.: ORİJİNAL ARAŞTIRMA
Cinsiyet Farklılığının İdrar Kültürlerinden İzole Edilen Escherichia coli Suşlarındaki Antibiyotik Direncine Etkileri:Kesitsel Tanımlayıcı Araştırma
The Effects of Sex Differences on Antibiotic Resistance in Escherichia coli Strains Isolated from Urine Cultures: Cross-Sectional Descriptive Research
J Reconstr Urol. 2023;13(2):60-6
doi: 10.5336/urology.2023-98144
Makale Dili: TR
Tam Metin
ÖZET
Amaç: Üriner enfeksiyonlar içerisindeki Escherichia coli (E. coli) yoğunluğunun tespit edilmesi, E. coli suşlarına karşı antibiyotik direncinin cinsiyet farklılığıyla ilişkisinin ve bölgesel antibiyotik direncinin öğrenilmesi. Gereç ve Yöntemler: Mart 2021-Aralık 2021 tarihleri arasında Samsun Vezirköprü Devlet Hastanesi poliklinikleri ve servislerinde alınan idrar kültürlerinde üreme saptanan 342 hasta değerlendirildi. E. coli suşlarına karşı gelişen antibiyotik direnci hastaların cinsiyet farklılığına göre değerlendirildi. Bulgular: Toplam 2.167 idrar kültürü alındı, 75 tanesi kontamine idi. 1.750 örnekte üreme saptanmadı, 342 örnekte bakteri ya da mantar üremesi saptandı. Pozitif idrar kültürü sonucu olanların yalnızca 10 tanesi yatan hastalardan, kalanların tamamı ayaktan hasta başvurusu sırasında polikliniklerden alındı. Polikliniklerden alınan örneklerden 252 tanesinde üreyen mikroorganizma E. coli idi. 80 örnekteki üreme Candida türleri ve diğer bakterilere aitti. Polikliniklerde E. coli üremesi olanların antibiyogram direnç profilinde en yüksek direnç %67,85 ile ampisiline karşı olmuştur. Siprofloksasin direnci kadınlarda %13,06 iken erkeklerde %30,26 tespit edilmiştir (p: 0,001). Sefazolin direnci kadınlarda %19,31 iken erkeklerde %51,31 tespit edilmiştir (p<0,001). Sonuç: Toplum kökenli üriner enfeksiyon etkenlerinin en sık sebebi E. coli'dir. Üriner enfeksiyondan şüphelenildiğinde ampirik antibiyoterapi başlanırken olası antibiyotik dirençleri de düşünülüp en uygun antibiyotik başlanmalıdır. Yüksek ampisilin direnci öngörülerek mümkünse ampirik tedavide bu antibiyotiğe yer verilmemelidir. Sefazolin ve siprofloksasin direnci erkeklerde kadınlara göre istatistiki anlamlı farklılık oluşturacak düzeyde daha fazladır. Ampirik antibiyoterapi başlanırken cinsiyet faktörünün göz önünde tutulması gerekmektedir.
Anahtar Kelimeler: Bakteri; ilaç direnci; cinsiyet; Escherichia coli
Amaç: Üriner enfeksiyonlar içerisindeki Escherichia coli (E. coli) yoğunluğunun tespit edilmesi, E. coli suşlarına karşı antibiyotik direncinin cinsiyet farklılığıyla ilişkisinin ve bölgesel antibiyotik direncinin öğrenilmesi. Gereç ve Yöntemler: Mart 2021-Aralık 2021 tarihleri arasında Samsun Vezirköprü Devlet Hastanesi poliklinikleri ve servislerinde alınan idrar kültürlerinde üreme saptanan 342 hasta değerlendirildi. E. coli suşlarına karşı gelişen antibiyotik direnci hastaların cinsiyet farklılığına göre değerlendirildi. Bulgular: Toplam 2.167 idrar kültürü alındı, 75 tanesi kontamine idi. 1.750 örnekte üreme saptanmadı, 342 örnekte bakteri ya da mantar üremesi saptandı. Pozitif idrar kültürü sonucu olanların yalnızca 10 tanesi yatan hastalardan, kalanların tamamı ayaktan hasta başvurusu sırasında polikliniklerden alındı. Polikliniklerden alınan örneklerden 252 tanesinde üreyen mikroorganizma E. coli idi. 80 örnekteki üreme Candida türleri ve diğer bakterilere aitti. Polikliniklerde E. coli üremesi olanların antibiyogram direnç profilinde en yüksek direnç %67,85 ile ampisiline karşı olmuştur. Siprofloksasin direnci kadınlarda %13,06 iken erkeklerde %30,26 tespit edilmiştir (p: 0,001). Sefazolin direnci kadınlarda %19,31 iken erkeklerde %51,31 tespit edilmiştir (p<0,001). Sonuç: Toplum kökenli üriner enfeksiyon etkenlerinin en sık sebebi E. coli'dir. Üriner enfeksiyondan şüphelenildiğinde ampirik antibiyoterapi başlanırken olası antibiyotik dirençleri de düşünülüp en uygun antibiyotik başlanmalıdır. Yüksek ampisilin direnci öngörülerek mümkünse ampirik tedavide bu antibiyotiğe yer verilmemelidir. Sefazolin ve siprofloksasin direnci erkeklerde kadınlara göre istatistiki anlamlı farklılık oluşturacak düzeyde daha fazladır. Ampirik antibiyoterapi başlanırken cinsiyet faktörünün göz önünde tutulması gerekmektedir.
