What Should Be the Preference of Empirical Treatment in Urinary Tract Infections?

Metin Özdemir; Zeynep Şentürk Köksal

Makale detayları

What Should Be the Preference of Empirical Treatment in Urinary Tract Infections?

Yazarlar:

Metin Özdemir | Zeynep Şentürk Köksal

Yayıncı:

Karyay Karadeniz Yayımcılık

Ana Başlıklar:

Klinik Tıp Bilimleri (Diğer) | Aile Hekimliği

Dergi:

Black Sea Journal of Health Science Vol.7 Issue 2, pp.67-72

Belge Tipi:

Makale

Yayın Tarihi:

1/2024

Belge Dili:

Türkçe

Document ID (Org No.):

2001311723

pISSN:

2619-9041

Anahtar kelimeler:

Özet:

 Urinary tract infections are one of the most common infections in hospitals and society. In cases where culture is not possible, empirical treatment is critical in the treatment of the disease and the prevention of its complications. The aim of this study is to guide the clinician in starting empirical treatment with cumulative antibiogram analysis. The cultures of the urine samples that came to our laboratory between January 2014 and December 2022 were performed. The growing bacteria were identified using conventional methods, disc diffusion, BD Phoenix BD, USA and Vitek2 Biomerieux, France automated systems, and antibiotic susceptibility tests were performed. Initial isolate data were used when bacteria grown in a patient were of the same species. Antibiotics with a sensitivity rate of over 90 were recommended for empirical treatment. In our study, 86.6 of the factors grown in urine cultures were Gram - bacteria and 62.9 of the total were Escherichia coli. Considering all isolates, ciprofloxacin resistance is high and increasing in outpatients 44.6; It was determined that fosfomycin 10.8 and nitrofurantoin 13.2 resistances were low. In hospitalized patients, resistance to intravenous ceftriaxone 63.3 was found to be high, while resistance to ertapenem 29.3 was lower. It was observed that nitrofurantoin and ertapenem resistances were below 10 in E. coli isolates grown in outpatients and inpatients, and this was not valid for isolates other than E. coli. The resistance rate to all antibiotics in E. coli isolates was found to be significantly higher in inpatients than in outpatients P0.001 for each. Resistance to ciprofloxacin, imipenem and meropenem was found over 60 in patients hospitalized with non-fermenter bacteria. The findings obtained in our study show that nitrofurantoin and fosfomycin may be successful in outpatient treatment, and ertapenem and fosfomycin may be successful in empiric treatment compared to other antibiotics in inpatients, in cases where culture is not possible or until culture antibiogram results are obtained.

 Urinary tract infections are one of the most common infections in hospitals and society. In cases where culture is not possible, empirical treatment is critical in the treatment of the disease and the prevention of its complications. The aim of this study is to guide the clinician in starting empirical treatment with cumulative antibiogram analysis. The cultures of the urine samples that came to our laboratory between January 2014 and December 2022 were performed. The growing bacteria were identified using conventional methods, disc diffusion, BD Phoenix BD, USA and Vitek2 Biomerieux, France automated systems, and antibiotic susceptibility tests were performed. Initial isolate data were used when bacteria grown in a patient were of the same species. Antibiotics with a sensitivity rate of over 90 were recommended for empirical treatment. In our study, 86.6 of the factors grown in urine cultures were Gram - bacteria and 62.9 of the total were Escherichia coli. Considering all isolates, ciprofloxacin resistance is high and increasing in outpatients 44.6; It was determined that fosfomycin 10.8 and nitrofurantoin 13.2 resistances were low. In hospitalized patients, resistance to intravenous ceftriaxone 63.3 was found to be high, while resistance to ertapenem 29.3 was lower. It was observed that nitrofurantoin and ertapenem resistances were below 10 in E. coli isolates grown in outpatients and inpatients, and this was not valid for isolates other than E. coli. The resistance rate to all antibiotics in E. coli isolates was found to be significantly higher in inpatients than in outpatients P0.001 for each. Resistance to ciprofloxacin, imipenem and meropenem was found over 60 in patients hospitalized with non-fermenter bacteria. The findings obtained in our study show that nitrofurantoin and fosfomycin may be successful in outpatient treatment, and ertapenem and fosfomycin may be successful in empiric treatment compared to other antibiotics in inpatients, in cases where culture is not possible or until culture antibiogram results are obtained.

 Urinary tract infections are one of the most common infections in hospitals and society. In cases where culture is not possible, empirical treatment is critical in the treatment of the disease and the prevention of its complications. The aim of this study is to guide the clinician in starting empirical treatment with cumulative antibiogram analysis. The cultures of the urine samples that came to our laboratory between January 2014 and December 2022 were performed. The growing bacteria were identified using conventional methods, disc diffusion, BD Phoenix BD, USA and Vitek2 Biomerieux, France automated systems, and antibiotic susceptibility tests were performed. Initial isolate data were used when bacteria grown in a patient were of the same species. Antibiotics with a sensitivity rate of over 90 were recommended for empirical treatment. In our study, 86.6 of the factors grown in urine cultures were Gram - bacteria and 62.9 of the total were Escherichia coli. Considering all isolates, ciprofloxacin resistance is high and increasing in outpatients 44.6; It was determined that fosfomycin 10.8 and nitrofurantoin 13.2 resistances were low. In hospitalized patients, resistance to intravenous ceftriaxone 63.3 was found to be high, while resistance to ertapenem 29.3 was lower. It was observed that nitrofurantoin and ertapenem resistances were below 10 in E. coli isolates grown in outpatients and inpatients, and this was not valid for isolates other than E. coli. The resistance rate to all antibiotics in E. coli isolates was found to be significantly higher in inpatients than in outpatients P0.001 for each. Resistance to ciprofloxacin, imipenem and meropenem was found over 60 in patients hospitalized with non-fermenter bacteria. The findings obtained in our study show that nitrofurantoin and fosfomycin may be successful in outpatient treatment, and ertapenem and fosfomycin may be successful in empiric treatment compared to other antibiotics in inpatients, in cases where culture is not possible or until culture antibiogram results are obtained.

