Toplum kaynaklı erişkin üriner sistem enfeksiyonlarında izole edilen enterobaktericea türlerinin bazı antibiyotiklere duyarlılıkları: Geriye dönük çalışma
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Tarih
2007
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Yaygın ve düzensiz antibiyotik kullanımına bağlı olarak antibiyotiklere rezistans oranı giderek artmaktadır. Direnç bakımından bölgeler arasında da büyük farklılıklar vardır. Bölgemizdeki direnç oranlarını gösteren bir çalışma yoktur. Bu çalışmanın amacı bölgemizdeki toplum kaynaklı erişkin idrar yolu enfeksiyonlarından izole edilen enterobakteriacea türlerinin bazı antibiyotiklere olan direnç oranlarını araştırmaktır. Bu çalışmada Ağustos 2004-2006 arası dönemde AİBÜ hastanesinde polikliniklerden mikrobiyoloji laboratuvarına gönderilen erişkin hastalara ait idrar kültür örnekleri çalışılmıştır. Kültürlerde 100.000 koloni/ml ve üzerinde üreme gösteren Enterobacteriacea suşlarının antibiyotik duyarlılıkları araştırılmıştır. Ampisilin, siprofloksasin, gentamisin, amikasin, nitrofurantoin ve SXT direnç oranları Kirby-Bauer disk difüzyon yöntemi ile araştırılmıştır. Antibiyotik duyarlılık sonuçlarının değerlendirilmede 2006 yılı Clinical and Laboratory Standards Institute kriterleri esas alınmıştır. Çalışmaya alınan 3575 hastadan kontaminasyonu olan 305 hasta değerlendirme dışı bırakılmıştır. Kalanların 697’sinde (%21,3) üreme olmuştur. Üreme olanların 529’u (%75,9) Enterobacteriacae ailesindendir. En sık izole edilen mikroorganizma Escherichia coli (%87,1) olmuştur. Bunu %9,6 sıklıkla Klebsiella pneumoniae izlemektedir. Bölgemizde E. coli suşlarının en yüksek direnci %41,0 ile ampisilin’e en düşük direnci ise %0,05 nitrofurantoin’e karşı gösterdikleri bulunmuştur. Üriner sistem enfeksiyonlarının tedavisi, kullanılan antibiyotiklere karşı gelişen direnç nedeniyle her geçen gün biraz daha problemli hale gelmektedir. Üropatojenlerin antibiyotiklere direnç oranları ülkeden ülkeye, bölgeden bölgeye değişmektedir. Hekimler bölgesel direnç oranlarını bilmeli ve tedavilerini bu oranlara göre yönlendirmelidirler.
Introduction: The rates of antibiotic resistance in common pathogenic bacteria have been increasing due to high and unnecessary antibiotic use. It can vary according to geographical and regional location. But little is known about the epidemiology of community-acquired antibiotic resistant enterobacteriacea spices in our region. The aim of this study is to assess the antimicrobial susceptibility of enterobacteriacea spices causing community-acquired urinary tract infection in our region. Materials and Methods: Medical records of AIBU microbiology laboratory from August 2004 to August 2006 were retrospectively reviewed to identify all adult patients with community acquired urinary tract infection (UTI). Patients, who had more than three episodes of UTI in the last year, hospitalization in the last month, pregnancy and those with upper UTI were excluded. Susceptibility testing for urinary tract isolates was performed if there were ≥100,000 colonies per milliliter. The resistance rates of ampicilline, ciprofloxacine, gentamisin, amikacin, nitrofurantoin and SXT were investigated by Kirby-Bauer disk diffusion technique. Antibacterial susceptibility testing was performed according to the Clinical and Laboratory Standards Institute criteria’s (CLSI). Results: During the study period, 3575 urine samples were analyzed and the mean age was 47.2 years (range: 17-74). The overall female to male ratio was 4.8. A total of 305 patients were excluded due to contamination and 697 (21.3%) bacterial isolates were examined in the study. E. coli was the most causative agent (87.1%) and it was followed by Klebsiella pneumonia with a percentage of 9.6%. Highest and lowest antibiotic resistance to Escherichia coli was ampicillin (41%) and nitrofurantoin (0.05%), respectively. Conclusion: Resistance rates of SXT and kinolons are increasing in every day due to high and widespread antibiotic usage. In our region nitrofurantoin and amikacin may be better empiric choices in patients with community-acquired UTI, because their resistance rates are only 0.05% and 3.5%, respectively. Although nitrofurantoin has maintained excellent activity against almost all E. coli strains causing UTI, it is not active against some strains of Enterobacter, Klebsiella and most strains of Proteus species. Urine culture and antimicrobial susceptibility should be essential in the treatment of UTI. Antibiotic resistance rates are changing in every region. Physicians must be educated continuously about the antibiotic resistance and they should know the local antibiotic resistance rates in order to prescribe appropriate antibiotics. Local infection control guidelines must be prepared in every year.
Introduction: The rates of antibiotic resistance in common pathogenic bacteria have been increasing due to high and unnecessary antibiotic use. It can vary according to geographical and regional location. But little is known about the epidemiology of community-acquired antibiotic resistant enterobacteriacea spices in our region. The aim of this study is to assess the antimicrobial susceptibility of enterobacteriacea spices causing community-acquired urinary tract infection in our region. Materials and Methods: Medical records of AIBU microbiology laboratory from August 2004 to August 2006 were retrospectively reviewed to identify all adult patients with community acquired urinary tract infection (UTI). Patients, who had more than three episodes of UTI in the last year, hospitalization in the last month, pregnancy and those with upper UTI were excluded. Susceptibility testing for urinary tract isolates was performed if there were ≥100,000 colonies per milliliter. The resistance rates of ampicilline, ciprofloxacine, gentamisin, amikacin, nitrofurantoin and SXT were investigated by Kirby-Bauer disk diffusion technique. Antibacterial susceptibility testing was performed according to the Clinical and Laboratory Standards Institute criteria’s (CLSI). Results: During the study period, 3575 urine samples were analyzed and the mean age was 47.2 years (range: 17-74). The overall female to male ratio was 4.8. A total of 305 patients were excluded due to contamination and 697 (21.3%) bacterial isolates were examined in the study. E. coli was the most causative agent (87.1%) and it was followed by Klebsiella pneumonia with a percentage of 9.6%. Highest and lowest antibiotic resistance to Escherichia coli was ampicillin (41%) and nitrofurantoin (0.05%), respectively. Conclusion: Resistance rates of SXT and kinolons are increasing in every day due to high and widespread antibiotic usage. In our region nitrofurantoin and amikacin may be better empiric choices in patients with community-acquired UTI, because their resistance rates are only 0.05% and 3.5%, respectively. Although nitrofurantoin has maintained excellent activity against almost all E. coli strains causing UTI, it is not active against some strains of Enterobacter, Klebsiella and most strains of Proteus species. Urine culture and antimicrobial susceptibility should be essential in the treatment of UTI. Antibiotic resistance rates are changing in every region. Physicians must be educated continuously about the antibiotic resistance and they should know the local antibiotic resistance rates in order to prescribe appropriate antibiotics. Local infection control guidelines must be prepared in every year.
Açıklama
Anahtar Kelimeler
Escherichia Coli, İdrar Yolu Enfeksiyonu, Antibiyotik Direnci, Enterokoklar, Escherichia Coli, Urinary Tract Infection, Antibiotic Resistance, Enterobacteriacea
Kaynak
Türk Üroloji Dergisi
Turkish Journal of Urology
Turkish Journal of Urology
WoS Q Değeri
Scopus Q Değeri
N/A
Cilt
33
Sayı
1
