Investigation of Antibiotic Resistance and ESBL-Presence of Community-Acquired Escherichia Coli Strains, Isolated from UTI in Afşin State Hospital [Afşin Devlet Hastanesinde, İdrar Örneklerinden İzole Edilen Toplum Kaynaklı Escherichia Coli Suşlarının Ant

Yücel DUMAN; İlkay BOZKURT; Mehmet Sait TEKEREKOĞLU

Article Details

Investigation of Antibiotic Resistance and ESBL-Presence of Community-Acquired Escherichia Coli Strains, Isolated from UTI in Afşin State Hospital [Afşin Devlet Hastanesinde, İdrar Örneklerinden İzole Edilen Toplum Kaynaklı Escherichia Coli Suşlarının Ant

Authors:

Yücel DUMAN | İlkay BOZKURT | Mehmet Sait TEKEREKOĞLU

Publisher:

Inonu University

Journal:

Medicine Science 2014 Vol.3 Issue 3, pp.1408-1418

Document Type:

Article

Publication Date:

9/2014

Document Language:

Turkish

Document ID (Org No.):

2000828452

Frequency:

Quarterly

eISSN:

2147-0634

pISSN:

2147-0634

Keywords:

Abstract:

 

Escherichia coli is the most common microorganisms isolated from community-acquired urinary tract infections (UTIs). Furthermore increasing frequency of extended spectrum β-lactamase (ESBL) positive E. coli strains in community-acquired UTIs has led to increasing rates of resistance to antibiotics that used in empirical treatment. The aim of this study was to determine the antimicrobial resistance patterns and epidemiological characteristics of community-acquired E.coli strains in our geographical region. The 3887 (2146 women and 1741 men) urine culture samples examined between September 2011 - September 2013 which were sent to microbiology laboratory from outpatient clinics of our hospital with a preliminary diagnosis of UTIs. 697 (18%) of urine culture samples were find positive; 423 (61%) were female, 274 (39%) were male. By using conventional methods, 352(51%) of the isolated strains were identified as E.coli. Antimicrobial susceptibilities of E.coli strains determined by Clinical Laboratory Standards Institute criteria. Extended spectrum β-lactamase was investigated by double-disk synergy test. The 352 isolated strains of E.coli belong to 47% of urology, 28% of internal medicine and 25% of pediatric patients urine cultures. The highest resistance ratio was observed against to ampicillin according to 68% treatments. There was no resistance found against imipenem and amikacin and 2% of resistance determined to fosfomycin trometamol. The 53 (15%) of isolated strains had extended spectrum β-lactamase. Determination of the antimicrobial resistance rates and selection of the empirical treatment according to these results will prevent the ESBL production and development of resistance to antimicrobials in our region. Also, we hope this study will help to determine the differences between similar geographical regional studies and comparing the results.

 


Abstract

Escherichia coli is the most common microorganisms isolated from community-acquired urinary tract infections (UTIs). Furthermore increasing frequency of extended spectrum β-lactamase (ESBL) positive E. coli strains in community-acquired UTIs has led to increasing rates of resistance to antibiotics that used in empirical treatment. The aim of this study was to determine the antimicrobial resistance patterns and epidemiological characteristics of community-acquired E.coli strains in our geographical region. The 3887 (2146 women and 1741 men) urine culture samples examined between September 2011 - September 2013 which were sent to microbiology laboratory from outpatient clinics of our hospital with a preliminary diagnosis of UTIs. 697 (18%) of urine culture samples were find positive; 423 (61%) were female, 274 (39%) were male. By using conventional methods, 352(51%) of the isolated strains were identified as E.coli. Antimicrobial susceptibilities of E.coli strains determined by Clinical Laboratory Standards Institute criteria. Extended spectrum β-lactamase was investigated by double-disk synergy test. The 352 isolated strains of E.coli belong to 47% of urology, 28% of internal medicine and 25% of pediatric patients urine cultures. The highest resistance ratio was observed against to ampicillin according to 68% treatments.  There was no resistance found against imipenem and amikacin and 2% of resistance determined to fosfomycin trometamol. The 53 (15%) of isolated strains had extended spectrum β-lactamase. Determination of the antimicrobial resistance rates and selection of the empirical treatment according to these results will prevent the ESBL production and development of resistance to antimicrobials in our region. Also, we hope this study will help to determine the differences between similar geographical regional studies and comparing the results.

