%), and amikacin, respectively. The most sensitive antibiotics in all gram-positive isolates were linezolid and glycopeptides.Conclusion: To guide empirical treatment, each center should examine its own blood culture results, question the antimicrobial resistance status, and make rational antibiotic selection, aiming to reduce mortality in cases of sepsis and bacteremia
Anahtar Kelimeler
Blood culture antibiotic resistance bloodstream infections intensive care unit
Etik Beyan
Ethical approval for the study was received from Nevşehir Hacı Bektaş Veli University Non-invasive Clinical Research Publication Ethics Committee (Decision number: 2023/12, Date: 19.04.2023).
Teşekkür
We would like to thank Nevşehir Provincial Health Directorate for supporting us in providing and classifying the data.
Kaynakça
- Amanati, A., Sajedianfard, S., Khajeh, S., Ghasempour, S., Mehrangiz, S., Nematolahi, S., & Shahhosein, Z. (2021). Bloodstream infections in adult patients with malignancy, epidemiology, microbiology, and risk factors associated with mortality and multi-drug resistance.BMC Infectious Diseases,21(1), 636. https://doi.org/10.1186/s12879-021-06243-z
- Baker, M. A., Sands, K. E., Huang, S. S., Kleinman, K., Septimus, E. J., Varma, N., et al.CDC Prevention Epicenters Program (2022). The Impact of Coronavirus Disease 2019 (COVID-19) on Healthcare-Associated Infections.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America,74(10), 1748–54. https://doi.org/10.1093/cid/ciab688
- Berktaş, M., Çıkman, A., Parlak, M., Güdücüoğlu, H.,Özkaçmaz, A. (2013) The Antibiotic Resistance of Enterococcus Strains İsolated from Blood Cultures. Sakaryamj, 3(2):76-9
- Böll, B., Schalk, E., Buchheidt, D., Hasenkamp, J., Kiehl, M., Kiderlen, T. R., Kochanek, M., Koldehoff, M., Kostrewa, P., Claßen, A. Y., Mellinghoff, S. C., Metzner, B., Penack, O., Ruhnke, M., Vehreschild, M. J. G. T., Weissinger, F., Wolf, H. H., Karthaus, M., & Hentrich, M. (2021). Central venous catheter-related infections in hematology and oncology: 2020 updated guidelines on diagnosis, management, and prevention by the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO).Annals of hematology,100(1), 239–259. https://doi.org/10.1007/s00277-020-04286-x
- Doi, Y., Park, Y. S., Rivera, J. I., Adams-Haduch, J. M., Hingwe, A., Sordillo, E. M., Lewis, J. S., 2nd, Howard, W. J., Johnson, L. E., Polsky, B., Jorgensen, J. H., Richter, S. S., Shutt, K. A., & Paterson, D. L. (2013). Community-associated extended-spectrum β-lactamase-producing Escherichia coli infection in the United States.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America,56(5), 641–648. https://doi.org/10.1093/cid/cis942
- Forrest, G. N., Roghmann, M. C., Toombs, L. S., Johnson, J. K., Weekes, E., Lincalis, D. P., & Venezia, R. A. (2008). Peptide nucleic acid fluorescent in situ hybridization for hospital-acquired enterococcal bacteremia: delivering earlier effective antimicrobial therapy.Antimicrobial agents and chemotherapy,52(10), 3558–3563. https://doi.org/10.1128/AAC.00283-08
- Kalın, BS., Türkoğlu, M. (2018). Catheter-Related Bloodstream Infections in Intensive Care Units.Turkiye Klinikleri J Intensive Care-Special Topics, 4(1):34-41.
- Kern, W. V., & Rieg, S. (2020). Burden of bacterial bloodstream infection-a brief update on epidemiology and significance of multidrug-resistant pathogens.Clinical microbiology and infection: the official publication of the European Society of Clinical Microbiology and Infectious Diseases,26(2), 151–7. https://doi.org/10.1016/j.cmi.2019.10.031
- Lee, C. M., Kim, C. J., Kim, S. E., Park, K. H., Bae, J. Y., Choi, et al.Korea Infectious Diseases (KIND) Study Group (2022). Risk factors for early mortality in patients with carbapenem-resistant Acinetobacter baumannii bacteraemia.Journal of global antimicrobial resistance,31, 45–51. https://doi.org/10.1016/j.jgar.2022.08.010
- Livermore D. M. (2012). Current epidemiology and growing resistance of gram-negative pathogens.The Korean journal of internal medicine,27(2), 128–42. https://doi.org/10.3904/kjim.2012.27.2.128
- Mac, S., Fitzpatrick, T., Johnstone, J., & Sander, B. (2019). Vancomycin-resistant enterococci (VRE) screening and isolation in the general medicine ward: a cost-effectiveness analysis.Antimicrobial resistance and infection control,8, 168. https://doi.org/10.1186/s13756-019-0628-x
- Michels, R., Last, K., Becker, S. L., & Papan, C. (2021). Update on Coagulase-Negative Staphylococci-What the Clinician Should Know.Microorganisms,9(4), 830. https://doi.org/10.3390/microorganisms9040830.