Anahtar Kelimeler: Bakteri; ilaç direnci; cinsiyet; Escherichia coli
ABSTRACT
Objective: To determine the frequency of Escherichia coli (E. coli) in urinary infections, to learn the relationship between antibiotic resistance against E. coli strains with sex differences and regional antibiotic resistance. Material and Methods: Between March 2021 and December 2021, 342 patients with urine cultures collected from Samsun Vezirköprü State Hospital outpatient clinics and services were evaluated. Antibiotic resistance to E. coli strains was evaluated according to the sex differences of the patients. Results: A total of 2,167 urine culture samples were collected, 75 of them were contaminated. No growth was detected in 1,750 samples, there were only 342 samples containing bacteria or fungus. Only 10 of the patients with a positive urine culture result were taken from hospitalized inpatients at the time of admission, and all of the remaining ones from the outpatient clinics. The microorganism that grew in 252 of the samples taken from the outpatient clinics was E. coli. Growth in 80 samples was Candida species and other bacteria. In the antibiogram resistance profile of those with E. coli growth in outpatient clinics, the highest resistance was against ampicillin with 67.85%. While ciprofloxacin resistance was 13.06% in women, it was 30.26% in men (p: 0.001). Cefazolin resistance was determined as 19.31% in women and 51.31% in men (p<0.001). Conclusion: The most common cause of community-acquired urinary infections is E. coli. When a urinary infection is suspected, possible antibiotic resistances should be considered while starting empirical antibiotic therapy, and the most appropriate antibiotic should be started. Considering high ampicillin resistance, this antibiotic should not be included in empirical treatment if possible. Cefazolin and ciprofloxacin resistance is higher in males than in females, at a level that creates a statistically significant difference. Sex factor should be taken into consideration when starting empirical antibiotic therapy.
Keywords: Bacteria; drug resistance; sex; Escherichia coli
Objective: To determine the frequency of Escherichia coli (E. coli) in urinary infections, to learn the relationship between antibiotic resistance against E. coli strains with sex differences and regional antibiotic resistance. Material and Methods: Between March 2021 and December 2021, 342 patients with urine cultures collected from Samsun Vezirköprü State Hospital outpatient clinics and services were evaluated. Antibiotic resistance to E. coli strains was evaluated according to the sex differences of the patients. Results: A total of 2,167 urine culture samples were collected, 75 of them were contaminated. No growth was detected in 1,750 samples, there were only 342 samples containing bacteria or fungus. Only 10 of the patients with a positive urine culture result were taken from hospitalized inpatients at the time of admission, and all of the remaining ones from the outpatient clinics. The microorganism that grew in 252 of the samples taken from the outpatient clinics was E. coli. Growth in 80 samples was Candida species and other bacteria. In the antibiogram resistance profile of those with E. coli growth in outpatient clinics, the highest resistance was against ampicillin with 67.85%. While ciprofloxacin resistance was 13.06% in women, it was 30.26% in men (p: 0.001). Cefazolin resistance was determined as 19.31% in women and 51.31% in men (p<0.001). Conclusion: The most common cause of community-acquired urinary infections is E. coli. When a urinary infection is suspected, possible antibiotic resistances should be considered while starting empirical antibiotic therapy, and the most appropriate antibiotic should be started. Considering high ampicillin resistance, this antibiotic should not be included in empirical treatment if possible. Cefazolin and ciprofloxacin resistance is higher in males than in females, at a level that creates a statistically significant difference. Sex factor should be taken into consideration when starting empirical antibiotic therapy.
Keywords: Bacteria; drug resistance; sex; Escherichia coli
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