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Antibiotic susceptibility patterns among respiratory isolates of Gram-negative bacilli in a Turkish university hospital

DOI: 10.1186/1471-2180-4-32

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Abstract:

We cultured organisms from sputum (54%), tracheal aspirate (25%), and bronchial lavage fluid (21%). The most common organisms were Klebsiella spp (35%), A. baumanii (27%), and Escherichia coli (15%). Imipenem was the most active agent, inhibiting 90% of Enterobacteriaceae and A. baumanii organisms. We considered approximately 12% of Klebsiella pneumoniae and 21% of E. coli isolates to be possible producers of extended-spectrum beta-lactamase. K. pneumoniae isolates of the extended-spectrum beta-lactamase phenotype were more resistant to imipenem, ciprofloxacin, and tetracycline in our study than they are in other regions of the world.Our results suggest that imipenem resistance in our region is growing.Nosocomial bacterial pneumonia is frequently polymicrobial, with gram-negative bacilli predominating [1]. Because delays in antimicrobial treatment can lead to adverse outcomes, the choice of empirical therapy is vital. Many effective antimicrobial agents are available, but the treatment of nosocomial pneumonia remains challenging. We recently reported the antibiotic-resistance patterns of respiratory isolates of Pseudomonas aeruginosa in our region [2]. The current study investigates the distribution and drug resistance of other gram-negative bacteria in the respiratory secretions of hospitalized patients.Table I and Table II present the antibiotic susceptibility patterns of our isolates. The most common organisms were Klebsiella spp (35%), A. baumanii (27%), and E. coli (15%). We also isolated rare organisms such as Stenotrophomonas maltophilia, Burkholderia spp, and Hafnia alvei. All studied Enterobacteriaceae (except Enterobacter spp) were far more susceptible to ticarcillin-clavulanate than to ticarcillin alone, which suggests that the primary mechanism of resistance in these organisms is β-lactamase production.K. pneumoniae accounted for 79% of Klebsiella isolates. Klebsiella spp were generally more susceptible to the tested antimicrobials than were Enterobacter

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