Hastanede yatmakta olan üriner kateterli hastaların idrar kültür sonuçlarının değerlendirilmesi
Küçük Resim Yok
Tarih
1997
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Selçuk Üniversitesi Tıp Fakültesi Genel Cerrahi, Dahiliye, Nöroşirurji, Nöroloji, Üroloji ve înfeksiyon Hastalıkları Kliniklerinde yatmakta olan üriner kateter takılı 110 hastanın üriner kateterlerinden idrar kültürü yapılarak sonuçlar değerlendirildi. Toplam 1 10 örneğin 27'sinden (%24.5) mikroorganizma izole edildi. En fazla izole edilen mikroorganizma pseudomonas (%33.3) idi. Bunu sırasıyla klebsiella (%22.2), Escherichia coli (%18.6), enterobacter (%11.1), proteus (%3.7), Staphylococcus epidermidh (%3.7), enterococcus (%3.7) ve Candida (%3.7) takip etmekteydi. Diabetes Mellitus varlığı, ileri yaş ve kateter kalma süresinin uzun olması bakterimi gelişimi için önemli risk faktörleri olarak belirlendi. Direk mikroskopi ve Gram boyama ile mikroorganizma görülen, piyüri saptanan ve lökosit esteraz testi pozitif olan idrar örneklerinde üreme anlamlı derecede yüksek bulundu (sırasıyla pO.001, p<0.001,p<0.001, pO.001). Kliniklere göre idrar kültürlerinde mikroorganizma üreme oranlarına bakıldığında cerrahi kliniklerde yatmakta olan hastalarda kültür pozitifliği %30.55 kadar yüksek oranda iken, dahili kliniklerde bu oran %16.6'ya kadar düşmekteydi. Aralarında istatistiksel olarak anlamlı farklılık saptanmadı (p>0.05). İzole edilen mikroorganizmaların antibiyotik duyarlılık testi sonucunda genelde antimikrobiyal ilaçlara yüksek oranda direnç saptandı: İmipenem (%0.0), amikasin (%11.5), sefoperazon-sulbaktam (%15.2), siprofloksasin (%46.0), tetrasiklin (%50.1), piperasilin (%58.0), seftazidim (%65.1), aztreonam (%65.1), amoksisilin-klavulunat (%73.1), sefotaksim (%73.1), trimetoprim-sulfometaksazol (%84.6), sulbaktam-ampisilin (%84.6), kloramfenikol (%88.4), sefazolin (%88.4), sefuroksim (%92.3), ampisilin (%92.3), amoksisilin (%96.1). Sonuç olarak, klinisyenler üriner kateter takmadan önce, üriner kateterizasyonun risklerini hatırlamalı, hastalarına ampirik antimikrobiyal tedavi başlarken, yerel mikroorganizma ve direnç profiline dikkat etmelidir.
Results of urine cultures of 110 urinary catheterized patients who were hospitalized in General Surgery, Neurology, Internal Medicine, Neurosurgery, Urology and Infectious Diseases Departments in Selçuk University Faculty of Medicine were evaluated. 27 microorganisms were isolated from 27 of 110 samples. Pseudomonas (%33.3) was the most frequent microorganisms isolated. The other microorganisms were klebsiella (%22.2), Escherichia coli (%18.6), enterobacter (%1 1.1), proteus (%3.7), Staphylococcus epidermidis (%3.7), enterococcus (%3.7) and Candida (%3.7). Diabetes Mellitus, advanced age and long-term urinary catheterization were determined as the important risk factors for development of bacteriuria. Significantly higher microorganisms were isolated from the samples which bacteriuria determined by direct microscopy and Gram staining and pyuria determined by direct microscopy and positive leukocyte esterase test (p<0.001, p<0.001, p<0.001, respectively). Although the rate of microorganisms' isolation was as high as %33.3 in surgical departments, it was reduced to %16.6 in medical departments. However, statistically significant difference was not determined. High level of resistance to antimicrobial drugs were found in the microorganisms on antimicrobial susceptibility test: imipenem (%0.0), amikacin (%11.5), cefoperazone-sulbactam (%15.2), ciprofloxacin (%46.0), tetracycline (%50.1), piperacillin (%58.0), ceftazidime (%65.1), aztreonam (%65.1), amoxicillin-clavulanate (%73.1), cefotaxime (%73.1), trimethoprim- sulfamethoxazole (%84.6), sulbactam-ampicillin (%84.6), chloramphenicol (%88.4), cefazolin (%88.4), cefuroxime (%92.3), ampicillin (%92.3), amoxicillin (%96.1). As a result, clinicians must remember the risk of catheterization before indwelling an urinary catheter and they must pay attention to local profile of microorganisms and resistance, while they are beginning an empirical antimicrobial therapy to their patients.
Results of urine cultures of 110 urinary catheterized patients who were hospitalized in General Surgery, Neurology, Internal Medicine, Neurosurgery, Urology and Infectious Diseases Departments in Selçuk University Faculty of Medicine were evaluated. 27 microorganisms were isolated from 27 of 110 samples. Pseudomonas (%33.3) was the most frequent microorganisms isolated. The other microorganisms were klebsiella (%22.2), Escherichia coli (%18.6), enterobacter (%1 1.1), proteus (%3.7), Staphylococcus epidermidis (%3.7), enterococcus (%3.7) and Candida (%3.7). Diabetes Mellitus, advanced age and long-term urinary catheterization were determined as the important risk factors for development of bacteriuria. Significantly higher microorganisms were isolated from the samples which bacteriuria determined by direct microscopy and Gram staining and pyuria determined by direct microscopy and positive leukocyte esterase test (p<0.001, p<0.001, p<0.001, respectively). Although the rate of microorganisms' isolation was as high as %33.3 in surgical departments, it was reduced to %16.6 in medical departments. However, statistically significant difference was not determined. High level of resistance to antimicrobial drugs were found in the microorganisms on antimicrobial susceptibility test: imipenem (%0.0), amikacin (%11.5), cefoperazone-sulbactam (%15.2), ciprofloxacin (%46.0), tetracycline (%50.1), piperacillin (%58.0), ceftazidime (%65.1), aztreonam (%65.1), amoxicillin-clavulanate (%73.1), cefotaxime (%73.1), trimethoprim- sulfamethoxazole (%84.6), sulbactam-ampicillin (%84.6), chloramphenicol (%88.4), cefazolin (%88.4), cefuroxime (%92.3), ampicillin (%92.3), amoxicillin (%96.1). As a result, clinicians must remember the risk of catheterization before indwelling an urinary catheter and they must pay attention to local profile of microorganisms and resistance, while they are beginning an empirical antimicrobial therapy to their patients.
Açıklama
Anahtar Kelimeler
Bakteriüri, Bacteriuria, Üriner kateterizasyon, Urinary catheterization, Üriner sistem enfeksiyonları, Urinary tract infections
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Çopur, E. (1997). Hastanede yatmakta olan üriner kateterli hastaların idrar kültür sonuçlarının değerlendirilmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Enfeksiyon Hastalıkları Anabilim Dalı, Konya.
