Murat GÜMÜŞSOY, İBRAHİM ÇUKUROVA, Gülfem ECE, Erdem Atalay ÇETİNKAYA

Bir üçüncü basamak hastanesindeki kronik dakriyosistit hastalarının kültür sonuçlarının klinik ve mikrobiyolojik değerlendirmesi

Amaç: Bu çalışmada, kronik dakriyosistitli hastalardan izole edilen örnekler yardımıyla farklı anatomik bölgeler ile bunların antibiyotik duyarlılığı arasındaki ilişkinin incelenmesi amaçlanmıştır. Yöntem: Kronik dakriyosistit tanısı konmuş ve Mart 2013 ile Mayıs 2014 arasında endoskopik endonazal dakriyosistorinostomi ameliyatı geçiren 50 hasta çalışma kapsamına alındı. Swab örnekleri konjunktiVa ve alt nazal meatustan ameliyat öncesi, lakrimal kese örnekleri ise ameliyat sırasında alındı. İzole edilmiş örneklerin tanımlanmasında ve antibiyotik duyarlılığının belirlenmesinde Vitek version 2.0 sistemle-- ri kullanıldı (BioMeriuex Inc., Marcy-l'Etoile, Fransa). Bulgular: Otuz dokuzu kadın (%78), 11'i erkek (%22) toplam 150 hasta ameliyat edildi ve kendilerinden swab örnekleri alındı. Kültür örneklerinin 136'sında (%90.6) bakteri gelişimi saptanmıştır. Kültür ortamında tek (n=125; %91.9) veya iki farklı (n=11; %9.1) mikroorganizma ekimi yapıldı. Gram-pozitif ve gram--negatif örneklerin dağılı- mı sırasıyla %61.9 (n=91) ve %38.1 (n=56) oldu. En çok rastlanan gram-pozitif örnek Staphylococcus idi. Gram--negatif izolatlar 3. nesil sefalosporinlere, sefepime ve karbapenemlere duyarlılık gösterirken gram-pozitif izolatlar vankomisin, teikoplana ve linezolide duyarlılık gösterdi. Sonuç: Metisilin duyarlı koagülaz-negatif Staphylococci ve metisilin di-- rençli koagülaz-negatif Staphylococci için bakteri büyümesi, konjonkti-- va, lakrimal kese ve alt meatus olmak üzere üç bölgede benzerlik gös-- termiştir. Başka bir deyişle bu mikro--organizmaların bir lokasyonda büyümesi başka bir lokasyonda da hızla büyüyebileceklerini göster-- mektedir

Clinical and microbiological evaluation of the culture results of the patients with chronic dacryocystitis at tertiary care hospital

Objective:In this study, we aimed to evaluate the isolated strains fromthe patients with chronic dacryocystitis and the relationship betweendifferent anatomical areas and their antibiotic susceptibilities. Methods:Fifty patients diagnosed with chronic dacryocystitis wereincluded. Fifty patients underwent endoscopic endonasal dacryocystorhinostomy from March 2013 to April 2014. Swab samples wereobtained from conjunctiva and inferior nasal meatus before surgery,obtained from lacrimal sac during surgery. Identification and antibiotic susceptibility of the isolated strains were performed by automatedVitek version 2.0 systems (BioMeriuex Inc., Marcy-l'Étoile, France). Results: A total of 39 (78%) female and 11 (22%) male patients wereoperated and 150 swab samples were evaluated. Bacterial growth wasdetected in 136 (90.6%) culture samples. A single (n=125; 91.9%) or twodifferent (n=11; 9.1%) microorganisms were grown on culture media.The distribution of gram-positive strains (n=91) and gram-negativestrains (n=56) were 61.90% and (38.10%), respectively. The most frequently isolated gram-positive isolate was Staphylococcus. Gram-negativeisolates were susceptible to third-generation cephalosporins, cefepimeand carbapenems while gram-positive isolates were susceptible to vancomycin, teicoplanin and linezolide. Conclusion:For methicillin-sensitive coagulase-negative Staphylococciand methicillin-resistance coagulase-negative Staphylococci, bacterialgrowth demonstrated similarities among three different compartments(conjunctiva, lacrimal sac and inferior meatus). In other words, growthof these microorganisms in one location points to their proliferation inthe other location or vice versa. This data can be used to guide antimicrobial therapy for these cases; but further studies are required.

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