COMMONLY ISOLATED MICROORGANISMS FROM WOUNDS WITH THEIR ANTIBIOTIC RESISTANCE PATTERNS. Yara yeri kültürlerinden izole edilen etkenler ve antibiyotik direnç profilleri.

ABSTRACT Etiology of wound infections varies with the location of infection and risk factors. In this study, we aimed to analyse the wound cultures and the frequency of antibiotic resistance of the isolated microorganisms from patients hospitalized in intensive care unit (ICU) of the General Surgery Clinic. We retrospectively scanned the results of wound cultures from the patients in  ICU of General Surgery Clinic between 2009-2012, and recruited the ones in which at least one microorganism is isolated from culture.  Identification of the microorganisms and antibiotic susceptibility tests were done with conventional methods and automated systems. Of the 1754 specimens, pathogen bacteria is isolated in 638 (30%)  of them,  and the most common pathogens isolated were as followed:  Escherichia coli (39.8%), Staphylococcus aureus (11.9%), Acinetobacter baumannii (9.1%), Pseudomonas aeruginosa (7.5%), Candida spp. (7.8%), Enterobacter cloacae (7.1%), Klebsiella pneumoniae (6.1%), Enterococcus spp. (6.9%), Coagulase Negative Staphylococcus (CNS) (2.4%) and other Gram negative bacterias (1.4%). Methicillin resistance was observed in all S. aureus and CNS strains whereas extended spectrum beta lactamase was observed in 72.4% of E. coli and K. pneumoniae strains. On the other hand,  carbapenem resistance was observed in 27.1% of P. aeuroginosa and 68.9% of A. baumannii strains. The enteric bacteria; E. coli and K. pneumoniae , showed the highest resistance to cefotaxime (82.4%) and ceftazidime (74.6%). For P. aeruginosa resistance to tazobactam-piperacilline was 77% and to ceftazidime 70%, for A. baumannii ceftazidime resistance was 92% and cefaperazone-sulbactam resistance was 78%. The most common microorganisms isolated in the intensive care unit of general surgery clinic are enteric bacteria, non-fermentative bacteria and staphylococci. Hospital based data for the colonizing microorganisms, wound organisms, distribution patterns as well as their resistance patterns are important for empirical treatment schemes. OZET Yara yeri enfeksiyon etkenleri, enfeksiyonun gelistigi bolgeye ve risk faktorlerine gore farklilik gosterirler. Bu calismada AKU Tip Fakultesi Hastanesinde Genel Cerrahi yogun bakim unitesinde yatan hastalarin yara yeri kulturlerinden izole edilen mikroorganizmalarin sikligi ve antibiyotik direnc profilleri irdelenmistir. Calismada Genel Cerrahi yogun bakim biriminden 2009-2012 yillari arasinda hastanemiz klinik mikrobiyoloji laboratuvarina gonderilen yara yeri kulturleri retrospektif olarak taranmis ve en az bir mikroorganizmanin izole edildigi kultur sonuclari degerlendirilmistir. Mikroorganizmalarin identifikasyonu ve antibiyotik duyarlilik testleri konvansiyonel yontemler ve otomatize sistemlerle gerceklestirilmistir. Genel Cerrahi yogun bakim biriminden gonderilen 1754 ornegin 638’inde (%30) patojen bakteri izole edilmis, en sik rastlanan etkenlerin Escherichia coli (%39.8), Staphylococcus aureus (%11.9), Acinetobacter baumannii (%9.1), Pseudomonas aeruginosa (%7.5), Candida spp. (%7.8), Enterobacter cloacae (%7.1), Klebsiella pneumoniae (%6.1), Enterococcus spp. (%6.9), Koagulaz Negatif Stafilokok (KNS) (%2.4) ve diger Gram negatif bakteriler (%1.4)oldugu gozlenmistir. S. aureus ve KNS suslarinin tumunde metisilin direnci gozlenirken, E. coli ve K. pneumoniae suslarinda Genislemis Spektrumlu Beta Laktamaz direnci (GSBL) 72.4%, P. aeuroginosa ve A. baumannii suslarinda karbapenem direnci sirasiyla 27.1% ve 68.9% oraninda tespit edilmistir. Enterik bakterilerden E. coli ve K. pneumoniae icin en yuksek direnc sefotaksim (%82.4) ve seftazidim (74.6%), P. aeruginosa icin tazobaktam-piperasilin (77%) ve seftazidim (70%), A. baumannii icin seftazidim (92%) ve sefaperazon-sulbaktam (78%) saptanmistir. Hastanemizin Genel Cerrahi yogun bakim unitesinde yara yeri enfeksiyonu etkeni olarak en sik enterik bakteriler, non-fermentatif bakteriler ve stafilokoklar gozlenmektedir. Hastanemizde kolonize olan ve enfeksiyon etkeni olarak karsimiza cikabilen mikroorganizmalarin dagilimi ve direnc paternine iliskin kendi verilerinin olmasi, etkene yonelik ampirik tedavi acisindan buyuk onem tasimaktadir.