Hasan NAZ, Figen Çağlan ÇEVİK, Nevin AYKIN

Hastane kökenli üriner sistem infeksiyonları ve antibiyotik direnç profili

Hastane kökenli üriner sistem infeksiyonu (HKÜSİ) en sık görülen hastane kökenli infeksiyon (HKİ)’dur. Hastane kökenli üriner sistem infeksiyonu (HKÜSİ) tanısı ile izlenen hastalarda risk faktörleri, laboratuvar bulguları, etkenlerin dağılımı ve antibiyotik duyarlılıklarının incelenmesi amaçlanmıştır. Çalışma periyodunda 161 HKÜSİ olgusu tesbit edilmiştir. Hastanede uzun yatış, üriner kateter, cerrahi girişim, yoğun bakımda yatış ve nörolojik hastalık en sık predispozan faktörler olarak tesbit edilmiştir. HKÜSİ’da en sık izole edilen etkenler Escherichia coli 33 (% 29.5), Pseudomonas spp. 32 (% 28.6) ve Klebsiella spp. 12 (% 10.7) olarak saptanmıştır. Çalışmamızda E.coli, Pseudomonas spp. ve Klebsiella spp. suşlarına en düşük direnç amikasin (sırasıyle % 3, % 9, % 8), imipenem (% 9, % 41, % 8), piperasilin/tazobaktam (PİP/TAZ) (% 24, % 47, % 17) ve siprofloksasinde (52 %, 69 %, 25 %) gözlenmiştir. HKÜSİ tanısı ile izlenen 161 hastanın 31 (% 19)’inde mortalite saptandı. Sonuç olarak Başta Pseudomonas spp olmak üzere bakteriyel etken mikroorganizmalarda yüksek oranda direnç saptanmıştır.

Nosocomial urinary tract infections and resistance profile to antibiotics

The aim of this study is to investigate the risk factors, laboratuary results, distrubition of pathogens and sensitivity to antibiotics in patients with hospital acquired urinary tract infections (HAUTI). 161 HAUTI patients were diagnosed. The most common predisposing factors were identified as long term hospitalization, urinary catheterization, hospitalization at intensive care unit and neurologic diseases. The most commom pathogens isolated were Escherichia coli 33 (29.5 %), Pseudomonas spp. 32 (28.6 %) and Klebsiella spp. 12 (10.7 %). The lowest rates of resistance in E.coli, Pseudomonas spp. and Klebsiella spp. were observed to amikacin (respectively 3 %, 9 %, 8 %), to imipenem (9 %, 41 %, 8 %), to piperacilin/tazobactam (PIP/TAZ) (24 %, 47 %, 17 %) and to ciprofloxasin (52 %, 69 %, 25 %). Mortality was detected in 31(19%) of 161 patients diagnosed with HAUTI. As a result, high rate resistance was found in bacterial microorganism, especially in Pseudomonas spp.

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