Duygu MERT, Sabahat ÇEKEN, Mustafa ERTEK

İdrar yolu enfeksiyonlarında kültürden izole edilen bakteriler ve antibiyotik duyarlılıkları

Amaç: İdrar yolu enfeksiyonu tüm enfeksiyon hastalıkları içinde ikinci sıklıkta görülmektedir. Kostovertebral açı hassasiyeti, ateş, suprapubik hassasiyet, dizüri, pollaküri ve idrar kaçırma gibi klinik bulgularla birlikte bakteriüri ve/veya piyüri bulunması idrar yolu enfeksiyonu olarak tanımlanır. Akut enfeksiyonlarda en sık izole edilen bakteri Escherichia coli’dir. Bu çalışmanın amacı idrar yolu enfeksiyonu olan hastaların idrar kültürlerinden izole edilen bakterileri saptamak ve bu bakterilerin antibiyogram sonuçlarını inceleyerek tedavide yaygın olarak kullanılan antibiyotiklere karşı duyarlılıklarını ve direnç durumlarını araştırmaktır.Yöntem: Bu çalışmada idrar yolu enfeksiyonu tanısı ile 1 Aralık 2014 ile 1 Ekim 2016 tarihleri arasında üçüncü basamak bir hastanenin klinik mikrobiyoloji laboratuvarına gönderilen idrar kültürleri retrospektif olarak incelenmiştir. Tam otomatik idrar tetkikinde piyürisi ve kültürde 105 koloni/mL üremesi olan idrar yolu enfeksiyonu tanısı konmuş hastalar çalışmaya alınmıştır. Üreyen etkenlerin tanımlanması ve antibiyotik duyarlılık testleri disk difüzyon yöntemiyle Avrupa Antimikrobiyal Duyarlılık Testi Komitesi European Committee on Antimicrobial Susceptibility Testing EUCAST . The data was expressed as numbers and percentages.Results: The urine culture results of 76 patients were evaluated. 48 strains isolated from urine cultures and antibiogram results of these strains were examined. The most frequently isolated microorganism was E. coli 69% and 33 strains were detected. Expanded spectrum betalactamase ESBL -positive E.coli 20 42% , ESBL-negative E. coli 13 27% , ESBL-positive Klebsiella pneumoniae 5 10% in 48 100% strains isolated and ESBL-negative K. pneumoniae 2 4% , other gram negative and positive bacteria were detected as 8 17% strains. Proteus mirabilis, Enterococcus faecalis, Enterococcus faecium, Pseudomonas aeruginosa, Streptococcus agalactiae, Stenotrophomonas maltophilia and Acinetobacter lwoffii have been identified as other factors. Sensitivity of imipenem, meropenem, cefoperazone-sulbactam, piperacillin-tazobactam, amikacin and nitrofurantoin was 100% and tobramycin was 92.31% in ESBL-negative E. coli.cefepime, ciprofloxacin, Conclusion: ESBL-positive E. coli was detected at 42%. This rate supports the increasing antibiotic resistance results over the years. The resistance to ciprofloxacin, cefuroxime, which are often preferred in the treatment of empirical antibiotics, increases. Therefore, empirical antibiotic treatment selection should be revised in patients with urinary tract infections.trimethoprim-sulfamethoxazole and Sonuç: GSBL-pozitif E. coli %42 oranında saptanmıştır. Bu oran yıllar içinde artan antibiyotik direnci antibiyotik siprofloksasin, sefuroksime karşı direnç artmaktadır. Bu nedenle idrar yolu enfeksiyonu olan olgularda ampirik antibiyotik tedavi seçiminin gözden geçirilmesi gerekmektedir.sonuçlarını desteklemektedir. Ampirik edilen tedavisinde sıklıkla trimetoprim-sulfametoksazol tercih ve

Anahtar Kelimeler:

İdrar yolu enfeksiyonu, idrar kültürü, antibiyotik duyarlılık

The isolated bacteria from culture and antibiotic susceptibilities in urinary tract infections

Objective: Urinary tract infection is the second most common among all infectious diseases. Urinary tract infection is defined as presence of bacteriuria and/or pyuria with clinical findings such as costovertebral angle sensitivity, fever, suprapubic tenderness, dysuria, pollacuria and urinary incontinence. The most commonly isolated bacterium in acute infections is Escherichia coli. The aim of this study is to determine the bacteria isolated from the urine cultures of patients with urinary tract infections and to investigate the antibiogram results of these bacteria and to investigate their susceptibility and resistance to antibiotics commonly used in treatment.Methods: In this study, urine cultures sent to the clinical microbiology laboratory of a tertiary hospital between December 1, 2014 and October 1, 2016 with the diagnosis of urinary tract infection were retrospectively analyzed. Patients diagnosed with urinary tract infection with pyuria and 105 colony/mL growth in culture in a fully automated urine test were included in the study. Identification of the reproductive factors and antibiotic susceptibility tests were performed by disc diffusion method according to the recommendations of The hastalıkları içinde ikinci sıklıkta görülmektedir. İdrar yolu enfeksiyonları tüm enfeksiyon European Committee on Antimicrobial Susceptibility Testing EUCAST . The data was expressed as numbers and percentages.Results: The urine culture results of 76 patients were evaluated. 48 strains isolated from urine cultures and antibiogram results of these strains were examined. The most frequently isolated microorganism was E. coli 69% and 33 strains were detected. Expanded spectrum betalactamase ESBL -positive E.coli 20 42% , ESBL-negative E. coli 13 27% , ESBL-positive Klebsiella pneumoniae 5 10% in 48 100% strains isolated and ESBL-negative K. pneumoniae 2 4% , other gram negative and positive bacteria were detected as 8 17% strains. Proteus mirabilis, Enterococcus faecalis, Enterococcus faecium, Pseudomonas aeruginosa, Streptococcus agalactiae, Stenotrophomonas maltophilia and Acinetobacter lwoffii have been identified as other factors. Sensitivity of imipenem, meropenem, cefoperazone-sulbactam, piperacillin-tazobactam, amikacin and nitrofurantoin was 100% and tobramycin was 92.31% in ESBL-negative E. coli.cefepime, ciprofloxacin, Conclusion: ESBL-positive E. coli was detected at 42%. This rate supports the increasing antibiotic resistance results over the years. The resistance to ciprofloxacin, cefuroxime, which are often preferred in the treatment of empirical antibiotics, increases. Therefore, empirical antibiotic treatment selection should be revised in patients with urinary tract infections.trimethoprim-sulfamethoxazole and

Keywords:

Urinary tract infection, urine culture, antibiotic susceptibility,

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