 İdrar yolu enfeksiyonları hastane ve toplumda en sık karşılaşılan enfeksiyonların başında gelmektedir. Kültür imkanı olmayan durumlarda ampirik tedavi hastalığın sağaltım ve komplikasyonlarının önlenmesinde kritik öneme sahiptir. Bu çalışmada amaç kümülatif antibiyogram analizi ile klinisyene ampirik tedaviye başlamada yol gösterici olmaktır. 2014 Ocak - 2022 Aralık arasında laboratuvarımıza gelen idrar örneklerinin kültürleri yapıldı. Üreyen bakteriler konvansiyonel yöntemler, disk difüzyon, BD Phoenix BD, ABD ve Vitek2 Biomerieux, Fransa otomatize sistemleri ile identifiye edilerek antibiyotik duyarlılık testleri yapıldı. Bir hastada üretilen bakterilerin aynı türden olması durumunda ilk izolat verisi kullanıldı. Duyarlılık oranı 90 üzerinde olan antibiyotikler ampirik tedavide önerildi. Çalışmamızda idrar kültürlerinde üreyen etkenlerin 86,6sının Gram - bakteriler ve toplamın 62,9unun Escherichia coli olduğu görüldü. Tüm izolatlara bakıldığında ayaktan hastalarda siprofloksasin direncinin yüksek ve artmakta olduğu 44,6; fosfomisin 10,8 ve nitrofurantoin 13,2 dirençlerinin düşük olduğu saptandı. Yatan hastalarda intravenöz olarak tercih edilen seftriakson direncinin 63,3 yüksek olduğu, ertapenem direncinin 29,3 daha düşük olduğu görüldü. Ayaktan ve yatan hastalarda üreyen E. coli izolatlarında nitrofurantoin ve ertapenem dirençlerinin 10 altında olduğu, E. coli dışındaki izolatlar için bu durumun geçerli olmadığı görüldü. E. coli izolatlarında tüm antibiyotiklere direnç oranının yatan hastalarda ayakta tedavi görenlere göre anlamlı yüksek olduğu saptandı her biri için P0,001. Non-fermenter bakterilerde yatan hastalarda siproflaksasin, imipenem ve meropenem direnci 60ın üzerinde bulundu. Çalışmamızda elde edilen bulgular kültür imkanı olmayan durumlarda veya kültür antibiyogram sonuçları elde edilene kadar ayaktan tedavide nitrofurantoin ve fosfomisinin, yatan hastalarda ertapenem ve fosfomisinin diğer antibiyotiklere göre ampirik tedavide başarılı olabileceğini göstermektedir.

Makale detayları

What Should Be the Preference of Empirical Treatment in Urinary Tract Infections?

Yazarlar:

Metin Özdemir | Zeynep Şentürk Köksal

Yayıncı:

Karyay Karadeniz Yayımcılık

Ana Başlıklar:

Klinik Tıp Bilimleri (Diğer) | Aile Hekimliği

Dergi:

Black Sea Journal of Health Science Vol.7 Issue 2, pp.67-72

Belge Tipi:

Makale

Yayın Tarihi:

1/2024

Belge Dili:

Türkçe

Document ID (Org No.):

2001311723

pISSN:

2619-9041

Urinary tract infection

Antibiotic resistance

Empirical treatmentİdrar yolu enfeksiyonu

Antibiyotik direnci

Ampirik tedavi

Sayı

Makale detayları

What Should Be the Preference of Empirical Treatment in Urinary Tract Infections?

Yazarlar: Metin Özdemir | Zeynep Şentürk Köksal

Yayıncı: Karyay Karadeniz Yayımcılık

Ana Başlıklar: Klinik Tıp Bilimleri (Diğer) | Aile Hekimliği

Dergi: Black Sea Journal of Health Science Vol.7 Issue 2, pp.67-72

Belge Tipi: Makale

Yayın Tarihi: 1/2024

Belge Dili: Türkçe

Document ID (Org No.): 2001311723

pISSN: 2619-9041

Urinary tract infection

Antibiotic resistance

Empirical treatmentİdrar yolu enfeksiyonu

Antibiyotik direnci

Ampirik tedavi

Sayı

Yazarlar:

Metin Özdemir | Zeynep Şentürk Köksal

Yayıncı:

Karyay Karadeniz Yayımcılık

Ana Başlıklar:

Klinik Tıp Bilimleri (Diğer) | Aile Hekimliği

Dergi:

Black Sea Journal of Health Science Vol.7 Issue 2, pp.67-72

Belge Tipi:

Makale

Yayın Tarihi:

1/2024

Belge Dili:

Türkçe

Document ID (Org No.):

2001311723

pISSN:

2619-9041