Çocukluk çağı idrar yolu enfeksiyonlarında Escherichia coli ve antibiyotik direnci

SDÜ Tıp Fakültesi Dergisi; Vol 13, No 2 (2006) 01/2006;
Source: OAI


SüleymanDemirel Üniversitesi TIP FAKÜLTESİ DERGİSİ: 2006 Haziran; 13(2) Çocukluk çağı idrar yolu enfeksiyonlarında Escherichia coli ve antibiyotik direnci Hasan Çetin, Faruk Öktem, Ahmet R. Örmeci, Birdal Yorgancıgil, Güler Yaylı Özet EGb Mannitol ve U74389F ile karşılaştırmalı olarak serebral iskemi üzerine koruyucu rolü Amaç: Çocukluk çağında idrar yolu enfeksiyonları ve antibiyotik direnci halen önemli bir sağlık sorunudur. Bu çalışmada E. coli ile gelişen idrar yolu enfeksiyonunda antibiyotik direncini ve yıllar içinde antibiyotik direncinde gelişen değişiklikleri ortaya çıkarmayı amaçladık. Yöntem: İdrar yolu enfeksiyonu olan çocukların mikrobiyolojik sonuçlarını retrospektif olarak değerlendirdik. Bulgular: İki yılda E. coli ile gelişen toplumdan kazanılmış idrar yolu enfeksiyonu olan 132 çocuk vardı. Ampisiline %79, ampisilin-sulbaktama %63.2, amoksisilin klavunata %53, ko-trimoksazole %82.2, gentamisine %6.6, netilmisine %10, amikasine %11.5, sefuroksime %21.9 ve seftriaksona %6.8 oranında direnç saptandı. Ko-trimoksazole karşı dirençte 3 yıl içinde anlamlı artış görüldü (p

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Available from: Ahmet Rifat Ormeci, Oct 19, 2014
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    ABSTRACT: Objective: In this study we aimed to determine the causative agents and their antibiotic susceptibility in children with urinary tract infection. Material and Methods: Urine cultures and antibiotic suspectibility testings were evaluated retrospectively in children diagnosed with urinary tract infection between September 2006 and August 2007.Results: In total, positive urine cultures of 166 female and 31 male patients were analysed. Results were classifıed by paediatric age groups; Group 1, 1-24 months; group 2, 2-14 years. The most common causative agent was Escherichia coli (E. coli) (84.8% of cases) followed by Enterobacter spp. (6.1% of cases). Antibiotic resistance were detected for E. coli as 71.3% to ampicillin, 52.7% to trimethoprim-sulphamethoxazole, 37.1% to ampicillin-sulbactam, 23.4% to amoxicillin-clavulanat, 7% to cefuroxime-axetil, 6% to cefotaxim, 6% to ceftriaxone, 5.5% to cefixim, 12% to ciprofloxacin, 5.4% to gentamycine and amikacin has no resistance. It was found that resistance to empirically and frequently used trimetoprim-sulphametoxasol and ampicillin was high.Conclusion: This state of affairs indicates the significance and necessity of performing antibiogram in the treatment of urinary infections in children, and suggests that, in cases where it is necessary to initiate empirical treatment, it is not appropriate to select trimetoprim-sulphametoxasol and Ampicillin. According to this study, it seems that in oral empirical treatment, primarily second-generation cephalosporins and secondarily penicillin type antibiotics that are resistant to beta lactamase are the appropriate alternatives.
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    ABSTRACT: To show the distribution and changes of causative agents of urinary tract infections in children and resistance rates by years and select the most appropriate antibiotics. In this study, the Başkent University Alanya Research and Application Hospital automation system microbiology recording book was screened retrospectively. Growth of a single microorganism above 105 colonies (cfu/mL) was included in the assessment. Throughout the study, 10 691 urinary cultures were studies and growth was found in 392 (3.7%). Three hundred and nine (78.8%) of the samples with growth belonged to girls. Growth was found in the neonatal period in 32 patients (8.2%). The most commonly isolated microorganism was Escherichia coli (E. coli) which was found in 68.4% of the patients. Klebsiella spp. were found with a rate of 12.0%; Enterobacter spp. were found with a rate of 10.7% and proteus spp. were found with a rate of 5.1%. Resistance to cefalotin (62.1%), trimethoprim-sulfamethoxasole (43.1%), amoxycillin-clavulanate (34.8%), ampicillin (30.4%), cefixim (26.3%) and nitrofurantoin (3.6%) was found in E. coli species. The antibiotic which had the highest resistance rate was ampicillin with a rate of 93.2% for klebsiella and 83.4% for enterobacter. Klebsiella spp. were the most commonly grown pathogens in newborns (40.6%). In a follow-up period of 5 years, the resistance of E. coli to amoxycillin-clavulanate regressed from 40.3% to 31.3%, while the resistance to trimethoprim-sulfamethoxasole (TMP-SMX) regressed from 45.6% to 34.7%. A high resistance against first-generation cephalosporins, ampicillin, amoxycillin-clavulanate and TMP-SMX which are the first-line antibiotics in childhood urinary tract infections was found. Carbapenem (meropenem, imipenem) resistance was not found in our center. Nitrofurantoin, aminoglycosides and cefixime can be recommended for empirical treatment in our hospital because of low resistance. Antibiotic treatment should be redecided according to in vitro antibiotic sensitivity results.
    Full-text · Article · May 2014 · Turk Pediatri Arsivi