Zakir Zeki CALİK, MURAT KARAMEŞE, OSMAN AKTAŞ

Diyareli Hastalarda Patojenik E. coli Serogruplarının Araştırılması

Amaç: Diyare ile ilişkili hastalıklar başta gelişmekte olan ülkeler olmak üzere birçok ülkede ciddi bir sağlık problemidir. Diyare ile ilişkili hastalıkların gerçek nedeni, birincil ve ikincil sağlık hizmetlerinin düşük bütçelerinin yanı sıra sanitasyon ve kötü hijyen olarak tespit edilmiştir. Bu çalışmada, bölgemizdeki ishalli hastalardan alınan dışkı örneklerinde, başta ishal oluşturan Escherichia coli suşları olmak üzere bakteriyel enteropatojenlerin varlığının tespit edilmesi amaçlanmıştır.Yöntemler: İshal şikayeti olan 343 hastadan dışkı örnekleri toplandı. Toplanan dışkı örnekleri ilk olarak makroskobik ve mikroskobik incelemeye tabi tutuldu. Ardından, örneklerin EMB Agar, MacConkey Agar and Selenite F besiyerlerine ekim işlemleri gerçekleştirildi. Son olarak, E.coli bakterileri spesifik antiserumlar kullanılarak tanımlandı. Bulgular: Parazitolojik ve bakteriyolojik incelemeye tabi tutulan 343 dışkı örneğinin 156'sı kadın, 187'si erkek hastalara aitti. 262 dışkı örneğinde (%76,4) yalnızca E.coli bakterisi tespit edildi. E.coli tespit edilen 262 hastanın 77'sinde (%29,4) lateks aglütinasyon yöntemi ile sınıflandırma yapıldı. En çok tespit edilen EHEC, EPEC, ETEC ve EIEC suşları sırasıyla O26, O55, O128 ve O152 alt serotipleri olarak tanımlandı. Bu çalışmada, E.coli O157:H7 suşu tespit edilmedi.Sonuç: Sonuç olarak, sadece O antiserumunun kullanılması tüm patojenik bakterilerin tanımlanması için yeterli olmamaktadır. Ancak, bölgemizdeki bakteriyel serogrupların tanımlanması, konu hakkında klinisyenlerin dikkatini çekecek ve doğru tanı ve tedavi konusunda daha doğru sonuçlara ulaşılmasına olanak sağlayacaktır. İshal oluşturan E.coli suşlarının sebep olduğu infeksiyonların önüne geçebilmenin en temel yolu, hijyen kurallarına özen göstermektir.

The Investigation of Pathogenic E. coli serogroups in Patients with Diarrhea

Objective: Diarrheal diseases express a major health problem especially in developing countries. The real reasons of diarrheal disease are largely due to low hygiene or sanitation as well as low budgets of primary and secondary health care. In this study, it was aimed to determine the presence of bacterial enteropathogens especially diarrheagenic Escherichia coli serogroups in stool samples taken from patients with diarrhea in our geographic region.Methods: 343 stool samples were collected from the patients who were diarrhea. Stool samples were subjected to macroscopic and microscopic examinations, and then were cultured into EMB Agar, MacConkey Agar and Selenite F to isolate and distinguish E.coli from other intestinal pathogens. Finally, all isolated E.coli species were identified by using specific antisera. Results: 343 (156 female, 187 male) stool samples were bacteriologically and parasitologically examined. Only E. coli presence was detected in 262 (76.4%) samples. 77 (29.4%) of total isolated 262 E.coli strains were identified with latex agglutination test. Most common EHEC, EPEC, ETEC and EIEC strains were detected as following; O26, O55, O128 and O152 respectively. E.coli O157:H7 serovar was not detected.Conclusion: As a consequent, just usage of O antisera (except H7) is not adequate to detect all the pathogenic bacteria. However, determination of bacterial serogroups which often seen in a region may lead to draw the attention of the clinicians on these bacteria and provide an opportunity for more accurate diagnosis and treatment. The main way to prevent diarrheal E. coli infections is to obey the hygiene rules.

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