Abstract:

Aim: In this study, we aimed to provide guidance on the empirical antibiotic treatment and determine antibiotic resistance rates of extended spectrum beta-lactamase (ESBL) and inducible beta-lactamase ( IBL) producing bacteria isolated from upper and lower respiratory specimens in the outpatients and hospitalized patients. Materials and Methods: Respiratory specimens sent in a two-year period between August 2015 and July 2013 were evaluated retrospectively in Izmir Katip Celebi University Atatürk Education and Research Hospital Microbiology Laboratory. Identification and antimicrobial susceptibilities of the isolates were determined by conventional methods and BD Phoenix 100 (Becton-Dickinson, ABD) automated systems. Antibiotic susceptibilities were established by disk diffusion and were evaluated according to the Clinical Laboratory Standards Institute (CLSI) criteria in 2011-2014 and EUCAST criteria in 2015. Results: A total of 299 strains isolated from respiratory samples, including 226 ESBL and 73 IBL positive strains were analyzed retrospectively. The most common ESBL-producing strains were found to be Klebsiella pneumoniae and Escherichia coli. All of IBL-positive strains were found to be Pseudomonas aeruginosa. ESBL and IBL positive strains were found in the highest resistance to trimethoprim-sulfamethoxazole. Cefoperazone-sulbactam and piperacillin-tazobactam resistance rates were found to be quite high in both groups. Conclusion: Empirical antibiotic choices are quite restricted due to the increase in the rate of beta-lactamase-producing bacterial isolation. The treatment failure will be reduced with the appropriate use of empirical antibiotic treatment by determining the resistance ratio of these strains against other antibiotics.

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