Evaluation of Bacterial Profile and Antibiotic Resistance in Patients in the Chest Diseases Service: a Retrospective Study

Abstract

Bu tezin amacı; Pnömoni,KOAH, Bronşektazi, Hışıltı(Wheezing), Astım ve Bronşit tanılırı ile göğüs hastalıkları servisine başvuruda bulunan hastaların balgam kültür sonuçlarında üreyen bakteri/bakterilerin antibiyotik direnç profillerinin belirlenmesidir. Çalışma Grubu Ocak 2021- Şubat 2022 tarihleri arasında YYÜ Tıp Fakültesi Göğüs Hastalıkları Servisinde Pnömoni, KOAH, Bronşektazi, Hışıltı(Wheezing), Astım ve Bronşit tanılı olgularda çalışılan balgam kültürleri, üreyen mikroorganizmalar ve antibiyotik dirençleri retrospektif olarak tarandı. Bu çalışmada Pnömoni, KOAH, Bronşektazi, Hışıltı (Wheezing), Astım ve Bronşit tanılarıyla ile takip edilen, 20-87 yaş arası ve yaş ortalaması 36,2 olan ve 295'i (%59) erkek, 205'i (%41) kadın ve toplam olarak 500 hasta izlendi. Hastalarımızın tamamı serviste yatarak tedavi gören; 1 hastada Achromobacter piechaudii, 2 hastada Acinetobacter baumannii 30 hastada Acinetobacter baumannii/haemolyticus, 1 hastada Citrobacter freundii 2 hastada Citrobacter youngae 16 hastada Enterobacter cloacae 1 hastada Enterobacter hormaechei 2 hastada Enterococcus faecalis 7 hastada Enterococcus faecium, 97 hastada Escherichia coli, 28 hastada Gram - Bacilli 12 hastada Haemophilus influenzae, 1 hastada Hafnia alvei 13 hastada Klebsiella oxytoca, 42 hastada Klebsiella pneumoniae, 13 hastada Klebsiella pneumoniae ssp ozaenae 79 hastada Klebsiella pneumoniae ssp pneumoniae, 11 hastada Klebsiella species 2 hastada Pantoea agglomerans 2 hastada Proteus mirabilis, 2 hastada Proteus species, 20 hastada Pseudomonas aeruginosa, 1 hastada Pseudomonas fluorescens/putida 2 hastada Pseudomonas stutzeri 9 hastada Serratia marcescens 78 hastada Staphylococcus aureus ve 1 hastada Staphylococcus schleiferi 6 hastada Stenotrophomonas maltophilia, 2 hastada Streptococcus 1 hastada Streptococcus group C, 1 hastada Streptococcus mitis group), 1 hastada Streptococcus oralis), 7 hastada Streptococcus pneumoniae), 2 hastada Streptococcus species ve son olarakta 1 hastada Yersinia intermedia bakteri üremiştir. Bu hastalara ait olan balgam kültürlerine ve antibiyogram verilerine ulaşılmıştır. Kültürde üremesi olmayan hastalar çalışmaya dahil edilmedi. Hastalarda balgam kültürlerinde yoğun olarak üremiş olup ve saptadığımız bakterilerin antibiyotiklere karşı dirençliliği ise şu şekilde belirlendi. Escherichia Coli, Amikasın (%16,4), Trimetoprim+ Sulfametaksazol (%8,24), Aztreonam (%9,27), Cefazolin (%6,18), Sefaperazon/Sulbaktam (%15,46), Ceftazidim (%20,61), Ampisilin+ Sulbaktam (%10,30), Cefotaxim (%13,40), Cefoxitim (%4,12), Piperasilin+ Tazobaktam (%14,43). Acinetobacter Baumanni, Amikasın (%13,33), Trimetoprim + Sulfametaksazol (%16,66), Aztreonam (%10,00), Cefazolin (%10,00), Sefaperazon/Sulbaktam (%3,33), Ceftazidim (%13,33), Ampisilin + Sulbaktam (%6,66), Cefotaxim (%10,00), Cefoxitim (%6,66), Piperasilin + Tazobaktam (%10,00). Pseudomonas Aeruginosa, Amikasın (%20,00), Trimetoprim + Sulfametaksazol (%15,00), Aztreonam (%10,00), Cefazolin (%10,00), Sefaperazon/Sulbaktam (%5,00), Ceftazidim (%5,00), Ampisilin + Sulbaktam (%15,00), Cefotaxim (%10,00), Cefoxitim (%5,00), Piperasilin + Tazobaktam (%5,00). Klebsiella Pneumonia Ssp, Amikasın (%8,86), Trimetoprim + Sulfametaksazol (%7,59), Aztreonam (%20,25), Cefazolin (%10,12), Sefaperazon/Sulbaktam (%5,06), Ceftazidim (%3,79), Ampisilin + Sulbaktam (%16,45), Cefotaxim (%11,39), Cefoxitim (%2,53), Piperasilin + Tazobaktam (%13,92). Enterobacter Clocae, Amikasın (%12,50), Trimetoprim + Sulfametaksazol (%18,75), Aztreonam (%12,50), Cefazolin (%6,25), Sefaperazon/Sulbaktam (%6,25), Ceftazidim (%6,25), Ampisilin + Sulbaktam (%12,50), Cefotaxim (%6,25), Cefoxitim (%6,25), Piperasilin + Tazobaktam (%12,50). Bu tür mikroorganizma kökenli hastalıklarda elde edilen verilere göre en çok karşılaşılan bakterileri ve bu bakterilere karşı duyarlılık ve dirençlilik verilerine göre hastalardaki etkenin bilinip ampirik tedavi başlanması hasta tedavisinde önemli bir rol alır.The