Cumulative Antibiogram Test Results of Isolated Microorganisms from Blood Culture Samples at Haydarpaşa Numune Training and Research Hospital

Abstract

Introduction: In this study, we aimed to investigate cumulative antibiogram results of microorganisms isolated from blood- stream infections of patients admitted to our hospital to provide a guideline for the empirical treatment. Methods: The blood culture samples sent to our laboratory between January 2017 and September 2018 were incubated in BACT-ALERT 3D (bioMerieux- France) system. The microorganisms were identified with conventional methods and MALDI- TOF MS (bioMerieux- France), and the antibiotic susceptibility test was performed with VITEK-2 (bioMerieux- France) auto- mated systems. The cumulative antibiogram data were analyzed according to Clinical and Laboratory Standards Institute M39-A4 criteria. Data analysed for our study were retrieved from our hospital information system. The cumulative antibiotic sensitivity limit for empirical treatment was considered to be at a level >90%. Results: In this study, 969 isolates were analysed. Vancomycin, teicoplanin, linezolid, and tigecycline were effective in Entero- coccus species. In addition to these antibiotics, daptomycin was evaluated to be effective against Staphylococcus aureus. Carbapenems and tigecycline were effective in Escherichia coli isolates, and they can be used as empiric antibiotics but not against Klebsiella pneumoniae isolates. Amikacin was effective against other bacteria in Enterobacteriaceae members. However, no appropriate antibiotic was detected to be effective for the empirical treatment of non-fermentative Gram-neg- ative rods, including Pseudomonas aeruginosa and Acinetobacter baumannii infections. Candida albicans was sensitive to all antifungal agents. Amphotericin B, micafungin and caspofungin were appropriate for empirical treatment of other Candida species. Discussion and Conclusion: Empirical treatment options for Gram-negative rods are highly limited and we believe that training programmes scheduled by the infection control committee and close monitoring of the associated processes will improve and decrease antibiotic resistance rates.