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2014, Cilt 44, Sayı 4, Sayfa(lar) 149-157
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Aerobic Bacteria Isolated from the Wound Cultures and Their Antibiotic Susceptibilities
Osman Sezer CİRİT1, Tuba MÜDERRİS2, Ayser UZALA MIZRAKLI3, Yalçın VURUPALMAZ3, Ayşe BARIŞ4
1Gaziantep Dr. Ersin Arslan Devlet Hastanesi, Tıbbi Mikrobiyoloji Laboratuvarı, Gaziantep
2Atatürk Eğitim ve Araştırma Hastanesi, Tıbbi Mikrobiyoloji Laboratuvarı, Ankara
3Şanlıurfa Eğitim ve Araştırma Hastanesi, Tıbbi Mikrobiyoloji Laboratuvarı, Şanlıurfa
4Şişli Etfal Eğitim ve Araştırma Hastanesi, Tıbbi Mikrobiyoloji Laboratuvarı, İstanbul
Keywords: Antibiotic resistance, ESBL, culture, wound infection

Objective: In this study we aimed to determine the isolation rate and antibiotic susceptibilites of aerobic bacteria cultured from the wound specimens obtained in our hospital. We also evaluated the changes in antibiotic resistance and extended spectrum β-lactamase positivity rates of the isolates and analysed the possible underlying causes of these changes in three years period.

Material and Method: The study included the retrospective evaluation of the antibiotic susceptibilities of bacteria isolated from the wound specimens between 2010 and 2012. Conventional methods (Gram staining, catalase, coagulase, PYR reaction, aesculine hydrolysis, 6.5% NaCl tolerance, oxidase reaction and various agar reactions such as TSI, Simmon's citrate, Christensen urea, indole and motility) and VITEK 2 (BioMérieux, France) were used for identification. Antibiotic susceptibilities of bacteria were determined by Kirby-Bauer disc diffusion test and VITEK 2 protocols.

Results: A total of 4447 wound samples were evaluated. Four hundred seventeen (38.1%) of the isolated 1093 bacteria were found to be gram positive while 676 (61.9%) were gram negative. Of these isolates 168 (15.3%) were isolated from the outpatient clinics whereas 925 (84.6%) from inpatients. The most commonly isolated bacterium was coagulase negative staphylococci (CNS) which was followed by Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii and other enteric bacteria. Among the S. aureus isolates rate of methicillin resistance was 27.3% and in CNS the rate was 54.6%. While rifampicin, co-trimoxazole, lincosamide and aminoglycosides were the most effective antimicrobial agents against staphylococci, carbapenem and aminoglycosides were the most effective ones against enteric bacteria. Quinolones were found to have decreased activity against E. coli and Klebsiella pneumoniae isolates, however, they were effective against the other enteric bacteria. Extended spectrum β-lactamase (ESBL) positivity rates were were 61%, 62% and 68% in E. coli isolates; 40%, 37% and 40% in K. pneumonia isolates and 8%, 7% and 16% in other enteric bacteria in 2010, 2011 and 2012, respectively.

Conclusion: Although methicillin resistance was found to be high in staphylococcus strains, rifampicin, co-trimoxazole, lincosamide and aminoglycosides were found to be effective in that group of bacteria. High rates of ESBL positivity were determined in E. coli and K. pneumoniae isolates. However, ESBL positivity was almost the same for the three consecutive years. Periodical evaluation of the microorganisms responsible for wound infections and their antibiotic susceptibilities may help to establish appropriate empirical treatment protocols and support data for the judicious antibiotic use in healthcare.


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