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

Yıl 2026, Cilt: 40 Sayı: 1 , 9 - 15 , 30.04.2026
https://doi.org/10.54962/ankemderg.1799813
https://izlik.org/JA44YX56KF

Öz

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.

Etik Beyan

Çalışma için Ankara Etlik Şehir Hastanesi Bilimsel Araştırmalar Değerlendirme ve Etik Kurulu’ndan AEŞH-BADEK-2024-1079 karar numarası ve 06/11/2024 tarihi ile onay alınmıştır.

Destekleyen Kurum

Çalışmamızda destekleyici kuruluş yoktur.

Kaynakça

  • Aktün LH, Karaca N, Akpak YK. Asymptomatic Bacteriuria in Pregnancy: Prevalence, Antibiotic Susceptibility, and Related Demographic Factors. Bezmialem Science. 2018;6(3):163-7. https://doi.org/10.14235/bs.2017.1772
  • Alenazi AM, Taher IA, Taha AE, et al. Pregnancy-associated asymptomatic bacteriuria and antibiotic resistance in the Maternity and Children’s Hospital, Arar, Saudi Arabia. J Infect Dev Ctries. 2023;17(12):1740-7. https://doi.org/ 10.3855/jidc.18184
  • Celen S, Oruç AS, Karayalçin R, et al. Asymptomatic bacteriuria and antibacterial susceptibility patterns in an obstetric population. ISRN Obstet Gynecol. 2011;2011:721872. https://doi.org/10.5402/2011/721872
  • Chelkeba L, Fanta K, Mulugeta T, Melaku T. Bacterial profile and antimicrobial resistance patterns of common bacteria among pregnant women with bacteriuria in Ethiopia: a systematic review and meta-analysis. Arch Gynecol Obstet. 2022;306(3):663-86. https://doi.org/10.1007/s00404-021-06365-4
  • Gilstrap LC 3rd, Ramin SM. Urinary tract infections during pregnancy. Obstet Gynecol Clin North Am. 2001;28(3):581-91. https://doi.org/10.1016/s0889-8545(05)70219-9
  • Glaser AP, Schaeffer AJ. Urinary Tract Infection and Bacteriuria in Pregnancy. Urol Clin North Am. 2015;42(4):547-60. https://doi.org/10.1016/j.ucl.2015.05.004
  • Greve VH, Greve T, Helmig RB. Bacteriuria in Pregnancy in a Danish Contemporary Cohort of Women. Infect Dis Obstet Gynecol. 2020;2020:8398537. https://doi.org/10.1155/2020/8398537
  • Macejko AM, Schaeffer AJ. Asymptomatic bacteriuria and symptomatic urinary tract infections during pregnancy. Urol Clin North Am. 2007;34(1):35-42. https://doi.org/10.1016/j.ucl.2006.10.010
  • Nicolle LE, Gupta K, Bradley SF, et al. Clinical Practice Guideline for the Management of Asymptomatic Bacteriuria: 2019 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2019;68(10):e83-e110. https://doi.org/10.1093/cid/ciy1121
  • Orji O, Dlamini Z, Wise AJ. Urinary bacterial profile and antibiotic susceptibility pattern among pregnant women in Rahima Moosa Mother and Child Hospital, Johannesburg. S Afr J Infect Dis. 2022;37(1):343. https://doi.org/10.4102/sajid.v37i1.343
  • Öztürk C, Kara M, Akyol R, Bolacalı M. Asemptomatik bakteriüri olan gebelerden izole edilen üropatojenlerin antimikrobiyal direnç ve çoklu ilaç direnç profilleri. Turk J Obstet Gynecol. 2025;22(4):321-8. https://doi.org/10.4274/tjod.galenos.2025.29938.
  • Peter CRM, Braga JCDPK, Rodrigues LHA, Arrieira MP, Arrieira RO, Böhlke M. Antibiotic resistance pattern in urine cultures from community-dwelling women in southern Brazil - a cross-sectional study short communication. Rev Gaucha Enferm. 2022;43:e20200485. https://doi.org/10.1590/1983-1447.2022.20200485.en
  • Soliman AA, Hussein AS, Ahmed AG. Assessment and Management of Asymptomatic Bacteriuria in Pregnancy. Egyptian J Hosp Med. 2019;75(1):1982-6. https://doi.org/10.21608/ejhm.2019.29171
  • The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 9.0, 2019. [https://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_tables/v_9.0_Breakpoint_Tables.pdf (erişim tarihi 15.12.2025).
  • Tokak S, Eriç Horasanlı J. Asymptomatic bacteriuria in pregnant women: frequency, antimicrobial susceptibility profile, causative microorganisms and risk factors. FLORA. 2020;25(4):555-62. https://doi.org/10.5578/flora.69477

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

Yıl 2026, Cilt: 40 Sayı: 1 , 9 - 15 , 30.04.2026
https://doi.org/10.54962/ankemderg.1799813
https://izlik.org/JA44YX56KF

Öz

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.

Etik Beyan

Approval for the study was obtained from the Ankara Etlik City Hospital Scientific Research Evaluation and Ethics Committee with decision number AEŞH-BADEK-2024-1079 and dated 06/11/2024.

Destekleyen Kurum

There is no supporting organisation in our study.