- Mun, S. J., Kim, S. H., Kim, H. T., Moon, C., & Wi, Y. M. (2022). The epidemiology of bloodstream infection contributing to mortality: the difference between community-acquired, healthcare-associated, and hospital-acquired infections.BMC infectious diseases,22(1), 336. https://doi.org/10.1186/s12879-022-07267-9
- Oliva, A., Garzoli, S., De Angelis, M., Marzuillo, C., Vullo, V., Mastroianni, C. M., & Ragno, R. (2019). In-vitro evaluation of Different Antimicrobial Combinations with and without Colistin Against Carbapenem-ResistantAcinetobacter Baumannii.Molecules (Basel, Switzerland),24(5), 886. https://doi.org/10.3390/molecules24050886
- Phan, H. T., Vo, T. H., Tran, H. T. T., Huynh, H. T. N., Nguyen, H. T. T., & Van Nguyen, T. (2020). Enhanced infection control interventions reduced catheter-related bloodstream infections in the neonatal department of Hung Vuong Hospital, Vietnam, 2011-2012: a pre-and post-intervention study.Antimicrobial resistance and infection control,9(1), 9. https://doi.org/10.1186/s13756-019-0669-1
- Taramasso, L., Tatarelli, P., & Di Biagio, A. (2016). Bloodstream infections in HIV-infected patients.Virulence,7(3), 320–328. https://doi.org/10.1080/21505594.2016.1158359
- Taşçı, L., Güreser, A.S., Boyacıoğlu, Zİ.,Karasartova, D.,Özkan, AT.(2016). Microorganisms Isolated from Blood Cultures and Their Antimicrobial Susceptibility in Hitit University Corum Training and Research Hospital. Flora, 21(1),27-32.
- Timsit, J. F., Ruppé, E., Barbier, F., Tabah, A., & Bassetti, M. (2020). Bloodstream infections in critically ill patients: an expert statement.Intensive care medicine,46(2), 266–84. https://doi.org/10.1007/s00134-020-05950-6
- Wisplinghoff, H., Bischoff, T., Tallent, S. M., Seifert, H., Wenzel, R. P., & Edmond, M. B. (2004). Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America,39(3), 309–317. https://doi.org/10.1086/421946
- Yılmaz, S., Gümral, R.,Güney, M., Bedir, O.,Güçlü, A. et al. (2013). İki yıllık dönemde kan kültürlerinden izole edilen mikroorganizmalar ve antibiyotik duyarlılıkların değerlendirilmesi. Gülhane Med Journal. 55: 247-52
- Zahar JR, Timsit JF, Garrouste-Orgeas M, Francais A, Vesin A, DescorpsDeclere A, Dubois Y, Souweine B, Haouache H, Goldgran-Toledano D, Allaouchiche B, Azoulay E, Adrie C (2011) Outcomes in severe sepsis and patients with septic shock: pathogen species andinfection sites are not associated with mortality. Crit Care Med 39:1886–1895
Microorganisms Isolated from Blood Cultures of Intensive Care Patients and Follow-up of Antibiotic Susceptibilities in the Last Five Years
Öz
Objective: This study aimed to determine the antimicrobial resistance profiles of microorganisms isolated from blood cultures of patients hospitalized in intensive care units of a secondary-level state hospital.
Materials and Methods: Samples sent to the Microbiology Laboratory between 2018 and 2022 from patients receiving treatment in intensive care units of Nevşehir State Hospital were studied with conventional methods and automated system, and the results of the samples for which identification and antimicrobial susceptibility tests were performed were evaluated retrospectively.
