Investigation of Antibiotic Susceptibilities in Carbapenem-Resistant Klebsiella pneumoniae and Escherichia coli Strains Isolated from Clinical Samples: A Four-Year Analysis in a Comprehensive Healthcare Facility

INTRODUCTION: The profile of carbapenem-resistant Enterobacterales (CRE), antibiotic susceptibilities were analyzed in our hospital providing a wide range of healthcare services in Southeastern Anatolia. METHODS: This retrospective study included carbapenem-resistant Klebsiella pneumoniae (CRKP, 1022 isolates) and carbapenem-resistant E. coli (CREC, 700 isolates) isolated from patients admitted to xxxxxx Hospital between 2019 and 2022. Isolate typing and antibiotic susceptibility profiles were determined using the BD Phoenix automated system (Becton Dickinson, USA), and the Diagnostics MIC-COL test kit (Diagnostics, Slovakia) was used to determine colistin susceptibility. RESULTS: Out of the total 1022 CRKP isolates, 663 (64.9%) were obtained from intensive care units, 207 (20.2%) from inpatient clinics, and 152 (14.9%) from outpatient clinics. The most sensitive antibiotics for CRKP isolates were found to be ceftazidime-avibactam (CZA) (57%), gentamicin (51%), and amikacin (40%), respectively. Statistically significant changes in susceptibilities to CZA, colistin, trimethoprim-sulfamethoxazole (SXT), tobramycin, meropenem, imipenem, and levofloxacin were observed over the years (p<0.05). Among the total 700 CREC isolates, 258 (36.9%) were obtained from inpatient clinics, 229 (32.7%) from intensive care units, and 213 (30.4%) from outpatient clinics. Statistically significant changes in susceptibilities to imipenem, tobramycin, SXT, levofloxacin, cefepime, ampicillin-sulbactam (AMP-SM), and cefuroxime were observed over the years (p<0.05). Over 80% of the isolates were susceptible to amikacin, and over 60% were susceptible to gentamicin, imipenem, colistin, and CZA. DISCUSSION AND CONCLUSION: Presentation of regional data on carbapenem resistance in health centers and understanding of antibiotic resistance/susceptibility specific to CSI are vital to guide empirical treatment decisions as well as provide important regional epidemiological data

Antimicrobial Susceptibilities and Distribution of Stenotrophomonas maltophilia Strains Isolated from Clinical Specimens

Objective: Stenotrophomonas maltophilia is an opportu­nistic pathogen of increasing importance. Since it is intrin­sically resistant to many antimicrobial agents, the treat­ment of S. maltophilia infections is quite difficult. The aim of this study was to investigate the distribution and anti­microbial susceptibility patterns of S. maltophilia strains isolated in four years’ time. Methods: In this study; a total of 53 S. maltophilia strains, isolated from various clinical specimens between 2011- 2015 years were investigated in terms of antibiotic resis­tance rates. The isolates were identified and antibiotic susceptibility tests performed by conventional methods and BD Phoenix 100 automated system (Becton Dickin­son Diagnostic Systems, Sparks, USA). Results: S. maltophilia infections were mostly encoun­tered in the intensive care units. The most effective anti­microbial agents against S. maltophilia strains were found as trimethoprim-sulfamethoxazole and levofloxacin. Conclusion: Antimicrobial susceptibility tests should be performed for nosocomial infections caused by S. malto­philia due to high antimicrobial resistance rates. If this is not possible, trimethoprim-sulfamethoxazole and levo­floxacin could be good choices for empiric treatment

Evaluation of febrile neutropenic patients hospitalized in a hematology clinic

Objective: To evaluate the febrile neutropenic patients with hematological malignancies hospitalized in hematology clinic with poor hygiene standards. Methods: A total of 124 patients with hematological malignancies (69 male, 55 female) hospitalized in hematology clinic with poor hygiene conditions depending on hospital conditions, between January 2007 and December 2010, were evaluated, retrospectively. Results: In this study, 250 febrile neutropenia episodes developing in 124 hospitalized patients were evaluated. Of the patients, 69 were men (56%) and 55 women (44%). A total of 40 patients (32%) had acute myeloid leukemia, 25 (20%) acute lymphoblastic leukemia, 19 (15%) non-Hodgkin's lymphoma, 10 (8%) multiple myeloma, and 8 (8%) chronic myeloid leukemia. In our study, 56 patients (22%) were diagnosed as pneumonia, 38 (15%) invasive aspergillosis, 38 (15%) sepsis, 16 (6%) typhlitis, 9 (4%) mucormycosis, and 4 (2%) urinary tract infection. Gram-positive cocci were isolated from 52% (n = 20), while Gram-negative bacilli 42% (n = 16) and yeasts from 6% (n = 2) of the sepsis patients, respectively. The most frequently isolated Gram-positive bacteria were methicillin-resistant coagulase-negative staphylococci (n = 18), while the most frequently isolated Gram-negative bacteria was Escherichia coli (n = 10). Conclusions: Febrile neutropenia is still a problem in patients with hematological malignancies. The documentation of the flora and detection of causative agents of infections in each unit would help to decide appropriate empirical therapy. Infection control procedures should be applied for preventing infections and transmissions