Examination of Blood and Tracheal Aspirate Culture Results in Intensive Care Patients: 5-year analysis

重症监护患者血液和气管吸出物培养结果分析:5年随访研究

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Abstract

OBJECTIVE: Majority of nosocomial infections are seen in intensive care units (ICUs) and they course with higher rates of mortality, and morbidity rates. In this study, we aimed to investigate the distribution of microorganisms isolated from the tracheal aspirate and blood cultures of ICU hospitalized patients, and their antibiotic resistance profiles. METHOD: Tracheal aspirate and blood cultures sent from ICU patients were evaluated retrospectively between 2014-2018. Antimicrobial susceptibility tests were performed on microorganism cultures that were identified by conventional methods and using an automated system. RESULTS: A total of 23.275 samples were accepted during the study period. The microorganisms isolated from tracheal aspirate cultures were Gram-negative (89.7%), Gram-positive (9.3%) and yeasts (1%). The most common Gram (-) microorganisms were A.baumannii (%25.7). The rates of meropenem resistance were documented as 98.3% for A.baumannii in 2014, 95.7% in 2018, 69.2% for P.aeruginosa. in 2014, and 35.6% in 2018, 45.55 for K.pneumoniae in 2014, and 5.8% in 2018 and 8% for E.coli in 2014, and 2% in 2018. The rates of methicillin resistance in S.aureus were documented as 28.0% in 2018, and 67.7% in 2015. The rates of penicillin resistance for S. pneumonia was documented as 76.8% in 2018, and 13.4% in 2015. The microorganisms isolated from blood culture were Gram (-) (31.4%), Gram (+) (57.9%) and yeasts (10.6%). The most frequently isolated Gram (-) bacteria were K.pneumonia (9.3%) and A.baumannii (8.8%). The rates of meropenem resistance were documented as 97.3% for A.baumannii. in 2014 and 79.2% in 2018, as 76.9% for K.pneumoniae in 2014 and 37.3% in 2018 and 79.2% for P.aeruginosa in 2014 and 26.1% in 2018. The artes of methicillin resistance were documented as 89.2% in 2018, and 78.5% for CNS in 2015, and 42.6% in 2018 while it was 92.4% for S. aureus in 2015. CONCLUSIONS: Our study showcased a drop throughout the year in rates of carbapenem resistance against Gram (-) microorganisms and methicillin resistance in S.aureus. However, the persistently high carbapanem resistance in A.baumannii isolates demonstrates the crucial need to continue with infection control measures.

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