Results: Gram-negative bacteria growth was detected in 54.5% of all samples, gram-positive bacteria growth was detected in 40.7%, and yeast growth was detected in 4.8%; Among gram-negative bacteria, Acinetobacter baumanniwith a maximum of 28% (n = 47); Enterococcus faecaliswas isolated as gram-positive bacteria with a maximum of 20.3% (n = 34). The rate of methicillin resistance in CNSs was found to be 92.8% (26/28), and in Staphylococcus aureus,it was 33% (2/6). Extended-spectrum beta-lactamase (ESBL) positivity was detected in 72% (13/18) and 80% (20/25) of Escherichia coliand Klebsiella pneumoniaisolates, respectively. Carbapenem resistance was observed in all A.baumaniiisolates (100%). The antibiotics E. coliand K. pneumoniawere most sensitive to, and they were imipenem, meropenem (100%), and amikacin, respectively. The most sensitive antibiotics in all gram-positive isolates were linezolid and glycopeptides.
Conclusion: To guide empirical treatment, each center should examine its own blood culture results, question the antimicrobial resistance status, and make rational antibiotic selection, aiming to reduce mortality in cases of sepsis and bacteremia.
Anahtar Kelimeler
Blood culture antibiotic resistance bloodstream infections intensive care unit
Etik Beyan
Ethical approval for the study was received from Nevşehir Hacı Bektaş Veli University Non-invasive Clinical Research Publication Ethics Committee (Decision number: 2023/12, Date: 19.04.2023).
Teşekkür
We would like to thank Nevşehir Provincial Health Directorate for supporting us in providing and classifying the data.
Kaynakça
- Amanati, A., Sajedianfard, S., Khajeh, S., Ghasempour, S., Mehrangiz, S., Nematolahi, S., & Shahhosein, Z. (2021). Bloodstream infections in adult patients with malignancy, epidemiology, microbiology, and risk factors associated with mortality and multi-drug resistance.BMC Infectious Diseases,21(1), 636. https://doi.org/10.1186/s12879-021-06243-z
- Baker, M. A., Sands, K. E., Huang, S. S., Kleinman, K., Septimus, E. J., Varma, N., et al.CDC Prevention Epicenters Program (2022). The Impact of Coronavirus Disease 2019 (COVID-19) on Healthcare-Associated Infections.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America,74(10), 1748–54. https://doi.org/10.1093/cid/ciab688
- Berktaş, M., Çıkman, A., Parlak, M., Güdücüoğlu, H.,Özkaçmaz, A. (2013) The Antibiotic Resistance of Enterococcus Strains İsolated from Blood Cultures. Sakaryamj, 3(2):76-9
- Böll, B., Schalk, E., Buchheidt, D., Hasenkamp, J., Kiehl, M., Kiderlen, T. R., Kochanek, M., Koldehoff, M., Kostrewa, P., Claßen, A. Y., Mellinghoff, S. C., Metzner, B., Penack, O., Ruhnke, M., Vehreschild, M. J. G. T., Weissinger, F., Wolf, H. H., Karthaus, M., & Hentrich, M. (2021). Central venous catheter-related infections in hematology and oncology: 2020 updated guidelines on diagnosis, management, and prevention by the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO).Annals of hematology,100(1), 239–259. https://doi.org/10.1007/s00277-020-04286-x
- Doi, Y., Park, Y. S., Rivera, J. I., Adams-Haduch, J. M., Hingwe, A., Sordillo, E. M., Lewis, J. S., 2nd, Howard, W. J., Johnson, L. E., Polsky, B., Jorgensen, J. H., Richter, S. S., Shutt, K. A., & Paterson, D. L. (2013). Community-associated extended-spectrum β-lactamase-producing Escherichia coli infection in the United States.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America,56(5), 641–648. https://doi.org/10.1093/cid/cis942
- Forrest, G. N., Roghmann, M. C., Toombs, L. S., Johnson, J. K., Weekes, E., Lincalis, D. P., & Venezia, R. A. (2008). Peptide nucleic acid fluorescent in situ hybridization for hospital-acquired enterococcal bacteremia: delivering earlier effective antimicrobial therapy.Antimicrobial agents and chemotherapy,52(10), 3558–3563. https://doi.org/10.1128/AAC.00283-08
- Kalın, BS., Türkoğlu, M. (2018). Catheter-Related Bloodstream Infections in Intensive Care Units.Turkiye Klinikleri J Intensive Care-Special Topics, 4(1):34-41.