aim of this thesis; It is to determine the antibiotic resistance profiles of bacteria/bacteria grown in the sputum culture results of patients who applied to the chest diseases service with the diagnosis of Pneumonia, COPD, Bronchiectasis, Wheezing, Asthma and Bronchitis. Sputum cultures, growing microorganisms and antibiotic resistances studied in patients diagnosed with COPD, Bronchiectasis, Wheezing, Asthma and Bronchitis were retrospectively screened. In this study, 295 (59%) males, 205 (41%) of whom were aged 20-87 years with a mean age of 36.2, followed with the diagnoses of Pneumonia, COPD, Bronchiectasis, Wheezing, Asthma and Bronchitis. female and a total of 500 patients were followed. All of our patients are hospitalized in the service; Achromobacter piechaudii in 1 patient, Acinetobacter baumannii in 2 patients, Acinetobacter baumannii/haemolyticus in 30 patients), Citrobacter freundii in 1 patient, Citrobacter youngae in 2 patients, Enterobacter cloacae in 16 patients, Enterobacter hormaechei in 1 patient, Enterococcus Enterochereccus faecalis in 2 patients, Enterococcus disease faecalis in 2 patients, Gram in patients 28 patients Haemophilus influenzae in 12 patients with bacilli, Hafnia alvei in 1 patient, Klebsiella oxytoca in 13 patients, Klebsiella pneumoniae in 42 patients, Klebsiella pneumoniae ssp ozaenae in 13 patients, Klebsiella pneumoniae ssp pneumoniae in 79 patients, Klebsiella pneumoniae ssp pneumoniae in 79 patients, Klebsiella species in 11 patients, Protoglomeradaglomerada in 2 patients species, Pseudomonas aeruginosa in 20 patients, Pseudomonas fluorescens/putida in 1 patient, Pseudomonas stutzeri in 2 patients, Serratia marcescens in 9 patients, Staphylococcus aureus in 78 patients, Staphylococcus aureus in 1 patient, and Staphylococcus schleiferi in 1 patient, Stenotrophomonas stutzeri in 1 patient, malt in 2 patients p C, Streptococcus mitis group in 1 patient), Streptococcus oralis in 1 patient), Streptococcus pneumoniae in 7 patients), Streptococcus species in 2 patients and finally Yersinia intermedia bacteria in 1 patient. Sputum cultures and antibiogram data of these patients were obtained. Patients without growth in culture were not included in the study. The sputum cultures of the patients were intensely grown and the resistance of the bacteria we detected to antibiotics was determined as follows. Escherichia Coli, Amikacin (16.4%), Trimethoprim + Sulfamethoxazole (8.24%), Aztreonam (9.27%), Cefazolin (6.18%), Cefaperazone/Sulbactam (15.46%), Ceftazidime (20%) .61), Ampicillin + Sulbactam ( 10.30%), Cefotaxim (13.40%), Cefoxitim (4.12%), Piperacillin + Tazobactam (14.43%). Acinetobacter Baumanni, Amikacin (13.33%), Trimethoprim + Sulfamethoxazole (16.66%), Aztreonam (10.00%), Cefazolin (10.00%), Cefaperazone/Sulbactam (3.33%), Ceftazidime (13.33%), Ampicillin + Sulbactam (6.66%) , Cefotaxim (10.00%), Cefoxitim (6.66%), Piperacillin + Tazobactam (10.00%). Pseudomonas Aeruginosa, Amikacin (20.00%), Trimethoprim + Sulfamethoxazole (15.00%), Aztreonam (10.00%), Cefazolin (10.00%), Cefaperazone/Sulbactam (5.00%), Ceftazidime (%) 5.00), Ampicillin + Sulbactam (15.00%) ), Cefotaxim (10.00%), Cefoxitim (5.00%), Piperacillin + Tazobactam (5.00%). Klebsiella Pneumonia Ssp, Amikacin (8.86%), Trimethoprim + Sulfamethoxazole (7.59%), Aztreonam (20.25%), Cefazolin (10.12%), Cefaperazone/Sulbactam (5.06%), Ceftazidime ( 3.79%), Ampicillin + Sulbactam (16.4%) ), Cefotaxim (11.39%), Cefoxitim (2.53%), Piperacillin + Tazobactam (13.92%). Enterobacter Clocae, Amikacin (12.50%), Trimethoprim + Sulfamethoxazole (18.75%), Aztreonam (12.50%), Cefazolin (6.25%), Cefaperazone/Sulbactam (6.25%), Ceftazidime (6.25%), Ampicillin + Sulbactam (12.50%) ), Cefotaxim (6.25%), Cefoxitim (6.25%), Piperacillin + Tazobactam (12.50%). According to the data obtained in diseases of this type of microorganism origin, the most common bacteria and the sensitivity and resistance to these bacteria, according to the data, knowing the effect in patients and starting empirical treatment play an important role in the treatment of patients.