İdrar Yolu Enfeksiyonu Geçiren Diyabetli Hastalarda Siprofloksasin İyi Bir Seçenek Değildir
Amaç: Bu çalışmanın amacı diyabetik ve diyabeti olmayan bireylerden izole edilen Gram-negatif bakterilerin toplum kaynaklı idrar yolu enfeksiyonlarının enfeksiyöz ajanları olarak antibakteriyel duyarlılıklarını saptamak ve ampirik tedavide sıklıkla kullanılan antibiyotiklere direnç oranlarını karşılaştırmaktır. Yöntemler: 1 Ocak- 31 Aralık 2014 tarihleri arasında Fırat Üniversitesi Endokrinoloji ve Enfeksiyon Hastalıkları kliniklerine başvuran toplum kaynaklı idrar yolu enfeksiyonu tanısı almış ve idrar kültürlerinde gram negatif bakteri üremesi olan 96 diyabetik ve 68 diyabetik olmayan hastanın dosyaları retrospektif olarak incelendi. İzole edilen bakterilerin antibiyotik duyarlılıkları, Vitek 2 otomatik sistem kullanılarak belirlenmişti ve sonuçlar duyarlı ve dirençli olarak değerlendirildi. Bulgular: Hem diyabetik hem de diyabetik olmayan hasta gruplarında en sık Escherichia coli (diyabetiklerde %88,5 ve diyabetik olmayan grupta %85,3) izole edildi. Diyabetik grupta mikroorganizmalar, ampisiline, sefalosporinlere, siprofloksasine, amoksisilin-klavulanik aside ve diyabetik olmayan grup ampisilin, amoksisilin-klavulanik asit, sefuroksim ve trimetoprim-sülfametoksazole karşı en yüksek direnç oranlarını göstermiştir. Sonuç: Diyabetik grupta Siprofloksasin direnci anlamlı olarak daha yüksekti. Üriner sistem enfeksiyonları olan diyabetik hastalarda, antibiyotik verileceği zaman antibakteriyel duyarlılık testi sonuçlarına dayanarak verilmesi daha uygun olacaktır.
Ciprofloxacin is not a better choice in the patients with diabetes suffering urinary tract infection
Objective: The aim of this study is to determine antibacterial susceptibilities of Gram-negative bacteria isolated fromdiabetic and non-diabetic patients as infectious agents of community-acquired urinary tract infections (UTI) and tocompare their rates of resistance to the antibiotics frequently used in empirical treatment.Methods: Ninety-six diabetic and sixty-eight non-diabetic (total n=164) patients’ data were evaluated retrospectivelywho diagnosed as community-acquired urinary system infection and consulted to outpatient clinics of Department ofEndocrinology and Infectious Diseases of Firat University School of Medicine between January 1st , 2014 andDecember 31st, 2014 whose urine cultures demonstrated Gram-negative bacteria were included in the study.Antibiotic susceptibilities of the isolated bacteria were determined using Vitek 2 automated system and the resultswere evaluated as sensitive and resistant. Results: In both diabetic and non-diabetic patient groups, most frequently Escherichia coli (88.5% in diabetic and85.3% in non-diabetic groups) were isolated. In the diabetic group, microorganisms mostly demonstrated the highestrates of resistance against ampicillin, cephalosporins, ciprofloxacin, amoxicillin-clavulanic acid and in the non-diabeticgroup ampicillin, amoxicillin-clavulanic acid, cefuroxime and trimethoprim-sulfamethoxazole.Conclusion: Resistance to ciprofloxacin was at a significantly higher rate in the diabetic group. In diabetic patients, itwill be more appropriate to give antibiotherapy in urinary system infections based on the antibacterial susceptibilitytest results.
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