HALİM YILMAZ, Muhammet Güzel KURTOĞLU, RECEP KEŞLİ, Osman TÜFEKÇİ

Spinal kord yaralanmalı hastalarda idrar kültürünün kantitatif çalışması

Amaç: Kronik dönem spinal kord yaralanmalı (SKY) hastaların idrar kültürlerinde asemptomatik bakteriüri varlığını tespit etmek ve üreme varlığı ile risk faktörleri arasındaki ilişkiyi araştırmak. Yöntem: SKY'li 36 hasta ve üriner sistem şikayeti olmayan 36 sağlıklı kontrol çalışmaya alındı. Hastaların tümü günde dört kez kendi kendine temiz aralıklı kateterizasyon (TAK) yapıyordu. Hastalardaki bakteri üreme sıklığı kontrol grubuyla karşılaştırıldı. Hastalarda üreme varlığı üzerine etkili risk faktörleri araştırıldı. Bulgular: SKY' li hastalarda en sık üreyen bakteri Eshercia coli (E. coli) idi (% 44.4). Kontrol grubunda en sık üreyen bakteri Koagülaz negatif Stafilokok (% 8.4), ikinci sırada üreyen bakteri E. coli (% 2.8) olarak belirlendi. İdrar kültürlerindeki E. coli üreme sıklığı SKY'li hastalarda kontrol grubuna göre istatistik olarak anlamlı derecede yüksekti. Hastalarda asemptomatik bakteriüri varlığı ile cinsiyet, yaralanma süresi, nörolojik seviye, yaralanma tipi ve anal sfikter kusuru arasında anlamlı bir ilişki saptanmadı. Sonuç: Kronik dönemdeki TAK yapan SKY'li hastalarda asemptomatik bakteriüri sık bir bulgudur. SKY'li hastaları takip eden hekimler bu hastalarda asemptomatik bakteriürinin sık bir bulgu olabileceğini göz önünde bulundurmalı ve üriner sistem enfeksiyonun (ÜSE) klinik bulguları yoksa antimikrobiyal ajanlarla tedavi edilmemelidir.

Quantitative study of urine cultures in patients with spinal cord injuries

Objective: To investigate the association between risk factors and bacterial reproduction and to determine asymptomatic bacteriurea existence in urinary samples of patients with spinal cord injuries (SCI) at chronical stage. Methods: Thirty-six patients with SCI and 36 healthy controls with no complaint of urinary system were included into the study. All patients were performed clean intermittent catheterization (IC) by themselves four times per day. In patients, the frequency of bacterial reproduction was compared with that of health controls. Results: The most commonly encountered bacterium was E. coli (% 44.4) in patients. In controls, the most commonly reproducing bacteria were Coagulase negative Staphilococci (% 8.4) and E. coli (% 2.8), in turn. In urinary cultures, the frequency of reproduction of E. coli was found to be significantly higher in patients with SCI, compared to healthy controls (p<0.001). No significant correlation was found between reproduction of bacteria, and age, gender, level of the injury and neurologic level (p>0.05). Conclusion: In patients with SCI performing IC at chronic stage, asymptomatic bacteriurea is a widespread finding. Healtcare providers treating patients with SCI should be aware that asymptomatic bacteriurea may be widespread in such patients, and these patients should not be treated with antimicrobial agents unless clinical findings of urinary tract infections are present.

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