Mehmet Bilgehan YÜKSEL

Güncel pratikte komplike olmamış idrar yolu enfeksiyonlarında sık karşılaşılan etken mikroorganizmalar ve antibiyotik duyarlılıklarının değerlendirilmesi

Amaç: Komplike olmamış üriner enfeksiyonlarda saptanan etken mikroorganizmaların sıklığını, antimikrobiyal ajanların enfeksiyon etkenlerine karşı etkinliğini ve sık rastlanan patojen mikroorganizmaların antibiyotik rezistanslarını değerlendirmek.Gereç ve yöntem: Komplike olmamış idrar yolu enfeksiyonu şüphesi olan hastaların idrar kültürleri retrospektif olarak incelendi. Orta akım temiz yakalama tekniği kullanılarak üç idrar örneği rutin olarak toplandı. Alınan örnekler, standart mikrobiyolojik prosedürler kullanılarak test edildi. Antibiyotik duyarlılığı, KirbyBauer tekniği kullanılarak analiz edildi.Bulgular: 2850 idrar kültürü değerlendirildi. En sık izole edilen etken patojen mikroorganizma E. Coli idi %66.4 . E. Coli’ nin en sık direnç gösterdiği antibiyotikler ampisilin 63.2% ve amoksisilin klavulonat 58.1% idi; fakat tüm E. Coli örnekleri karbapeneme duyarlı idi. Enterokok grubunda vankomisin rezistansı bulunmazken; bu grupta nitrofurantoinin en etkili antibiyotik idi. Tüm stafilokok grubu vankomisin ve teikoplanine duyarlı iken bu gruptaki metisilin direnci sıklığı 33.3% olarak bulundu. Streptokokların tümü penisilinin yanısıra levofloksasin 95.4% ve sefotaksime de 93.9% duyarlı idi. Bu grupta tetrasiklin rezistans oranı 75.1% olarak saptandı.Sonuçlar: Komplike olmamış idrar yolu enfeksiyonlarında en sık saptanan etken patojen mikroorganizma E. Coli’dir 66.4% . Üriner enfeksiyonlarda genelde idrar kültürü sonucu olmadan tedaviye başlandığından antibiyotiklerin etkisi daha az olmaktadır

Anahtar Kelimeler:

Üriner sistem enfeksiyonu, etyolojik ajanlar, antibiyotik duyarlılığı, geleneksel tedavi

The evaluation of the common pathogenic microorganisms in uncomplicated urinary tract infections and the antibiotic susceptibilities in daily practice

Objective: To evaluate the frequency of the causative pathogens for the uncomplicated urinary tract infections, the efficacy of antimicrobial agents and the antimicrobial resistance of common pathogens.Materials and methods: The culture-antibiogram results of patients with probable uncomplicated urinary tract infections were retrospectively analysed. Three urine samples were routinely collected by the mid-stream “clean catch” method. The samples were tested microbiologically by standard procedures. Antibiotic susceptibility was analysed by Kirby-Bauer technique.Results: 2850 urine cultures were analysed. The most commonly isolated pathogen was E. Coli %66.4 . E.Coli most commonly had antibiotic resistance for ampicillin 63.2% and amoxicillin clavulanat 58.1% ; but all E. Coli samples were susceptible for Carbapenems. Vancomycin resistance was not found in Enterococcus spp and Nitrofurantoin was the most effective antibiotic against this group. All Staphilococcus spp. were susceptible for Vancomycin and Teicoplanin and the resistance rate of Methicillin was 33.3%. All of Streptococcus spp. had susceptibility for Penicillin and the other susceptible antibiotics were Levofloxacin 95.4% and Cefotaxime 93.9% . Tetracycline resistance in this group were 75.1%.Conclusion: The most common ethiologic pathogene in uncomplicated UTI is E.Coli 66.4% . The conventional antibiotics for UTI are less effective and the treatment commonly starts without any results of urine culture

Keywords:

Urinary tract infection, ethiologic agents, antibiotic susceptibility, conventional management,

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