- Kern, W. V., & Rieg, S. (2020). Burden of bacterial bloodstream infection-a brief update on epidemiology and significance of multidrug-resistant pathogens.Clinical microbiology and infection: the official publication of the European Society of Clinical Microbiology and Infectious Diseases,26(2), 151–7. https://doi.org/10.1016/j.cmi.2019.10.031
- Lee, C. M., Kim, C. J., Kim, S. E., Park, K. H., Bae, J. Y., Choi, et al.Korea Infectious Diseases (KIND) Study Group (2022). Risk factors for early mortality in patients with carbapenem-resistant Acinetobacter baumannii bacteraemia.Journal of global antimicrobial resistance,31, 45–51. https://doi.org/10.1016/j.jgar.2022.08.010
- Livermore D. M. (2012). Current epidemiology and growing resistance of gram-negative pathogens.The Korean journal of internal medicine,27(2), 128–42. https://doi.org/10.3904/kjim.2012.27.2.128
- Mac, S., Fitzpatrick, T., Johnstone, J., & Sander, B. (2019). Vancomycin-resistant enterococci (VRE) screening and isolation in the general medicine ward: a cost-effectiveness analysis.Antimicrobial resistance and infection control,8, 168. https://doi.org/10.1186/s13756-019-0628-x
- Michels, R., Last, K., Becker, S. L., & Papan, C. (2021). Update on Coagulase-Negative Staphylococci-What the Clinician Should Know.Microorganisms,9(4), 830. https://doi.org/10.3390/microorganisms9040830.
- Mun, S. J., Kim, S. H., Kim, H. T., Moon, C., & Wi, Y. M. (2022). The epidemiology of bloodstream infection contributing to mortality: the difference between community-acquired, healthcare-associated, and hospital-acquired infections.BMC infectious diseases,22(1), 336. https://doi.org/10.1186/s12879-022-07267-9
- Oliva, A., Garzoli, S., De Angelis, M., Marzuillo, C., Vullo, V., Mastroianni, C. M., & Ragno, R. (2019). In-vitro evaluation of Different Antimicrobial Combinations with and without Colistin Against Carbapenem-ResistantAcinetobacter Baumannii.Molecules (Basel, Switzerland),24(5), 886. https://doi.org/10.3390/molecules24050886
- Phan, H. T., Vo, T. H., Tran, H. T. T., Huynh, H. T. N., Nguyen, H. T. T., & Van Nguyen, T. (2020). Enhanced infection control interventions reduced catheter-related bloodstream infections in the neonatal department of Hung Vuong Hospital, Vietnam, 2011-2012: a pre-and post-intervention study.Antimicrobial resistance and infection control,9(1), 9. https://doi.org/10.1186/s13756-019-0669-1
- Taramasso, L., Tatarelli, P., & Di Biagio, A. (2016). Bloodstream infections in HIV-infected patients.Virulence,7(3), 320–328. https://doi.org/10.1080/21505594.2016.1158359
- Taşçı, L., Güreser, A.S., Boyacıoğlu, Zİ.,Karasartova, D.,Özkan, AT.(2016). Microorganisms Isolated from Blood Cultures and Their Antimicrobial Susceptibility in Hitit University Corum Training and Research Hospital. Flora, 21(1),27-32.
- Timsit, J. F., Ruppé, E., Barbier, F., Tabah, A., & Bassetti, M. (2020). Bloodstream infections in critically ill patients: an expert statement.Intensive care medicine,46(2), 266–84. https://doi.org/10.1007/s00134-020-05950-6
- Wisplinghoff, H., Bischoff, T., Tallent, S. M., Seifert, H., Wenzel, R. P., & Edmond, M. B. (2004). Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America,39(3), 309–317. https://doi.org/10.1086/421946
- Yılmaz, S., Gümral, R.,Güney, M., Bedir, O.,Güçlü, A. et al. (2013). İki yıllık dönemde kan kültürlerinden izole edilen mikroorganizmalar ve antibiyotik duyarlılıkların değerlendirilmesi. Gülhane Med Journal. 55: 247-52
- Zahar JR, Timsit JF, Garrouste-Orgeas M, Francais A, Vesin A, DescorpsDeclere A, Dubois Y, Souweine B, Haouache H, Goldgran-Toledano D, Allaouchiche B, Azoulay E, Adrie C (2011) Outcomes in severe sepsis and patients with septic shock: pathogen species andinfection sites are not associated with mortality. Crit Care Med 39:1886–1895
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri (Diğer) |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 28 Ağustos 2024 |
| Gönderilme Tarihi | 26 Temmuz 2024 |
| Kabul Tarihi | 20 Ağustos 2024 |
| Yayımlandığı Sayı | Yıl 2024 Cilt: 2 Sayı: 3 |
