Bir Üniversite Hastanesinde Kan Kültürlerinden İzole Edilen Enterobacterales Takımı Üyelerinin Dağılımının ve Antimikrobiyal Duyarlılıklarının İncelenmesi

Abstract

Objective: Members of Enterobacterales can cause various diseases in humans. The objective of this study was to determine the genus/species distribution and antimicrobial susceptibilities of Enterobacterales isolated from blood cultures in Central Laboratory of Hacettepe University Hospital. Method: Enterobacterales isolated from blood between July-2014 and April-2018 were included in the study. MALDI-TOF MS was used for the identification of isolates. Antimicrobial susceptibilities were determined with automated system (VITEK 2 Compact for the isolates between 2014 and 2018; BD Phoenix for the isolates in 2018) and disk diffusion method. Results of antimicrobial susceptibility testing were interpreted according to EUCAST breakpoints. Results: In total, 1765 isolates belonging to the order Enterobacterales were isolated from blood cultures. The most common microorganisms were Escherichia coli (47.6%), Klebsiella (34.1%), Enterobacter (6%), Proteus (4.4%) and Serratia spp. (3.5%), respectively. The remaining isolates included Salmonella, Citrobacter, M. morganii, Pantoea, Raoultella and Providencia spp. The lowest resistance rates among E. coli, Klebsiella and Enterobacter spp. isolates were observed against meropenem and amikacin. However, 21.1% of Klebsiella isolates were resistant to meropenem. The most active antimicrobials against Proteus isolates were piperacillintazobactam and meropenem. Resistance was not observed against piperacillin-tazobactam and meropenem among Proteus isolates. The most active antimicrobial against Serratia isolates was trimethoprim/ sulfamethoxazole with a resistance rate of 0%. Resistance was not noted against ampicillin and trimethoprim/ sulfamethoxazole among Salmonella isolates, whereas 26.1% of isolates were resistant to ciprofloxacin. All Citrobacter isolates were susceptible to meropenem, amikacin and cefepime. Conclusion: Findings of our study may guide the selection of proper antimicrobials for the treatment of bacteremia caused by Enterobacterales. Furthermore, this study provides important epidemiological information regarding the distribution of members of Enterobacterales causing bacteremia.