 

Key Words: E.coli, ESBL, community-acquired UTI, antimicrobial resistance

Özet

Escherichia coli toplum kaynaklı üriner sistem enfeksiyonlarından (ÜSE) etken olarak en sık izole edilen mikroorganizmadır. Genişlemiş spektrumlu β-laktamaz (GSBL) pozitif E.coli suşlarının toplum kaynaklı ÜSE’lerde sıklığının artması ile beraber ampirik tedavide kullanılan antibiyotiklere karşı direnç oranlarının artmasına neden olmaktadır. Bu çalışmanın amacı toplum kaynaklı ÜSE etkenlerinden olan E.coli suşlarının antimikrobiyal paternleri belirlenerek, bölgemizdeki direnç oranlarının ve epidemiyolojik özelliklerinin araştırılmasıdır. Eylül 2011- Eylül 2013 tarihleri arasında hastanemiz polikliniklerinden toplum kökenli ÜSE ön tanısıyla mikrobiyoloji laboratuvarımıza gönderilen 3887(2146 kadın, 1741 erkek) idrar kültür örneği incelendi. İdrar kültür örneklerinin 697’sinde(%18) üreme oldu. İdrar kültür örneklerinde üreme saptanan hastaların 423’ü(%61) bayan, 274’ü(%39) erkekti. İzole edilen bakterilerin 352’si(%51) konvansiyonel yöntemlerle E.coli olarak tanımlandı. Tanımlanan E.coli suşlarının antimikrobiyal direnç durumu Clinical Laboratory Standards Institute kriterleri ile belirlendi. GSBL oranları ise çift disk sinerji testi ile araştırıldı. İzole edilen 352 E.coli suşu’nun, %47’si üroloji, %28’i dahiliye ve %25’i pediatri polikliniklerine ayaktan başvuran hastaların idrar kültür örneklerine aitti. E.coli suşlarında %62 ile en yüksek direnç oranı ampisiline karşı görüldü. İmipenem ve amikasine karşı ise direnç saptanmazken fosfomisin trometamole %2 oranında direnç belirlendi. İzole edilen suşların 53’ünde(%15) GSBL varlığı saptandı. Bölgemizdeki antimikrobiyal direnç oranlarının belirlenmesi, ampirik tedavide akılıcı ilaç kullanımına katkıda bulunarak, GSBL üretimi ve direnç gelişimini önleyecek, antibiyotiklerin etkin kullanılmasına katkıda bulunacağı inancındayız. Ayrıca çalışmamızın benzer bölgesel çalışmalara ışık tutarak farklılıkların gösterilebilmesi ve sonuçların karşılaştırılabilmesi açısından yararlı olacağı kanısındayız. 

 

Anahtar Kelimeler: E.coli, GSBL, toplum kaynaklı üriner enfeksiyon, antimikrobiyal direnç

.

Article Details

Investigation of Antibiotic Resistance and ESBL-Presence of Community-Acquired Escherichia Coli Strains, Isolated from UTI in Afşin State Hospital [Afşin Devlet Hastanesinde, İdrar Örneklerinden İzole Edilen Toplum Kaynaklı Escherichia Coli Suşlarının Ant

Authors: Yücel DUMAN | İlkay BOZKURT | Mehmet Sait TEKEREKOĞLU

Publisher: Inonu University

Journal: Medicine Science 2014 Vol.3 Issue 3, pp.1408-1418

Document Type: Article

Publication Date: 9/2014

Document Language: Turkish

Document ID (Org No.): 2000828452

Frequency: Quarterly

eISSN: 2147-0634

pISSN: 2147-0634

E.coli

GSBL

toplum kaynaklı üriner enfeksiyon

antimikrobiyal direnç

Issues

Authors:

Yücel DUMAN | İlkay BOZKURT | Mehmet Sait TEKEREKOĞLU

Publisher:

Inonu University

Journal:

Medicine Science 2014 Vol.3 Issue 3, pp.1408-1418

Document Type:

Article

Publication Date:

9/2014

Document Language:

Turkish

Document ID (Org No.):

2000828452

Frequency:

Quarterly

eISSN:

2147-0634

pISSN:

2147-0634