Antibacterial Resistance in Lower Respiratory Tract Bacterial Pathogens: A Multicenter Analysis from Turkey

Keywords: Lower respiratory tract infection, antibacterial resistance, bacterial etiology


Introduction: This study aimed to evaluate the etiology of lower respiratory tract infections (LRTIs) and their antibiotic resistance.

Methodology: Bacterial culture results of LRT samples from 17 hospitals between 2016-2019 were included in the study. All isolates were identified and AST were performed by automated microbiology systems. AST was performed according to EUCAST.

Results: Non-duplicate 30,051 (26,890 HA and 3156 CA) isolates detected as causative pathogen. LRTIs are caused by 85.1% Gram-negative bacterial pathogens and 14.9% Gram-positive. The most common isolates among HA pathogens were Acinetobacter spp. (27.4%), P.aeruginosa (22.2%), K.pneumoniae (17.9%); among CA pathogen S.pneumoniae (19.9%), P. aeruginosa (18.9%), H.influenzae (14.6%). ESBL rate was 62.5% in K.penumoniae; 53.1% in E.coli; 19.1% in Klebsiella spp; 13.9% in Enterobacter spp.; 8.6% in Proteus spp.; 6.3% in Citrobacter spp.; and 4.3% in Serratia spp. Resistance rates to carbapenems and colistin were 92.8% and 12.8% in A baumannii, 39.8% and 7.5% in P.aeruginosa, 47.3% and 18.5% in K.penumoniae. Among staphylococci, 27.3% of S. aureus and 82.4% of CoNS were methicillin resistant. 7.6% of E.faecium and 0.9% of E.faecalis were vancomycin resistant.  Linezolid resistant S. aureus, CoNS, E.faecalis and E.faecium rates were 0.3%, 2.9%, 0.0% and 4.6%. Inducible clindamycin resistant rate was 17.2% in S. aureus 38.2% in CoNS. Non-susceptible S.pneumoniae isolate rate to penicillin was 37.0%. 6.5% of S.maltophilia and 4.4% of B.cepacia isolates were resistant to trimethoprim/sulfamethoxazole.

Conclusions: Antibiotic resistance was mainly observed among A.baumannii and K.pneumoniae and continuous surveillance of antimicrobial resistance patterns in the management of LRTIs is important.


Author Biography

Respiratory Study Group

Respiratory Study Group (Sorted alphabetically by last name): Keishid Abdahi, Sebahat Aksaray, Hikmet Eda Aliskan, Cigdem Arabaci, Mustafa Altay Atalay, Tugba Kula Atik, Aydin Aydinli, Naciye Badir, Yesim Besli, Hadiye Demirbakan, Devrim Dundar, Gulfem Ece, Oguz Alp Gurbuz, Aysel Karatas, Selcuk Kaya, Canan Kulah, Melda Ozdamar, Birol Safak, Pınar Sagiroglu, Ali Korhan Sig, Berksan Simsek.

How to Cite
Uskudar Guclu A, Altay Kocak A, Akcil Ok M, Tutluoglu B, Basustaoglu AC, Respiratory Study Group (2021) Antibacterial Resistance in Lower Respiratory Tract Bacterial Pathogens: A Multicenter Analysis from Turkey. J Infect Dev Ctries 15:254-262. doi: 10.3855/jidc.12599
Original Articles