NURAN ESEN, Güven ASLAN, Hikmet KÖSEOĞLU, Sevinç ÖZDEN, İlhan ÇELEBİ, Zeynep GÜLAY

Akut bakteriyel sistit olgularında kotrimoksazol ve siprofloksasin direnci

Amaç: Akut bakteriyel sistit olgularında sık olarak kullanılan kotrimoksazol ve siprofloksasine karşı iıı vitro direncin demografik verilerle ilişkisinin belirlenmesi amaçlandı. Gereç ve yöntem: Ocak 2000 ve Nisan 2002 tarihleri arasında Dokuz Eylül Üniversitesi Tıp Fakültesi Üroloji polikliniğine akut bakteriyel sistit semptomlanyla başvuran 462 hasta çalışmaya alındı. Bu hastaların kültürlerinde üreyen bakteriler ve disk diffüzyon yöntemi ile saptanan in vitro antibiyotik duyarlılıkları ile demografik verileri arasındaki ilişki incelendi. Bulgular: Çalışma kapsamına alınan hastalardan 120'sinin kültüründe üreme saptandı. Olguların 91'inde (%75,8) etken olarak Escberichia coli saptanırken, 29'undan (%24,2) enterokök, stafilokok, streptokok, Proteus ve Klebsiella cinsi bakteriler izole edildi. Etken mikroorganizma olarak saptanan E. coli izolatlarının %18,7'si sipro-floksasine, %31,9'u ise kotrimoksazole dirençli bulundu. Duyarlı ve dirençli suşların izole edildiği hasta grupları arasında; yaş, üriner sistemde patoloji varlığı, sonda öyküsü bakımından farklılık saptanmadı. Sonuç: Akut bakteriyel sistit olgularının ampirik tedavisinde tercih edilen ajanlardan kotrimoksazol ve siprofloksasine karşı in vitro direnç günümüzde önemli oranda artmış bulunmaktadır. Bu açıdan antibiyotik kullanımının uygun dozda ve yeterli sürede yapılması, kişilerin bu yönde bilinçlendirilmesi önem taşımaktadır.

Anahtar Kelimeler:

İlaç direnci, mikrobiyal, Siprofloksazin, Sistit, Trimetoprim-sulfametoksazol kombinasyonu

Cotrimoxazole and ciprofloxacin resistance in patients with acute bacterial cystitis

Cotrimoxazole and ciprofloxacin are the most frequently prescribed drugs in acute bacterial cystitis. We aimed to determine the relationship between the resistance to these drugs and demographic characteristics. Material and method: From January 2000 to April 2002 a total of 462 patients who were admitted to Dokuz Eylül University, Medical Faculty, Urology clinic with acute bacterial cystitis were included in this study. The possible correlation between the demographic'characteristics of patients and isolates from urine cultures and in vitro sensitivities for cotrimoxazole and ciprofloxacin results were evaluated. Results: Urine cultures were positive in 120 of 462 patients. The most common isolated uropathogen was Escherichia coli (75.8%). Enterococci, Staphylococci, Strep-tococci, Proteus, and Kkbsiella species were isolated in 29 (24.2%) of patients. Ciprofloxacin and cotrimoxazole resistance was determined in 18.7% and 31.9% of uropathogen E coli isolates respectively. Age, presence of urinary disorder, history of urethral catheterization was not significantly different between the patients with resistant and sensitive to these antibiotics.Conclusion: Ciprofioxacin resistance has been increasing during die last progressively as it is in cotrimoxazole because it is applied as the preferred treatment of choice in cystitis. It is concluded that only the appropriate treatment protocols may prevent the occurrence of resistance.

Keywords:

Drug Resistance, Microbial, Ciprofloxacin, Cystitis, Trimethoprim-Sulfamethoxazole Combination,

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