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    Acinetobacter species and their antibiotic resistance profiles isolated from various clinical specimens between 2014 and 2018
    (2020) Arabaci, Cigdem; Karabulut, Nuran
    Aim: Acinetobacter species have emerged as an important cause of nosocomial pneumonia and bloodstream infections, especially in immunocompromised patients with underlying pathologies. Worldwide, there has been a marked increase in resistance to most antimicrobial agents in recent years. The aim of this study was to evaluate Acinetobacter spp., their antimicrobial resistance rates and changes in resistance rates isolated from a tertiary hospital in a five-year period.Material and Methods: In this study, Acinetobacter strains isolated from inpatients or outpatients between January 2014 and December 2018 were included in the Medical Microbiology Laboratory of our hospital. BD Phoenix 100 (Becton Dickinson, USA) was used for identification and antibiotic susceptibility of the isolates.Results: Acinetobacter baumannii and A. baumannii - A. calcoaceticus complex constituted 91% of all isolates. Acinetobacter strains were mostly isolated from inpatients with pneumonia (37%) and soft tissue infections (22.5%). Colistin resistance was not observed between 2014 and 2016, but it was detected in 2017 and 2018. Colistin resistance was 2.5% and 12.6% in A. baumannii and 2.9% and 13.5% in A.baumannii-calcoaceticus complex in 2017 and 2018, respectively, and this increase was statistically significant. Colistin and tigecycline were the most effective agents in all isolates. The resistance rates of tigecycline in A.baumannii and A.baumanniicalcoaceticus complex strains were 11% and 14.3%, respectively. Extensively drug-resistant isolates were 91.7% and pan drugresistant isolates were 2.3%.Conclusion: It has been observed that resistance to all used drugs including colistin in Acinetobacter species increased and the rate of pan drug-resistant isolates were also elevated. Especially the significant increase in colistin resistance observed in recent years raises concern. In order to prevent and cope with the development of multiple resistance, each laboratory should determine the distribution of resistance in Acinetobacter species and in particular resistance to colistin.
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    Evaluation of antibiotic resistance patterns of Klebsiella isolates: Five-year observation
    (2019) Arabaci, Cigdem; Kutlu, Orkide
    Aim: Klebsiella spp. is a gram-negative rod, having many virulence factors such as capsule polysaccharides, adhesins, and determinants for iron acquisition. In this study, we aimed to determine the sub-species of Klebsiella spp. and their antibiotic resistance profiles isolated from a tertiary hospital in a five-year period.Material and Methods: The antibiotic resistance profiles of Klebsiella spp. isolated from various clinical specimens of patients between January 2014 and December 2018 were retrospectively reviewed.Results: In a total of 4506 isolates were investigated. Among those isolates, 2,254 were obtained from females and 2.252 were obtained from males. The mean age of the patients was 47.71±29.56 while the median age was 56 years. On the other hand, 2.150 (47.7%) of the isolates were obtained from hospitalized patients, while 2356 (52.3%) were obtained from outpatients. Among those isolates, 1.859 (41.3%) were ESBL positive and along with ESBL positive isolates, 802 were obtained from females and 1,057 were obtained from males and ESBL positivity was significantly more common in males (p:0.001). Moreover, ESBL positivity was significantly more common in patients older than 18 years of age compared with the patients younger than 18 years of age. Ciprofloxacin resistance was reaching 67.4% and Ertapenem resistance was as high as 39.1% in ESBL positive Klebsiella spp. Conclusion: In conclusion, ESBL positive and carbapenem resistant Klebsiella spp. strains are increasing. Multidrug resistant Klebsiella spp. strains may cause severe infections increasing mortality. In that aspect, the antibiotic resistance profile should be identified clearly and further studies regarding the preventive measures should be planned.