İdrar Kültürlerinden İzole Edilen Escherichia Coli Suşlarının Antibiyogramlarının Değerlendirilmesi

Abstract

Objective: Our aim in this study is to determine the antimicrobial resistance profiles of Escherichia coli strains known to cause urinary tract infections most frequently in the region, to obtain microbiological data about their current status, and to contribute to the development of clinical strategies for the prevention and management of these infections.
 Materials and methods: Our study includes patients with E. coli isolated from urine cultures. In the study, urine cultures and antibiograms of patients between January 2019 and January 2020 were scanned retrospectively. 662 patients over the age of 18 were included in the study. The files of the patients included in the study, the information registered in the system and the pre-filled forms were examined by examining age, gender, reproductive status in urine cultures, ESBL status, antibiograms, hospitalization status, admission outpatient clinic, reason for hospitalization, chronic and additional diseases, symptom status, the blood, nitrite, leukocyte parameters in the urinary dipstick test and the antibiotic treatment started were recorded.
 Results: The antibiotics most frequently resistant to E. coli strains were cefuroxime (88.5%), tobramycin (75%), ceftazidime (72.9%), cefepime (59.5%) and ampicillin (57.5%). The antibiotics with the highest sensitivity were imipenem (100%), amikacin (99.1%), meropenem (98.2%), nitrofurantoin (96.3%) and fosfomycin (96.3%). It was observed that 25.7% of E. coli strains were ESBL positive.
 Conclusion: Our findings showed that E. coli strains, which are the most common causative agents of urinary tract infections, have high resistance to many antibiotics commonly used in treatment. Considering the local resistance rates in empirical treatment and starting the treatment by making a urine culture will guide the treatment. As a result of our research, we think that the use of fosfomycin and nitrofurantoin in uncomplicated infections and the use of carbapenems and aminoglycoside antibiotics in complicated infections and upper urinary tract involvement are appropriate in the empirical treatment of urinary tract infections.