Yoğun bakım ünitesinde hastane infeksiyonu etkenleri, antibiyotik duyarlılıkları ve antibiyotik kullanımı
Yükleniyor...
Tarih
2006
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Trakya Üniversitesi Hastanesi (TÜH) Merkez Yoğun Bakım Ünitesi (MYBÜ)'nde kullanılan antibiyotiklerin hastane infeksiyon (Hİ) etkeni mikro-organizmalara etkinliği ve antibiyotik kullanımı ile hastane infeksiyonu gelişimi arasındaki ilişkinin belirlenmesi amaçlandı. Hastalar prospektif olarak laboratuvara ve hastaya dayalı, aktif sürveyans yöntemiyle değerlendirildi. Mikro-organizmaların tanımlanması ve antibiyotik duyarlılıklarının belirlenmesi TÜH Mikrobiyoloji Laboratuvarı'nda yapıldı. Merkez Yoğun Bakım Ünitesi'ne dokuz ayda yatırılan 135 hastadan 36 Acinetobacter cinsi bakteri, 25 Pseudomonas aeruginosa, bir Stenotrophomonas maltophilia, 20 Candida cinsi maya, sekiz Enterobacteriaceae üyesi, 25 Staphylococcus kökeni, beş Enterococcus kökeni olmak üzere 120 mikro-organizma izole edildi. Acinetobacter türlerine karşı sefaperazon/sulbaktam, P. aeruginosa kökenlerine karşı piperasilin/tazobaktam ve meropenem en etkili antibiyotikler olarak belirlendi. Gram-pozitif bakterilerde vankomisin direnci saptanmadı, ancak Staphylococcus aureus kökenlerinin %85'i metisiline dirençli idi. Hastane infeksiyonu gelişimi ile antibiyotik kullanılması arasında anlamlı ilişki bulunmadı. Uygun dozda ve sürede, YBÜ'nün florasına uygun antibiyotik kombinasyonları ampirik tedavide kullanılmalı, hastaların kültür sonucuna göre tedavi tekrar düzenlenmeli ve antibiyotik kullanımına infeksiyon uzmanına danışılarak karar verilmelidir.
The aim of this study was to determine the antibiotics used in the Intensive Care Unit (ICU) of Trakya University Hospital, their effect on the microorganisms isolated as nosocomial infection agents and the relation between the antibiotic consumption and hospital infections. The patients hospitalized in ICU were evaluated prospectively with the active surveillance method based on the labor-atory and patients. The identification of microorganisms and antimicrobial susceptibilities tests were made the in Microbiology Laboratory of Trakya University Hospital. Thirty six Acinetobacter spp, 25 Pseudomonas aeruginosa, one Stenotrophomonas maltophilia, 20 Candida spp, eight bacteria belonging to Enterobectericeae, 25 Staphylococcus spp, five Enterococcus spp, in total 120 microorganisms were isolated. The most effective antibiotic against Acinetobacter spp. was cefoperasone/sulbactam, and to P. aeruginosa piperacillin/tazobactam and meropenem. The vancomycin resistance was not detected in gram positive bacteria, but 85% of Staphylococcus aureus strains were resistant to meticilline. No relation between the antibiotic usage and nosocomial infections was found. The antibiotics should be used in appropriate dosage and for appropriate periods, the combination of appropriate antibiotics according to the ICUs' flora should be used in empiric treatment and the treatment should be rearranged according to the reports of cultures. The antibiotics should be given following consultation with infectious disease specialists.
The aim of this study was to determine the antibiotics used in the Intensive Care Unit (ICU) of Trakya University Hospital, their effect on the microorganisms isolated as nosocomial infection agents and the relation between the antibiotic consumption and hospital infections. The patients hospitalized in ICU were evaluated prospectively with the active surveillance method based on the labor-atory and patients. The identification of microorganisms and antimicrobial susceptibilities tests were made the in Microbiology Laboratory of Trakya University Hospital. Thirty six Acinetobacter spp, 25 Pseudomonas aeruginosa, one Stenotrophomonas maltophilia, 20 Candida spp, eight bacteria belonging to Enterobectericeae, 25 Staphylococcus spp, five Enterococcus spp, in total 120 microorganisms were isolated. The most effective antibiotic against Acinetobacter spp. was cefoperasone/sulbactam, and to P. aeruginosa piperacillin/tazobactam and meropenem. The vancomycin resistance was not detected in gram positive bacteria, but 85% of Staphylococcus aureus strains were resistant to meticilline. No relation between the antibiotic usage and nosocomial infections was found. The antibiotics should be used in appropriate dosage and for appropriate periods, the combination of appropriate antibiotics according to the ICUs' flora should be used in empiric treatment and the treatment should be rearranged according to the reports of cultures. The antibiotics should be given following consultation with infectious disease specialists.
Açıklama
Anahtar Kelimeler
Enfeksiyon Hastalıkları
Kaynak
İnfeksiyon Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
20
Sayı
3
