ASEMPTOMATİK BAKTERİÜRİSİ OLAN GEBELERDE İDRAR KÜLTÜRÜNDEN ELDE EDİLEN ÜROPATOJENLER VE ANTİBİYOTİK DUYARLILIK SONUÇLARI: RETROSPEKTİF BİR ÇALIŞMA

Abstract

Asemptomatik bakteriüri varlığı, gebelerde taranması önerilen bir klinik durumdur. Bu çalışmada, asemptomatik gebelerde idrar kültürlerinde izole edilen mikroorganizmalar ve bu bakterilerin antibiyotik duyarlılık profillerinin değerlendirilmesi amaçlanmıştır. Kadın Hastalıkları ve Doğum Kliniği’nde Ocak 2023-Aralık 2023 tarihleri arasında ilk trimesterde başvuran asemptomatik gebelere ait idrar kültürü sonuçları retrospektif olarak incelendi. Kültürde üreme saptanan olgularda üreyen bakteriler ve antibiyotik duyarlılık sonuçları değerlendirildi. İncelenen 13827 kültür örneğinin 1283’ünde (%9.27) üreme saptandı. En sık izole edilen patojen Escherichia coli (%51.1) olup, bunu Streptococcus agalactiae (%21.8), Klebsiella pneumoniae (%11.0) ve Enterococcus faecalis (%6.4) izledi. Gram negatif bakteriler arasında amikasin, imipenem, meropenem ve gentamisin en etkili antibiyotiklerdi. E. coli izolatlarının amikasine %99.4, imipeneme %98.6 ve meropeneme %98.3 oranında duyarlı olduğu belirlendi. Gram pozitif bakterilerden E. faecalis, nitrofurantoine (%97.5) ve amoksisilin-klavulanik aside (%95.1) yüksek duyarlılık gösterdi. Çalışmamızda elde edilen veriler, gebelerde asemptomatik bakteriüri etkenlerinin dağılımı ve antibiyotik duyarlılık profilleri açısından ulusal ve uluslararası literatürle uyumlu bulunmuştur. Çalışmamıza göre fosfomisin ve nitrofurantoin gibi gebelikte güvenli ajanların yüksek duyarlılık oranları nedeniyle ampirik tedavide öncelikle tercih edilmesi önerilmektedir.

Keywords

• gebelik
• bakteriüri
• antibiyotikler
• antibiyotik direnci

UROPATHOGENS ISOLATED FROM URINE CULTURES AND ANTIBIOTIC SUSCEPTIBILITY RESULTS IN ASYMPTOMATIC PREGNANT WOMEN WITH BACTERIURIA: A RETROSPECTIVE STUDY

Abstract

The presence of asymptomatic bacteriuria is a clinical condition for which screening is recommended in pregnant women. This study aimed to evaluate microorganisms isolated from urine cultures in asymptomatic pregnant women and the antibiotic susceptibility profiles of these bacteria. Urine culture results from asymptomatic pregnant women who presented during the first trimester at the Department of Obstetrics and Gynecology between January 2023 and December 2023 were retrospectively reviewed. In cases where growth was detected in cultures, the growing bacteria and antibiotic susceptibility results were evaluated. Bacterial isolation was detected in 1,283 (9.27%) of the 13,827 culture samples examined. The most frequently isolated pathogen was Escherichia coli (51.1%), followed by Streptococcus agalactiae (21.8%), Klebsiella pneumoniae (11%), and Enterococcus faecalis (6.4%). Among Gram-negative bacteria, amikacin, imipenem, meropenem, and gentamicin were the most effective antibiotics. E. coli isolates were found to be susceptible to amikacin at a rate of 99.4%, imipenem at 98.6%, and meropenem at 98.3%. Among Gram-positive bacteria, E. faecalis showed high susceptibility to nitrofurantoin (97.5%) and amoxicillin-clavulanic acid (95.1%). The data obtained in our study were consistent with the national and international literature in terms of the distribution of asymptomatic bacteriuria causative agents in pregnant women and their antibiotic susceptibility profiles. According to our study, safe agents in pregnancy, such as fosfomycin and nitrofurantoin, are recommended as the first choice in empirical treatment due to their high susceptibility rates.

Keywords

• Pregnancy
• Bacteriuria
• Antibiotics
• Antibiotic Resistance

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