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Changes in antibacterial resistance patterns in Staphylococcus aureus strains which are related to microbiologically confirmed nosocomial bacteraemia in a tertiary care educational hospital in Turkey

Abstract number: 1733_1313

Sipahi O., Pullukcu H., Aydemir S., Tasbakan M., Tunger A., Arda B., Yamazhan T., Ulusoy S.

Objective: In this study it was aimed to evaluate the resistance patterns of microbiologically confirmed nosocomial bacteraemia (MCNB) related S. aureus strains between 2001–2005 retrospectively.

Method: Any patient in whom S. aureus was isolated in at least one set of blood cultures (Sent to the bacteriology laboratory 72 h after hospital admission) was considered to have MCNB. Data of antibacterial resistance and hospital admission dates were extracted from hospital patient record database. Double or more isolates during each episode were counted as one episode. Resistance patterns in the 2001–2002 and 2004–2005 periods were compared by Chi-square test. 2003 data was excluded to see the probable effect governmental antibiotic restriction policy, which was started in March 2003. Blood cultures were performed on Bact/Alert (bioMérieux, Durham, NC). Bacterial identifications were performed by automated API (bioMérieux, Durham, NC). Oxoid antibiotic dics (England) were used to test antibacterial susceptibility by disc diffusion method following the recommendations of CLSI. Results were interpreted as described by CLSI.

Results: Oxacillin resistance in 2001 was 73.8% and 55.2% in 2005. When 2001–2002 and 2004–2005 periods were compared, resistance to oxacillin, levofloxacin, gentamicin, erythromycin and clindamycin decreased significantly (p < 0.05) (Table 1). There was no glycopeptide resistance.

Table 1. Resistance patterns of S. aureus strains and comparison of resistance patterns in 2001–2002 and 2004–2005 periods

 200120022003200420052001–20022004–2005P
Methicillin73.8%70.5%76.7%63.2%55.2%72.2%59.0%<0.001
(186/252)(124/177)(89/116)(119/188)(115/208)(310/429)(234/396)  
Levofloxacin76.1%76.2%64.4%57.5%51.4%76.1%54.2%<0.001
(118/155)(93/122)(67/104)(99/172)(106/206)(211/277)(205/378)  
Gentamicin61.4%61.0%69.5%54.2%49.0%61.2%51.0%<0.001
(153/249)(108/177)(80/115)(102/188)(100/208)(261/426)(202/396)  
Erythromycin66.9%61.0%62.9%48.4%33.6%64.4%40.6%<0.001
(168/251)(108/177)(73/116)(91/188)(70/208)(276/428)(161/396)  
Clindamycin43.4%36.7%50.8%37.9%28.8%59.3%33.0%<0.001
(109/251)(65/177)(59/116)(71/187)(60/208)(254/428)(131/396)  
Penicillin92.8%93.2%96.5%93.0%92.3%92.9%92.6%NS
(233/251)(165/177)(112/116)(175/188)(192/208)(398/428)(367/396)  

Conclusion: Decrease in the resistance rates after the 2003 budget application suggests that the application is useful not only in decreasing the cost of antibiotics but the antimicrobial resistance in several bacteria.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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