Aysun TEKELİ, B. Nuray ALPMAN, Merve TIRIS, Hilal IŞIK, Cengiz ZEYBEK

Çocuk Acile Başvuran Hastalarda İdrar Yolu Enfeksiyonlarının Değerlendirilmesi

Özet Giriş: İdrar yolu enfeksiyonları çocuklarda en sık görülen enfeksiyonlardandır ve çocuk acil servisine başvuruların önemli nedenlerinden biridir. Çalışmamızda, idrar yolu enfeksiyon tanısı alan hastaların demografik özellikleri, yakınmaları, idrar kültüründe izole edilen mikroorganizmalar ve antibiyotik direnç oranlarının belirlenmesi amaçlanmıştır. Materyal metod: 01.01.2020 – 31.12.2020 tarihlerinde hastanemize başvuran İYE ön tanısıyla tam idrar tetkiki ve idrar kültürü alınan 18 yaş altı hastaların verileri retrospektif olarak bilgisayar kayıt sisteminden tarandı. Hastaların demografik özellikleri, yakınmaları, idrar kültüründe izole edilen mikroorganizmalar ve antibiyotik dirençleri değerlendirildi. Bulgular: Çalışmaya dahil edilen toplam 286 hastanın yaş ortalaması 75,5 ± 57,65 ay ve 238’i (%83,2) kız idi. En sık başvuru yakınması %39,9 dizüri, %35,3 ateş ve %26,9 karın ağrısıydı. İdrar kültüründe en sık tespit edilen mikroorganizmalar; 242 (%84,6) hastada E. coli, 21 (%7,3) hastada Proteus spp. ve 16 (%5,6) hastada Klebsiella spp. idi. En yüksek direnç ampisiline %54,9 ve en düşük direnç amikasine %6,6 tespit edilmiştir. Sonuç: İdrar yolu enfeksiyonlarında uygunsuz tedavi seçimleri ilerleyen dönemlerde ortaya çıkabilecek komplikasyonlar açısından önemlidir. Bu nedenle merkezler belirli aralıklar ile kendi enfeksiyon etkenlerini ve antibiyotik duyarlılıklarını takip ederek ampirik tedavi seçimlerini oluşturmalıdır. Ampirik başlanan tedavilerin idrar kültür ve duyarlılık sonucuna göre yeniden değerlendirilmesi gereklidir.

Anahtar Kelimeler:

acil servis, çocuk, idrar yolu enfeksiyonu, tedavi

Evaluation of Urinary Tract Infections in Pediatric Patients Admitted to the Emergency Department

Abstract Background/Aim: Urinary tract infections (UTIs) are among the most common infections in children and one of the important reasons for presentation to the pediatric emergency department. This study aimed to determine demographic characteristics, complaints, microorganisms isolated in urine culture analysis, and antibiotic resistance rates in pediatric patients diagnosed with UTIs. Material and Method: The data of patients aged under 18 years, who presented to our hospital from January 1, 2020, through December 31, 2020 with a preliminary diagnosis of UTIs and underwent urine culture analysis, were retrospectively screened from the computer registry system. The patients’ demographic characteristics, complaints, microorganisms isolated in urine culture analysis, and antibiotic resistance were evaluated. Results: The mean age of the 286 patients included in the study was 75.5±57.65 months, and 238 (83.2%) were girls. The most common complaint at presentation was dysuria (39.9%), followed by fever (35.3%) and abdominal pain (26.9%). In urine culture analysis, the most frequently detected microorganisms were Escherichia coli (n=242, 84.6%), Proteus spp. (n=21, 7.3%), and Klebsiella spp. (n=16, 5.6%). The highest antibiotic resistance was observed in ampicillin (54.9%) and the lowest in amikacin (6.6%). Conclusion: Inappropriate treatment choices in UTIs are important in terms of complications that may occur in future. Therefore, healthcare centers should evaluate their own infectious agents and antibiotic susceptibility at certain intervals and determine appropriate empirical treatment choices. Empirically initiated treatments should be re-evaluated according to urine culture and sensitivity results.

Keywords:

children, emergency department, treatment, urinary tract infections,

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