Özlem AYDIN, Damla DÖKMECİ GÜNEY, Ahmet Naci EMECEN, Pinar ERGEN, İhsan AYHAN, Reyhan AYAZ

Term ve Preterm Gebelerde Asemptomatik Bakteriüri Etkenleri ve Antimikrobiyal Duyarlılığın Karşılaştırılması

Amaç: Bu çalışmanın amacı, asemptomatik bakteriüri (ASB) etkenlerinin direnç paternlerini term ve preterm gebelikler arasında karşılaştırmaktır. Gereç ve Yöntemler: Hastanemiz kadın doğum bölümünde takip edilen ve idrar kültürleri laboratuvarda incelenmek üzere gönderilen ve ASB olarak rapor edilen 17-41 yaş arası gebeler çalışmaya dahil edildi. Hastalar gebelik haftalarına göre preterm (<37 hafta) ve term (≥37 hafta) olmak üzere iki gruba ayrıldı. Sonuçlar iki grup arasında karşılaştırıldı. Bulgular: Toplam 123 gebeden 29'u (%23,6) preterm, 94'ü (%76,4) term doğum yaptı. Tüm çalışma grubunda en sık izole edilen patojen %52,0 (n=64) ile Escherichia coli (E. coli) idi ve bunu %16,3 (n=20) ile Streptococcus agalactiae (S.agalactiae) izlemekteydi. Term ve preterm grupları arasında E. coli ve S. agalactiae dağılımı açısından istatistiksel olarak anlamlı bir fark yoktu (p=0,698 ve p=0,930). E. coli suşları ampisiline %56,3 (n=36) oranında, sefuroksime %40,6 (n=26) oranında dirençliydi. Fosfomisin direnci %1,6 (n=1) olarak belirlenirken, nitrofurantoin direnci saptanmadı. E. coli suşlarında genişletilmiş spektrumlu beta-laktamaz pozitifliği %23,4 (n=15) olarak tespit edildi. Term ve preterm grupları arasında E. coli suşlarının antibiyotik direnç oranları bakımından istatistiksel olarak anlamlı fark saptanmadı. Sonuç: En sık izole edilen patojen bakteri, beta laktamlara oldukça dirençli olan E. coli idi. Gebelerin ASB için taranması ve uygun antibiyoterapi ile tedavisi; maternal ve fetüste gelişecek komplikasyonları ve antimikrobiyal direnci önlemede etkili bir yoldur.

Anahtar Kelimeler:

gebelik, asemptomatik bakteriüri, antibiyotik direnci

Comparison of Asymptomatic Bacteriuria Agents and Antimicrobial Susceptibility in Term and Preterm Pregnancies

Aim: The aim of this study was to compare the resistance to asymptomatic bacteriuria (ABU) between term and preterm pregnancies. Material and Methods: Pregnant women aged 17-41 years who were followed up in the obstetrics department of our hospital and whose urine cultures were sent to the laboratory for analysis and reported as ABU were included in the study. Patients were divided into two groups according to gestational weeks as preterm (<37 weeks) and term (≥37 weeks). The results were compared between the two groups. Results: From among a total of 123 pregnant women, 29 (23.6%) delivered at preterm and 94 (76.4%) at term. The most frequently identified pathogen throughout the study group was 52.0% (n=64) Escherichia coli (E. coli), followed by 16.3% (n=20) Streptococcus agalactiae (S. agalactiae). There was no statistically significant difference in terms of the distribution of E. coli and S. agalactiae between the term and preterm groups (p=0.698 and p=0.930). E. coli was resistant to ampicillin 56.3% (n=36), to cefuroxime 40.6% (n=26). While fosfomycin resistance was 1.6% (n=1), nitrofurantoin resistance was not found. Extended-spectrum beta-lactamase positivity was 23.4% (n=15) in E. coli strains. No statistically significant difference was found in antibiotic resistance rates of E. coli strains between the term and preterm groups. Conclusion: The most commonly isolated pathogen was E. coli which was highly resistant to beta-lactams. Screening of pregnant women for ABU and treatment with appropriate antibiotics; is the most effective way to prevent both maternal and fetal complications and antimicrobial resistance.

Keywords:

pregnancy, asymptomatic bacteriuria, antibiotic resistance,

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