Distribution of Gram Negative Bacteria and Evaluation of Resistance Profiles

Aim: In this study, we aimed to examine the distributon of Gram negative bacteria isolated from urine cultures of out-patients in Afyonkarahisar State Hospital and evaluate the antimicrobial resistance rates of these pathogens. Material and Method: Urine samples of out-patients which were sent to microbiology laboratory between 2012-2013 were retrospectively evaluated. The isolates were identified using conventional methods and/or automated Vitec 2.0 system. Antibiogram sensitivities were determined by Kirby-Bauer disc diffusion method or automated system and interpreted on the basis of Clinical and Laboratory Standards Institute (CSI) criteria. Double disc sinergy test (DDST) or Vitec 2.0 system was used to detect extended spectrum beta-lactamase (ESBL).When conventional methods could%u2019t be clarified according to their colony morphologies, gram staining patterns, biochemical test; automated system has been used. Results: A total of 671 isolates acquired from urine samples were studied. 427 Escherichia coli (63.6 %), 165 Klebsiella spp. (24.6 %), 22 Pseudomonas spp. (3.3 %), nine Acinetobacter spp. (1.3 %), 41 Proteus spp. (6.1 %) and seven Serratia (1.0 %) strains were identified among isolates. 97 E.coli (22.8 %) and 41 Klebsiella (24.8 %) isolates were ESBL positive. Most common bacteria were E.coli, 31.1 % of which were resistant to trimethoprim-sulfamethoxazole, 16 % to ciprofloxacin and 3.6 % to nitrofurantoin. Among Enterobacteriaceae, no resistance aganist carbapenems were detected. Moreover, aminoglicoside sensitivity rate was significantly high in this group. Discussion: Microorganisms that have progressively increasing antimicrobial resistance should be considered in the treatment of urinary tract infections. It is also important to use the most appropriate antibiotics to avoid unnecessary usage of these drugs in order to decrease drug resistance rates and ESBL production which may effect the success of the treatment