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Kan ve dışkı örneklerinden izole edilen Salmonella ve Shigella izolatlarının antibiyotik dirençleri

Antimicrobial resistance of Salmonella and Shigella spp. isolated from blood and feces samples

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Abstract (2. Language): 
The present study was performed to contribute to the constitution of treatment protocols and to the follow up of future resistance development by determining antibiotic susceptibilities, the presence of extended spectrum beta lactamase and antimicrobial resistance rates in 21 Salmonella and 31 Shigella spp. isolated from feces samples and 30 Salmonella spp. isolated from blood samples at our bacteriology laboratory between 2001 and 2004. Antimicrobial susceptibilities were determined by using Kirby-Bauer disc diffusion method according to the criteria of Clinical and Laboratory Standards Instute, 2005. Resistance rates in Shigella isolates for trimethoprim/sulphamethoxazole and tetracycline were 71% and for amoxycillin/clavulanic acid was 9.7%. In Salmonella isolates from feces samples, resistance rates for ceftazidime, cefotaxime, trimethoprim/sulphamethoxazole and gentamicin were 4.8%, 9.5% for amoxycillin/clavulanic acid, and 33.3% for tetracycline. In Salmonella isolates from blood samples resistance rates were 50.0% for ampicillin, 20.0% for nalidixic acid, 10.0% for amoxycillin/clavulanic acid, and 6.7% for chloramphenicol, cefotaxime, trimethoprim/sulphamethoxazole, and 3.3% for gentamicin, tetracycline, ceftazidime, and piperasillin-tazobactam. There was no extended spectrum beta lactamase in isolates studied. Although there was no resistance for kinolons that have been frequently used instead of other antibiotics in treatment protocols recently, a clinical treatment failure risk should be kept in mind considering the resistance rate of 20.0% for nalidixic acid.
Abstract (Original Language): 
Bu çalışma, bakteriyoloji laboratuvarımızda 2001 ile 2004 yılları arasında dışkı örneklerinden izole edilen 21 Salmonella ve 31 Shigella izolatı ile kan örneklerinden izole edilen 30 Salmonella izolatının antibiyotik duyarlılıklarıyla, geniş spektrumlu beta laktamaz pozitifliklerinin saptanıp direnç paternlerinin belirlenerek tedavi protokollerine ve gelecekteki direnç gelişimlerinin izlenmesine katkıda bulunulması amacıyla yapılmıştır. Antibiyotik duyarlılıkları 2005 "Clinical and Laboratory Standards Institute" kriterlerine göre Kirby-Bauer disk difüzyon test yöntemiyle belirlenmiştir. Shigella izolatlarında trimetoprim-sülfametoksazol ve tetrasikline %71, amoksisilin-klavulanik aside %9.7 oranında direnç gözlenmiştir. Dışkı örneklerinden izole edilen Salmonella izolatlarında seftazidim, sefotaksim, trimetoprim-sülfametoksazol ve gentamisine %4.8, amoksisilin-klavulanik aside %9.5, tetrasikline %33.3 direnç belirlenmiştir. Kan örneklerinden izole edilen Salmonella izolatlarında ampisiline %50, nalidiksik aside %20, amoksisilinklavulanik aside %10, kloramfenikol, sefotaksim, trimetoprim-sülfametoksazole %6.7, gentamisin, tetrasiklin, seftazidim ve piperasilin-tazobaktama %3.3 direnç saptanmıştır. İzolatlarda geniş spektrumlu beta laktamaz pozitifliği belirlenmemiştir. Tedavi protokollerinde son yıllarda sıklıkla diğer ilaçların yerini alan kinolonlara direnç gözlenmemiş olmakla birlikte, %20 olarak belirlenen nalidiksik asid direnç oranı göz önüne alındığında, klinik başarısızlıkla karşılaşma olasılığı nedeniyle tedavi yaklaşımlarında bu durumun göz ardı edilmemesi gerektiği ortaya çıkmaktadır.
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