Serhat Samancı, Muhammet Köşker, Muhittin Çelik

Çocukluk çağı idrar yolu enfeksiyonlarında antibiyotik direnci; tek merkez deneyimi

Amaç: Çocuklarda idrar yolu enfeksiyonları en sık karşılaşılan genito-ü riner sistem hastalığı olup tedavide uygun olmayan antibiyotik ya dadoz seçimi direnç olasılığını artırmaktadır. Bu çalışmada, idrar yolu en feksiyonu patojenlerinin yaygınlığı, antibiyotiklere karşı direnç patern leri ve ampirik tedavi seçeneklerinin belirlenmesi amaçlanmıştır. Gereç ve Yöntemler: Ocak 2013–Aralık 2017 tarihleri arasında, 0 gün–16yaş arası çocuk hastaların idrar kültür ve antibiyogram sonuçları geriyedönük olarak analiz edildi. Antibiyotik duyarlılıkları “The Clinical andLaboratory Standards Institute” yöntemlerine uygun olarak disk difüz yon yöntemi ile yapıldı.Bulgular: Kültürde üremesi olan toplam 1326 çocuk hastadan 1070’i(%80,6) kız, 256’sı (%19,3) erkek cinsiyetteydi. En sık üreyen mikroor ganizma 1138 (%85,8) E. coli, daha az sıklıkta Klebsiella spp. 71 (%5,3),Enterobacter spp. 44 (%3,3), Proteus spp. 28 (%2,1) idi. Tüm mikroor ganizmalarda yüksek oranda ampicillin, ampicillin-sulbactam, amoxi cillin-clavulanate, cefuroxime-axetil, TMP-SMX direnci saptanırken,amikacin, meropenem, imipenem, ertapenem, fosfomycine ve nitrofu rantion’a karşı direnç düşük orandaydı. Çıkarımlar: Çocukluk yaş grubunda idrar yolu enfeksiyonunun en sıketkeni E. coli olarak saptandı. Merkezimizde tüm etkenlerde ampicillin,ampicillin-sulbactam, amoxicillin-clavulanate, cefuroxime-axetil, TMP SMX’e karşı yüksek düzeyde direnç saptand

Antibiotic resistance in childhood urinary tractinfections: A single-center experience

Aim: Urinary tract infections are the most common genitourinary tract disease in children, and inappropriate antibiotic and/or dose selection increase the likelihood of resistance. The aim of this study was to determine the prevalence of urinary tract infection pathogens, patterns of resistance to antibiotics, and empirical treatment options.Material and Methods: Between January 2013 and December 2017, urine culture and antibiogram results of pediatric patients aged 0 days to 16 years were analyzed retrospectively. Antibiotic susceptibilities were determined using disc diffusion according to methods of the Clinical and Laboratory Standards Institute.Results: Of the 1326 children with culture growth, 1070 (80.6%) were female and 256 (19.3%) were male. The most common microorganism found was (1138, 85.8%) E. Coli, followed by Klebsiella spp. (71, 5.3%), Enterobacter spp. (44, 3.3%), and Proteus spp. (28, 2.1%). High frequency of resistance to ampicillin, ampicillin-sulbactam, amoxicillin-clavulanate, cefuroxime axetil, as TMP-SMX was detected in all microorganisms, whereas resistance to amikacin, meropenem, imipenem, ertapenem, fosfomycin, and nitrofurantoin was low.Conclusion: E. coli was the most common causative agent of urinary tract infections in childhood. High resistance to ampicillin, ampicillinsulbactam, amoxicillin-clavulanate, cefuroxime axetil, and TMP-SMX was detected in all agents in our center

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