İdrar kültürlerinden izole edilen Escherichia coli suşlarının antibiyotik duyarlılığı ve genişlemiş spektrumlu beta-laktamaz oranı
Küçük Resim Yok
Tarih
2013
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bakteriyel infeksiyonların ilk sıralarında üriner sistem infeksiyonları yer almaktadır ve bu infeksiyonlardan en sık Escherichia coli izole edilmektedir. Antibiyotiklere karşı gelişen direncin artması ve yayılması bütün dünyada olduğu gibi ülkemizde de büyük bir sorundur. Genişlemiş spektrumlu beta-laktamaz (GSBL) üretimi, E.coli’nin de içinde bulunduğu Enterobacteriaceae üyelerinin geliştirdiği en önemli direnç mekanizmalarından biridir. Bu çalışmanın amacı üriner sistem infeksiyonu ön tanılı hastaların laboratuvarımıza gönderilen idrar örneklerinden izole edilen E.coli suşlarında GSBL üretimini araştırmak ve GSBL üreten ve üretmeyen suşlar arasındaki antibiyotik direnç profilini karşılaştırmaktır. İdrar örneklerinden izole edilen E.coli suşlarının antibiyotik duyarlılık profili ve GSBL üretimi retrospektif olarak değerlendirilmiştir. Bakteri identifikasyonu konvansiyonel yöntemlerle yapılmış, suşların antibiyotik duyarlılıkları Clinical and Laboratory Standards Institute önerileri dikkate alınarak Kirby-Bauer disk difüzyon yöntemi ile saptanmıştır. GSBL üretimi, çift disk sinerji testi ile belirlenmiştir. Poliklinik hastalarından 276, yatan hastalardan 135 olmak üzere toplam 411 anlamlı E. coli üremesi belirlenmiştir. GSBL üretimi, yatan hastalarda % 44, poliklinik hastalarında % 26 ve toplam % 32 olarak saptanmıştır. En etkili antibiyotiklerin GSBL üreten suşlarda sırasıyla meropenem (% 95), nitrofurantoin (% 82), amikasin (% 77) ve netilmisin (% 72); GSBL üretmeyen suşlarda ise meropenem, sefepim, seftriakson, seftazidim, ve sefotaksim (% 100), amikasin (% 99), netilmisin (% 97) ve piperasilin-tazobaktam (% 96) olduğu belirlenmiştir. Tüm suşların en yüksek direnç gösterdiği antibiyotikler ise ampisilin, sefalotin ve sefuroksim olarak saptanmıştır. Duyarlılık sonuçları GSBL üretimi açısından karşılaştırıldığında, GSBL üreten E.coli suşlarında direnç oranlarının üretmeyen suşlara oranla daha yüksek olduğu görülmüştür (p0.05). Sonuç olarak artan direnç gelişiminin izlenmesi ve elde edilen sonuçlara göre ulusal düzeyde antibiyotik kullanım politikalarının yeniden düzenlenmesi gerekmektedir.
Urinary system infections are ranked as the most seen ones among bacterial infections, and from these infections, Escherichia coli is the most isolated organism. The increasing rate and spread of resistance against antibiotics are a serious problem in our country as well as all over the world. Extended spectrum beta-lactamase (ESBL) production is one of the most significant resistance mechanisms produced by Enterobacteriaceae members included E.coli. The aim of this study is to investigate the production of ESBL in E.coli strains isolated from urinary specimens of patients with a prediagnosis of urinary system infection, and to compare differences of antibiotic resistance profiles between ESBL producing and nonproducing strains. Antibiotic susceptibility profiles and ESBL production of E.coli strains isolated from urine samples were evaluated retrospectively. Bacterial identification was performed by conventional methods and antibiotic susceptibility testing was investigated by Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute criteria. ESBL production was determined by double-disk synergy test. A total of 411 significant growth of E.coli, were identified belonging to 276 outpatients and 135 inpatients. The prevalence of ESBL production in inpatients was found to be 44 %, in outpatients 26 %, and in total 32 %. The antibiotics to which ESBL producing strains are most susceptible were as follows: meropenem (95 %), nitrofurantoin (82 %), amikacin (77 %) and netilmicin (72 %). The antibiotics to which ESBL nonproducing strains are most susceptible were as following: meropenem, cefepime, ceftriaxone, ceftazidime, cefotaxime (100 %), amikacin (99 %), netilmicin (97 %) and piperacillin-tazobactam (96 %). The antibiotics to which all strains are most resistant were ampicillin, cephalothin and cefuroxime. Comparing the results of sensitivity in terms of ESBL production, resistance rates were higher in ESBL producing E.coli than in nonproducing strains (p<0.05). In conclusion, the spread of increasing resistance must be surveyed, and national antibiotic usage policies must be reorganized according to data obtained from these studies.
Urinary system infections are ranked as the most seen ones among bacterial infections, and from these infections, Escherichia coli is the most isolated organism. The increasing rate and spread of resistance against antibiotics are a serious problem in our country as well as all over the world. Extended spectrum beta-lactamase (ESBL) production is one of the most significant resistance mechanisms produced by Enterobacteriaceae members included E.coli. The aim of this study is to investigate the production of ESBL in E.coli strains isolated from urinary specimens of patients with a prediagnosis of urinary system infection, and to compare differences of antibiotic resistance profiles between ESBL producing and nonproducing strains. Antibiotic susceptibility profiles and ESBL production of E.coli strains isolated from urine samples were evaluated retrospectively. Bacterial identification was performed by conventional methods and antibiotic susceptibility testing was investigated by Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute criteria. ESBL production was determined by double-disk synergy test. A total of 411 significant growth of E.coli, were identified belonging to 276 outpatients and 135 inpatients. The prevalence of ESBL production in inpatients was found to be 44 %, in outpatients 26 %, and in total 32 %. The antibiotics to which ESBL producing strains are most susceptible were as follows: meropenem (95 %), nitrofurantoin (82 %), amikacin (77 %) and netilmicin (72 %). The antibiotics to which ESBL nonproducing strains are most susceptible were as following: meropenem, cefepime, ceftriaxone, ceftazidime, cefotaxime (100 %), amikacin (99 %), netilmicin (97 %) and piperacillin-tazobactam (96 %). The antibiotics to which all strains are most resistant were ampicillin, cephalothin and cefuroxime. Comparing the results of sensitivity in terms of ESBL production, resistance rates were higher in ESBL producing E.coli than in nonproducing strains (p<0.05). In conclusion, the spread of increasing resistance must be surveyed, and national antibiotic usage policies must be reorganized according to data obtained from these studies.
Açıklama
Anahtar Kelimeler
Farmakoloji ve Eczacılık
Kaynak
ANKEM Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
27
Sayı
1
