Harran Üniversitesi Tıp Fakültesi Dergisi
Yazarlar: Mehmet Reşat CEYLAN, Mustafa KARAHOCA, Alper KARAGÖZ, Aytekin ÇIKMAN, Rıza DURMAZ
Konular:Tıp
DOI:10.35440/hutfd.757137
Anahtar Kelimeler:A. baumanni,Resistance,PFGE
Özet: Aim: With this study, the detection of the resistance rates of A. baumannii strains isolated from the patients in the intensive care units to the antibiotics and the demonstration of the clonal relationship of the isolates with multi-drug resistant of the factor of nosocomial infection were aimed by using the method of pulsed-field gel electrophoresis (PFGE). Material and Methods: A university hospital, 69 patients followed between January 2010-October 2011 at the Intensive Care Unit of Anesthesiology and Reanimation (ICUAR), Intensive Care Unit of Chest Diseases and Pediatric Intensive Care Unit and July-November 2012 at ICUAR and the same number of isolates formed with A. baumannii, Ventilator-Associated Pneumonia (VAP) and diagnosis of Primary Bloodstream Infection (PBI) were enrolled to the study. Findings: 63 (91%) of the patients were diagnosed with VAP and 6 (9%) of them with PBI. At least two invasive interference had been performed to all patients during the staying at the ICU. Urinary catheterization (100%), mechanical ventilation (94.2%), and peripheral venous catheterization (91.3%) were the most frequently performed invasive interferences. Antibiotic susceptibilities to imipenem, colistin and tigecycline were studied with the E-test and to the other antibiotics with the disk diffusion. Colistin was the most effective antibiotic for all of the strains (98.6%). Then, tigecycline (97.1%) and levofloxacin (69.6%) were in second place. All of the strains were resistant to ceftriaxone, piperacillin/tazobactam, meropenem, and imipenem. With the PFGE analysis of A. baumannii isolates performed to the genomic DNA cut with ApaI, it was found that 62 of the 69 A. baumannii strains (89.9%) were within the cluster. These strains were located within 16 clusters. 7 of the strains (10.1%) showed the profiles of specific PFGE and 23 pulsotypes were detected among the strains. Result: Being high of clustering rate of multidrug-resistant A. baumannii isolates and isolating the isolates in similar genotypes from the patients in different units is the indicator of these bacteria to be an endemic situation in the ICUs of our hospital. If precautions are not taken, A. baumannii has been able to remain in the hospitals for many years and can be easily transmitted among the patients. Especially for the prevention of cross-contamination, the necessity and importance of infection control programs have once again emphasized.