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2022, Cilt 52, Sayı 1, Sayfa(lar) 039-047
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A Comparison of the Species Distribution and Antibiotic Susceptibility Profiles of Blood Culture Isolates from Intensive Care Unit Patients Before and During COVID-19 Pandemic
Özlem Aytaç1 , Feray Ferda Şenol1, Arzu Şenol2, Pınar Öner1, Zülal Aşçı Toraman3
1Elâzığ Fethi Sekin Şehir Hastanesi, Mikrobiyoloji Bölümü, Elâzığ, Türkiye
2Elâzığ Fethi Sekin Şehir Hastanesi, Enfeksiyon Hastalıkları Bölümü, Elâzığ, Türkiye
3Fırat Üniversitesi Tıp Fakültesi Mikrobiyoloji Anabilim Dalı, Elâzığ, Türkiye
Keywords: Blood culture, COVID-19, Antibiotic sensitivity, Candida

Objective: The results of the blood culture samples delivered to our laboratory from intensive care units at Elâzığ Fethi Sekin City Hospital before pandemic (March 01, 2019 and February 29, 2020) and during pandemic (March 1, 2020-March 01, 2021) were analyzed retrospectively. The aim of this study was to compare the microorganisms grown in blood cultures and the antibiotic sensitivity of bacteria of patients in intensive care units of our hospital before and during the pandemic, and to determine whether there was any difference in the distribution of microorganisms and antibiotic sensitivity between the two periods.

Methods: The blood culture bottles were tracked by using the BACTEC 9120 (Becton Dickinson Diagnostic Instrument Systems, U.S.A.). For positive blood cultures, Vitek 2 (BioMérieux, France) was used to identify the grown microorganisms and determination of antibiotic sensitivity. Broth microdilution method was utilized for determination of susceptibility to colistin.

Results: A total of 1374 blood culture samples were delivered to our laboratory before COVID-19 pandemic and growth was detected in 163 (11.9%) samples. During the COVID-19 pandemic, a total of 847 blood culture samples were delivered. There was growth in 148 (17.5%) of these samples. Coagulase-negative staphylococcus (CNS) (40.5%), Klebsiella spp. (14.1%), and Staphylococcus aureus (13.5%) were the most frequently isolated microorganisms before the pandemic. CNS (50.7%), Candida spp. (10.1%), and Acinetobacter spp (9.5%) were the most common microorganism. A statistically significant difference was detected between two periods in terms of growth of Klebsiella spp, S. aureus, CNS and fungi (p<0.05). Antibiotic sensitivity of Escherichia coli was elevated, and the positivity of extended spectrum beta-lactamase decreased during the pandemic. Moreover, although not statistically significant, it was detected that particularly imipenem sensitivity decreased in Klebsiella spp. and Acinetobacter spp., during the pandemic period.

Conclusion: It was considered that candidemia was elevated in patients at intensive care unit of our hospital as a result of the prolonged hospitalization and the use of high doses of steroids for COVID-19 treatment. Early detection and surveillance for Candida infections would be critical in reducing COVID-19 deaths in cases of fungal co-infection in COVID-19 patients. Since carbapenem resistance was found to be elevated in Klebsiella spp. and Acinetobacter spp. during the COVID-19 pandemic, combined treatment options should be assessed if emprical treatment with carbapenem was required. Clonal evolution of carbepenem-resistance mechanisms was considered for Acinetobacter spp.


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