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Üriner sistem enfeksiyonu (ÜSİ) klinik pratikte en sık karşılaşılan enfeksiyonlardandır. Bu çalışmada, ÜSİ etkenlerinin ve antimikrobiyal duyarlılıklarının incelenmesi ve ampirik tedavide sıkça kullandığımız antibiyotikeri gözden geçirmek amaçlanmıştır. Ocak 2018-Aralık 2019 tarihlerinde, hastanemiz klinik mikrobiyoloji laboratuvarına ÜSİ ön tanısı ile gönderilen idrarlar incelendi. Üropatojenlerin identifikasyonu ve antibiyotik duyarlılıkları tam otomatize sistemle belirlendi. ÜSİ tanısı olan hastalardan izolen edilen 537 (%68,5 ayaktan ve %31,5 yatan hastalardan elde edilen) üropatojen arasında E.coli (%66,5) en sık etkendi. Gram-negatif bakterilerde genişlemiş spektrumlu beta-aktamaz (GSBL) üretimi %14,9 oranında saptandı. Antibiyotiklere duyarlılıkları incelendiğinde siprofloksasin ve trimetoprim-sulfametoksazol için %40, sefuroksim için %50, gentamisin için %17, nitrofurantoin için %15 ve fosfomisin için %6 civarında direnç saptandı. Direnç oranları, yatarak tedavi gören hastalarda anlamlı olarak daha yüksekti. Üropatojenlerde direnç artışı tedavide önemli bir sorundur. Bölgesel antibiyotik duyarlılıklarının bilinmesi, akılcı antibiyotik kullanımı için önem arz eder. Tedavide kinolon kullanımından kaçınılmalıdır. Komplike olmayan üriner sistem enfeksiyonlarında nitrofurantion ve fosfomisin kullanımı güvenli olacaktır.
Urinary system infection (URI) is a clinical practice of infections. This study aims to study the bacterial factors and antimicrobial sensitivities and to review the antibiotics we frequently use in ampyric therapy. In January 2018 and December 2019, the urine sent to the clinical microbiology laboratory of our hospital with pre-diagnosis was examined. The identification of uropathogens and antibiotic sensitivities were determined by a fully automated system. E.coli (66,5%) was frequently affected among the 537 (68,5% obtained from the legs and 31,5% from the beds) uropathogens that were isolated from the patients diagnosed with BSE. In Gram-negative bacteria, the extended spectrum beta-actamate (GSBL) production was observed at 14.9%. When antibiotic sensitivities were studied, there was a resistance of about 40% for siprofloksacin and trimetoprim-sulfametoxazole, 40% for sefuroxine, 15% for gentamine, 15% for nitrofurantoin and 6% for phosphomycin. Resistance rates were significantly higher in patients who were treated by bed. Increased resistance to uropathogens is a major problem in treatment. The knowledge of the regional antibiotic sensitivities is of importance for the reasonable use of antibiotics. The use of kinolone should be avoided. The use of nitrofurantion and phosphomycin in non-complicated urinary system infections will be safe.
Urinary system infection (UTI) is one of the most common infections in clinical practice. In this study, we aimed to examine the UTI agents and their antimicrobial susceptibility and to evaluate the antibiotics we use frequently in empirical treatment. The urine samples obtained from patients diagnosed with UTI were analyzed at the clinical microbiology laboratory of our hospital (from January 2018 to December 2019). A fully automated system was used to identify uropathogens and determine antibiotic susceptibilities. Among 537 (68.5% outpatients and 31.5% inpatients) isolates were evaluated. E.coli (66.5%) was the most common uropathogen. Extended spectrum beta-lactamase (ESBL) production was found in 14.9% of Gram-negative bacteria. The analysis of the antibiotic susceptibility test results indicated that resistance to ciprofloxacin and trimethoprim-sulfamethoxazole was 40%, cefuroxime was 50%, gentamicin was 17%, nitrofurantoin was 15% and fosfomycin was 6%, approximately. Resistance rates were found to be significantly higher in inpatients. Increased resistance rates in uropathogens is a serious problem for UTI treatment. It is important to know the local antibiotic resistance patterns for rational antibiotic use. The use of quinolone should be avoided for empiric treatment. Nitrofurantoin and fosfomycin use will be safe in uncomplicated urinary tract infections.
Alan : Sağlık Bilimleri
Dergi Türü : Ulusal
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