Prevalence and Antimicrobial Susceptibility Pattern of Staphylococcus species causing Urinary Tract Infections in Women of Reproductive Age: 5 Years Retrospective Study

Öz

Background/Aim: Infections of the urinary tract are amongst the most prevalent infections in women, females at child-bearing age have a higher predisposition to urinary tract infections. Approximately 13% of health-care-associated urinary tract infections occur due to Coagulase Negative Staphylococci (CNS); this species’ resistance rate is alarming. The study aims to describe urinary tract infections of women of reproductive age through 5 years of results, emphasizing Staphylococcus species as an etiological agent and their antimicrobial susceptibility patterns. Material and Methods: In the study, 4562 urine samples sent between November 2017 and November 2022 were retrospectively analyzed. Routine culture methods were used to isolate bacteria from urine specimens. According to the European Committee on Antimicrobial Susceptibility Testing (version 8.0-12.0) recommendations, an antimicrobial susceptibility test was performed using the disc diffusion technique. Obtained data analysis was achieved by Statistical Package for Social Sciences (SPSS 20.0), Categorical variables were presented as frequency and percentage however continuous variable was described as mean ± Standard deviation (SD), and binary logistic regression test was done to determine the association with statistical significance of (p<0.05). Results: Of the 4562 urine samples taken from women of reproductive age, 166 (3.6%) had a UTI due to Staphylococcus species. The most common species was CNS 110 (66.2%). Followed by, Staphylococcus aureus which was 42 (25.3%), and Staphylococcus saprophyticus 14 (8.4%). All isolate species showed susceptibility to tigecycline and linezolid (100%). The highest level of antibiotic resistance was showed by S. aureus and CNS against penicillin-G which was (83.30%) and (58.1%) respectively, while the majority of S. saprophyticus showed resistance against Erythromycin (64.2%). CNS displayed the highest oxacillin resistance (20.90%) among Staphylococcus species. Conclusion: The study illustrates the significance of Staphylococcus species as a pathogen of the urinary tract, especially in women of reproductive age. There is clear evidence of the resistance of isolates to penicillin-G which may suggest the production of penicillin-binding protein 2a. Regular surveillance of the frequency and resistance pattern of Staphylococcus species causing urinary tract infections in local regions, especially keeping in mind the high-risk patients mentioned in our study should be monitored.

Anahtar Kelimeler

• Reproductive age
• Staphylococcus species
• Urinary tract infection
• women

Üreme Çağındaki Kadınlarda İdrar Yolu Enfeksiyonlarına Neden Olan Stafilokok Suşlarının Prevalansı ve Antimikrobiyal Duyarlılık Paterni: 5 Yıl Retrospektif Çalışma

Öz

Giriş/Amaç: İdrar yolu enfeksiyonları kadınlarda en sık görülen enfeksiyonların arasındadır. Doğurganlık çağındaki kadınların idrar yolu enfeksiyonlarına yatkınlığı daha fazladır. Koagülaz Negatif Stafilokoklar (KNS), yatan hastalarda idrar yolu enfeksiyonlarının (İYE) yaklaşık %13’ünden sorumludur. Bu patojen grubunun antimikrobiyallerine karşı direncin artması da endişe vericidir. Bu çalışmada, üreme çağındaki kadınların idrar yolu enfeksiyonlarının etiyolojik bir ajanı olan Stafilokok türlerini ve bunların antimikrobiyal duyarlılık paternlerinin araştırması amaçlanmıştır. Materyal ve Metod: Bu çalışmada, Kasım 2017-Kasım 2022 tarihleri arasında toplanan 4562 adet idrar örneği retrospektif olarak incelenmiştir. Bakterileri idrar örneklerinden izole etmek için rutin kültür yöntemleri kullanıldı. European Committee on Antimicrobial Susceptibility Testing (versiyon 8.0-12.0) önerilerine göre disk difüzyon tekniği kullanılarak antimikrobiyal duyarlılık testi yapıldı Veriler Statistical Package for Social Sciences (SPSS 20.0) programıyla analiz edildi. Kategorik değişkenler frekans ve yüzde olarak ifade edildi, sürekli değişkenler ise ortalama ± Standart sapma (SS) şeklinde verildi. Tüm karşılaştırmalarda P<0,05 istatistiksel anlamlılık düzeyi olarak kabul edildi. Bulgular: Doğurgan çağındaki kadınlardan elde edilen 4562 idrar örneğinin 166'sında (%3,6) stafilokok türlerine bağlı İYE saptandı. En sık karşılaşılan Stafilokok türü KNS olup, 110 adet (% 66.2) idrar örneğinde etken olarak tespit edildi. Bunu takiben, 42 adet Staphylococcus aureus (%25.3) ve 14 adet (%8.4) Staphylococcus saprophyticus etken olarak saptandı. Tüm izolatlar tigesiklin ve linezolide karşı (%100) duyarlıydı. En yüksek antibiyotik direnci, penisilin-G'ye karşı Staphylococcus aureus (%83,30) ve KNS (%58,1) tarafından gelişirken, Staphylococcus saprophyticus'un büyük çoğunluğu eritromisin'e (%64,2) karşı direnç göstermiştir. KNS, Stafilokok türleri arasında en yüksek oksasilin direncini (%20,90) göstermiştir. Sonuç: Stafilokok türleri, özellikle üreme çağındaki kadınlarda idrar yolu patojeni olarak önemini göstermektedir. İzolatların penisilin-G'ye karşı direncine açık kanıtlar vardır. Bu direncin gelişmesine penisilin bağlayıcı protein 2a üretimi yol açmış olabilir. İdrar yolu enfeksiyonlarına neden olan Stafilokok türlerinin sık görülen prevalansı ve duyarlılık paternleri, özellikle çalışmamızda ele alınan yüksek riskli hastaları tedavi ederken göz önünde bulundurulmalıdır.

Anahtar Kelimeler

• Doğurgan çağ
• idrar yolu enfeksiyonu
• kadınlar
• Stafilokok Suşları

Kaynakça

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