In vitro efficacy of nitrofurantoin and some antibiotics in Escherichia coli strains isolated from urine cultures

Amaç: Bu retrospektif çalışmada, Escherichia coli’nin neden olduğu üriner sistem enfeksiyonlarının (ÜSE) tedavisinde yaygın olarak kullanılan bazı antibiyotikler ile nitrofurantoinin in vitro etkinliğini saptamayı amaçladık. Materyal ve metot: Toplam 3279 E.coli izolatı [2157’si (%65,8) ayakta tedavi edilen ve 1122’si (%34,2) yatan hasta olmak üzere] çalışma kapsamına alındı. E.coli izolatlarının identifikasyonları geleneksel yöntemler ve BD PhoenixTM 100 (Becton Dickinson, MD, USA) tam otomatik mikrobiyoloji sistemi ile yapıldı. Antimikrobik duyarlılık testleri Kirby-Bauer disk difüzyon yöntemi ile çalışıldı. Genişlemiş-spektrumlu beta-laktamaz (GSBL) aktivitesi ise çift-disk sinerji yöntemi kullanılarak belirlendi. Bulgular: Amosisilin-klavulanat, trimetoprim-sulfametoksazol ve siprofloksasin için duyarlılık oranları; sırasıyla %22,2, %39,8 ve %41,1 bulundu. Nitrofurantoin duyarlılık oranı ayakta tedavi edilen hastalar için %93,1 (n=2009) ve yatan hastalar için %89,2 (n=1001) olarak belirlendi. Ayakta tedavi edilen ve yatan hastaların nitrofurantoin duyarlılık oranları arasındaki fark istatistiksel olarak anlamlıydı (p

İdrar kültürlerinden izole edilen Escherichia coli suşlarında nitrofurantoin ve bazı antibiyotiklerin in vitro etkinliği

Objective: In this retrospective study, we aimed to detect the in vitro efficacy of nitrofurantoin and commonly used antibiotics in the treatment of urinary tract infections (UTIs) that are caused by Escherichia coli. Material and method: A total of 3,279 urine isolates of E.coli [2,157 (65.8%) outpatients, 1,122 (34.2%) inpatients] were included in this study. Identifications of E.coli isolates were performed by conventional methods and the BD PhoenixTM 100 (Becton Dickinson, MD, USA) fully automated microbiology system. Antimicrobial susceptibility tests were examined with Kirby-Bauer&#8217;s disc diffusion method. The double-disk synergy method was used for the detection of extanded-spectrum betalactamase (ESBL) activity. Results: The susceptibility rates for amoxicillinclavulanate, trimetoprim-sulfametoksazol, and ciprofloxacin were detected as 22.2%, 39.8%, and 41.1%, respectively. Nitrofurantoin susceptibility rate was 93.1% (n=2,009) in outpatients and 89.2% (n=1,001) in inpatients. The difference among nitrofurantoin susceptibility rates of outpatients and inpatients was statistically significant (p<0.001). But, there was no statistically significant relationship between the nitrofurantoin susceptibility and distribution according to the years of susceptibility rate (p=0.755). The rate of ESBL-producing E.coli isolates was detected as 38% (n=1,246). There was also statistically significant difference between ESBL-producing and ESBL-nonprocuding isolates for nitrofurantoin susceptibility rates (p<0.001). Conclusion: In the light of present study, we consider that nitrofurantoin may be used safely for the therapy of UTIs at least in our hospital.

Kaynakça

1. Hoban DJ, Nicolle LE, Hawser S, Bouchillon S, Badal R. Antimicrobial Susceptibility of Global Inpatient Urinary Tract Isolates of Escherichia Coli: Results from the Study for Monitoring Antimicrobial Resistance Trends (SMART) Program: 2009-2010. Diag Microbiol Infect Dis 2011;70(4):507-11.

2. Yoon JE, Kim WK, Lee JS, Shin KS, Ha TS. Antibiotic Susceptibility and Imaging Findings of the Causative Microorganisms Responsible for Acute Urinary Tract Infection in Children: a Five-year Single Center Study. Korean J Pediatr 2011;54(2):79-85.

3. Mendoza-Valdes A, Rosete A, Bueno ER, Frentzel A, Trapp S, Kirch W, et al. Antimicrobial and Clinical Efficacy of Nitrofurantoin in the Treatment of Acute Lower Urinary Tract Infections in Adults. Medizinische Klinik (Munich, Germany: 1983) 2010;105(10):698-704.

4. Liu HY, Lin HC, Yu SH, Wu WH, Lee YJ. Antimicrobial Susceptibilities of Urinary Extended-spectrum Beta-lactamase-producing Escherichia Coli and Klebsiella Pneumoniae to Fosfomycin and Nitrofurantoin in a Teaching Hospital in Taiwan. J Microbiol Immunol Infect 2011;44:364-8.

5. Kahlmeter G. The ECO.SENS Project: a Prospective, Multinational, Multicentre Epidemiological Survey of the Prevalence and Antimicrobial Susceptibility of Urinary Tract Pathogens-Interim Report. J Antimicrob Chemother 2000;46(Suppl 1):15-22.

6. Zhanel GG, Hisanaga TL, Laing NM, DeCorby MR, Nichol KA, Palatnick LP, et al. Antibiotic Resistance in Outpatient Urinary Isolates: Final Results from the North American Urinary Tract Infection Collaborative Alliance (NAUTICA). Int J Antimicrob Agents 2005;26(5):380-8.

7. Kashanian J, Hakimian P, Blute M, Wong J, Khanna H, Wise G, et al. Nitrofurantoin: The Return of an Old Friend in the Wake of Growing Resistance. BJU Int 2008;102(11):1634-7.

8. Benwan KA, Sweih NA, Rotimi VO. Etiology and Antibiotic Susceptibility Patterns of Community- and Hospital-acquired Urinary Tract Infections in a General Hospital in Kuwait. Med Princ Pract 2010;19(6):440-6.

9. Kahlmeter G, Poulsen HO. Antimicrobial Susceptibility of Escherichia Coli from Community-acquired Urinary Tract Infections in Europe: The ECO·SENS Study Revisited. Int J Antimicrob Agents 2011 (Available online 3 November 2011).

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Kaynak Göster

Yeni Tıp Dergisi
  • ISSN: 1300-2317
  • Yayın Aralığı: Yılda 0 Sayı
  • Başlangıç: 2018

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