Alicem TEKİN, Tuba DAL, Özcan DEVECİ, Recep TEKİN, Hasan BOZDAĞ, TUNCER ÖZEKİNCİ

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

Anahtar Kelimeler:

İlaç direnci, mikrobiyal, Nitrofurantoin, Mikrobiyal duyarlılık testleri, Escherichia coli, İdrar yolu enfeksiyonları

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’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.

Keywords:

Drug Resistance, Microbial, Nitrofurantoin, Microbial Sensitivity Tests, Escherichia coli, Urinary Tract Infections,

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