Journals / Çukurova Üniversitesi Tıp Fakültesi Dergisi / 2003 / Cilt: 28 - Sayı: 2
Investigation of the activity of ticarcillin-clavulanic acid against gram negative bacilli as nosocomial agents with E-test
- Pages
- 60–64
- DOI
- —
Abstract
PURPOSE: In our study, we aimed to determine the susceptibility of various nosocomial Gram negative bacteria strains against ticarcillin-clavulanic acid combination by the Epsilometer test (E-test) method. METHODS: Nosocomial agents were determined by classics! bacteriological tests and API 20E (Biomeriux, France) was used when necessary. The antibiotic susceptibility of the strains was tested according to the recommendation of the National Committee for Clinical Laboratory Standards (NCCLS) with E-test method. RESULTS: Of the 109 isolated Gram negative strains, Pseudomonas aeruginosa was 36 (33%), Escherichia coli was 18 (16.5%), Klebsiella pneumoniae was 17 (15.5%), Pseudomonas stutzeri was 13 (11.9%), Enterobacter cloacae was 7 (6.4%), Enterobacter aerogenes was 6 (5.5%), Klebsiella oxytoca was 3 (2.7%), Citrobacter diversus was 2 (1.8%), Proteus mirabilis was 2 (1.8%), Pseudomonas putida was 1 (0.9%), Hafnia alvei was 1 (0.9%), Proteus vulgaris was 1 (0.9%), Morganella morganii was 1 (0.9%), Enterobacter sakazakii was 1 (0.9%). These were isolated as follows; 59 (54.1%) from urine, 31 (28.4%) from wound-abscess, 12 (11%) from trakeal aspirate, 4 (3.6%) from blood, 2 (1.8%) from CSF and 1 (%0.9) from acid fluid. The activity of ticarcillin-clavulanic acid was found with E-test as 28% for Pseudomonas spp, 27.7% for E.coli, 15% for Klebsiella spp.and 28.5% other strains. CONCLUSION: ticarcillin-clavulanic acid was found to have a low activity against to the isolated Gram-negative bacilli as nosocomial agents. ticarcillin-clavulanic acid may be used in ampiric treatments of nosocomial infections when there is susceptibility.
Özet
AMAÇ: Çalışmamızda hastane enfeksiyonu etkeni çeşitli Gram negatif bakterilerin, Epsilometer test (E-test) yöntemi ile tikarsilin-klavulanik asit'e duyarlılıklarının belirlenmesi amaçlanmıştır. YÖNTEM: Hastane enfeksiyon etkenleri klasik bakteriyolojik testlerle tanımlanmış ve gerektiği durumlarda API 20E (Biomeriux, France) kullanılmıştır. National Committee for Clinical Labratory Standards (NCCLS) önerileri doğrultusunda E-test yöntemi ile suşların antibiyotik duyarlılıkları belirlenmiştir. SONUÇLAR: izole edilen 109 Gram negatif basilin; 36'sı (%33) Pseudomonas aeruginosa, 18'i (%16.5) Escherichia coli, 17'si (%15.5) Klebsiella pneumoniae, 13'ü (%11.9) Pseudomonas stutzeri, 7'si (%6.4) Enterobacter cloacae, 6'sı (%5.5) Enterobacter aerogenes, 3'ü (%2.7) Klebsiella oxytoca, 2'si (%1.8) Citrobacter diversus, 2'si (%1.8) Proteus mirabilis, 1'i (%0.9) Pseudomonas putida, 1'i (%0.9) Hafnia alvei, 1'i (%0.9) Proteus vulgaris, 1'i (%0.9) Morganella morganii, 1'i (%0.9) Enterobacter sakazakii'dir. Bu etkenlerin 59'u (%54.1) idrar, 31'i (%28.4) yara-abse, 12'si (%11) trakeal aspirat, 4'ü (%3.6) kan, 2'si (%1.8) BOS ve Ti (%0,9) asit mayii örneklerinden izole edilmiştir. Tikarsilin-klavulanik asit E test ile; Pseudomonas spp'de %28, E.coli'de %27.7, Klebsiella spp'de %15, Enterobacter spp'de %21.5 ve diğer suşlarda %28.5 duyarlı bulunmuştur, izole edilen 109 Gram negatif basilin genel duyarlılığı ise %24.7 olarak saptanmıştır. YORUM: Tikarsilin-klavulanik asit'in hastane enfeksiyonu etkeni olarak izole ettiğimiz Gram negatif basillere karşı etkinliği düşük bulunmuştur. Tikarsilin-klavulanik asit özellikle hastane enfeksiyonlarının ampirik tedavisinde uygun seçenek olarak görülmemektedir.