Kaynakça

  • Aktün LH, Karaca N, Akpak YK. Asymptomatic Bacteriuria in Pregnancy: Prevalence, Antibiotic Susceptibility, and Related Demographic Factors. Bezmialem Science. 2018;6(3):163-7. https://doi.org/10.14235/bs.2017.1772
  • Alenazi AM, Taher IA, Taha AE, et al. Pregnancy-associated asymptomatic bacteriuria and antibiotic resistance in the Maternity and Children’s Hospital, Arar, Saudi Arabia. J Infect Dev Ctries. 2023;17(12):1740-7. https://doi.org/ 10.3855/jidc.18184
  • Celen S, Oruç AS, Karayalçin R, et al. Asymptomatic bacteriuria and antibacterial susceptibility patterns in an obstetric population. ISRN Obstet Gynecol. 2011;2011:721872. https://doi.org/10.5402/2011/721872
  • Chelkeba L, Fanta K, Mulugeta T, Melaku T. Bacterial profile and antimicrobial resistance patterns of common bacteria among pregnant women with bacteriuria in Ethiopia: a systematic review and meta-analysis. Arch Gynecol Obstet. 2022;306(3):663-86. https://doi.org/10.1007/s00404-021-06365-4
  • Gilstrap LC 3rd, Ramin SM. Urinary tract infections during pregnancy. Obstet Gynecol Clin North Am. 2001;28(3):581-91. https://doi.org/10.1016/s0889-8545(05)70219-9
  • Glaser AP, Schaeffer AJ. Urinary Tract Infection and Bacteriuria in Pregnancy. Urol Clin North Am. 2015;42(4):547-60. https://doi.org/10.1016/j.ucl.2015.05.004
  • Greve VH, Greve T, Helmig RB. Bacteriuria in Pregnancy in a Danish Contemporary Cohort of Women. Infect Dis Obstet Gynecol. 2020;2020:8398537. https://doi.org/10.1155/2020/8398537
  • Macejko AM, Schaeffer AJ. Asymptomatic bacteriuria and symptomatic urinary tract infections during pregnancy. Urol Clin North Am. 2007;34(1):35-42. https://doi.org/10.1016/j.ucl.2006.10.010
  • Nicolle LE, Gupta K, Bradley SF, et al. Clinical Practice Guideline for the Management of Asymptomatic Bacteriuria: 2019 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2019;68(10):e83-e110. https://doi.org/10.1093/cid/ciy1121
  • Orji O, Dlamini Z, Wise AJ. Urinary bacterial profile and antibiotic susceptibility pattern among pregnant women in Rahima Moosa Mother and Child Hospital, Johannesburg. S Afr J Infect Dis. 2022;37(1):343. https://doi.org/10.4102/sajid.v37i1.343
  • Öztürk C, Kara M, Akyol R, Bolacalı M. Asemptomatik bakteriüri olan gebelerden izole edilen üropatojenlerin antimikrobiyal direnç ve çoklu ilaç direnç profilleri. Turk J Obstet Gynecol. 2025;22(4):321-8. https://doi.org/10.4274/tjod.galenos.2025.29938.
  • Peter CRM, Braga JCDPK, Rodrigues LHA, Arrieira MP, Arrieira RO, Böhlke M. Antibiotic resistance pattern in urine cultures from community-dwelling women in southern Brazil - a cross-sectional study short communication. Rev Gaucha Enferm. 2022;43:e20200485. https://doi.org/10.1590/1983-1447.2022.20200485.en
  • Soliman AA, Hussein AS, Ahmed AG. Assessment and Management of Asymptomatic Bacteriuria in Pregnancy. Egyptian J Hosp Med. 2019;75(1):1982-6. https://doi.org/10.21608/ejhm.2019.29171
  • The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 9.0, 2019. [https://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_tables/v_9.0_Breakpoint_Tables.pdf (erişim tarihi 15.12.2025).
  • Tokak S, Eriç Horasanlı J. Asymptomatic bacteriuria in pregnant women: frequency, antimicrobial susceptibility profile, causative microorganisms and risk factors. FLORA. 2020;25(4):555-62. https://doi.org/10.5578/flora.69477
Toplam 15 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Mikrobiyoloji, Klinik Tıp Bilimleri (Diğer)
Bölüm Araştırma Makalesi
Yazarlar

Murat Polat 0009-0002-2964-729X

Sait Erbey 0009-0007-1950-9041

Muhammed Furkan Kürkçü 0000-0002-7750-5002

Furkan Akın 0009-0004-4026-1974

Gönderilme Tarihi 9 Ekim 2025
Kabul Tarihi 24 Şubat 2026
Yayımlanma Tarihi 30 Nisan 2026
DOI https://doi.org/10.54962/ankemderg.1799813
IZ https://izlik.org/JA44YX56KF
Yayımlandığı Sayı Yıl 2026 Cilt: 40 Sayı: 1

Kaynak Göster

Vancouver 1.Murat Polat, Sait Erbey, Muhammed Furkan Kürkçü, Furkan Akın. ASEMPTOMATİK BAKTERİÜRİSİ OLAN GEBELERDE İDRAR KÜLTÜRÜNDEN ELDE EDİLEN ÜROPATOJENLER VE ANTİBİYOTİK DUYARLILIK SONUÇLARI: RETROSPEKTİF BİR ÇALIŞMA. ANKEM Derg. 01 Nisan 2026;40(1):9-15. doi:10.54962/ankemderg.1799813