Mustafa Sıtkı Gözeler, Hakan Uslu, Korhan Kılıç, Eylül Derman, Muhammed Sedat Sakat, Furkan Şengöz

Hemodiyaliz hastalarında dış kulak yolu ve nazal kavitede mikrobiyal kolonizasyon ve antimikrobiyal duyarlılık

Amaç: Normal bakteriyel floranın bağışıklık üzerindeki etkisi onu mikroorganizmaların zararlı etkilerine karşı daha etkili hale getirmek ve hızlı bir cevap oluşturacak şekilde hazır tutmaktır. Bu çalışmanın amacı hemodiyaliz hastalarında nazal kavite ve dış kulak yolundaki bakteriyel florayı tespit etmek, bunu normal populasyonla karşılaştırmak ve mikroorganizmaların antimikrobiyal duyarlılığını ortaya koymaktı. Gereç ve Yöntem: Çalışmaya en az 3 yıldır hemodiyaliz alan hastalar dâhil edildi. Herhangi bir immunsupresyon durumu olmayan ve kulak hastalıkları dışı sebeplerle hastaneye başvuran hastalardan da kontrol grubu oluşturuldu (n=62). Tüm katılımcıların nazal kavite ve dış kulak yollarından kültür çubuğu ile kültür örnekleri alındı. Kültür sonuçları ile antimikrobiyal duyarlılık test sonuçları kaydedildi. Bulgular: Çalışma grubunda dış kulak yolundan en çok izole edilen bakteri MRCoNS (%41) iken bunu MSCoNS (%15,5) ve Difteroidler (%9,8) izlemekteydi. Nazal kaviteden ise en sık izole edilen bakteri CoNS olup (%52,7) bunun %69,2’sini MRCoNS oluşturmaktaydı. Sonuç: Hemodiyaliz hastalarında mortalite ve morbiditede önemli rol oynayan enfeksiyonların nazal kavite kadar dış kulak yolundan da kaynaklanabileceğini, bu nedenle antimikrobiyal duyarlılık testleri ile belirlenen uygun antibiyoterapi ile bu bölgedeki mikroorganizmaların da elimine edilmesinin önemli olduğunu düşünmekteyiz.

Microbial colonization and antimicrobial susceptibility of the nose and external ear canal in hemodialysis patients

Aim: The effect of normal bacterial flora on the immune system is to make it more effective against harmful microorganisms and to maintain it in readiness for a more rapid response. The purpose of this study was to determine thebacterial flora in the external ear canal and nasal cavities in hemodialysis patients, to compare this with the normalpopulation and to show the microorganisms’ antibiotic susceptibilities.Materials and Methods: Patients receiving hemodialysis therapy for at least 3 years were included in the study. Acontrol group (n=62) was established consisting of patients with no immune-suppressive condition and presenting tohospital with non-ear symptoms. Swab specimens were taken from all subjects’ external ear canals and nasalcavities. Results of the cultures were recorded and antimicrobial susceptibility test was performed.Results: The most commonly isolated micro-organisms in the study group were MRCoNS (41%), followed byMSCoNS (15.5%) and diphtheroids (9.8%). The micro-organism most commonly isolated from the nasal cavity in thestudy group was CoNS (52.7%), of which MRCoNS constituted 69.2%.Conclusion: We think that infections that play a major role in mortality and morbidity in hemodialysis patients mayoriginate from the external ear canal as much as the nasal cavity, for this reason it is important for micro-organismscolonizing these regions to be eliminated with appropriate treatment on the basis of antibiotic susceptibility tests.

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