Diyareli Hastalarda Patojenik E. coli Serogruplarının Araştırılması

Yıl 2016, Cilt: 43 Sayı: 2, 205 - 211, 01.06.2016

Zakir Zeki Çalık Murat Karameşe Osman Aktaş

Öz

Amaç: Diyare ile ilişkili hastalıklar başta gelişmekte olan
ülkeler olmak üzere birçok ülkede ciddi bir sağlık problemidir.
Diyare ile ilişkili hastalıkların gerçek nedeni, birincil
ve ikincil sağlık hizmetlerinin düşük bütçelerinin yanı sıra
sanitasyon ve kötü hijyen olarak tespit edilmiştir. Bu çalışmada,
bölgemizdeki ishalli hastalardan alınan dışkı örneklerinde,
başta ishal oluşturan Escherichia coli suşları
olmak üzere bakteriyel enteropatojenlerin varlığının tespit
edilmesi amaçlanmıştır.
Yöntemler: İshal şikayeti olan 343 hastadan dışkı örnekleri
toplandı. Toplanan dışkı örnekleri ilk olarak makroskobik
ve mikroskobik incelemeye tabi tutuldu. Ardından, örneklerin
EMB Agar, MacConkey Agar and Selenite F besiyerlerine
ekim işlemleri gerçekleştirildi. Son olarak, E.coli
bakterileri spesifik antiserumlar kullanılarak tanımlandı.
Bulgular: Parazitolojik ve bakteriyolojik incelemeye tabi
tutulan 343 dışkı örneğinin 156’sı kadın, 187’si erkek hastalara
aitti. 262 dışkı örneğinde (%76,4) yalnızca E.coli
bakterisi tespit edildi. E.coli tespit edilen 262 hastanın
77’sinde (%29,4) lateks aglütinasyon yöntemi ile sınıflandırma
yapıldı. En çok tespit edilen EHEC, EPEC, ETEC
ve EIEC suşları sırasıyla O26, O55, O128 ve O152 alt serotipleri
olarak tanımlandı. Bu çalışmada, E.coli O157:H7
suşu tespit edilmedi.
Sonuç: Sonuç olarak, sadece O antiserumunun kullanılması
tüm patojenik bakterilerin tanımlanması için yeterli
olmamaktadır. Ancak, bölgemizdeki bakteriyel serogrupların
tanımlanması, konu hakkında klinisyenlerin dikkatini
çekecek ve doğru tanı ve tedavi konusunda daha doğru
sonuçlara ulaşılmasına olanak sağlayacaktır. İshal oluşturan
E.coli suşlarının sebep olduğu infeksiyonların önüne
geçebilmenin en temel yolu, hijyen kurallarına özen
göstermektir.

Anahtar Kelimeler

Diyare, E.coli, O ve H antijenleri

The Investigation of Pathogenic E. coli serogroups in Patients with Diarrhea

Öz

Objective: Diarrheal diseases express a major health problem especially in developing countries. The real reasons of diarrheal disease are largely due to low hy­giene or sanitation as well as low budgets of primary and secondary health care. In this study, it was aimed to determine the presence of bacterial enteropathogens especially diarrheagenic Escherichia coli serogroups in stool samples taken from patients with diarrhea in our geographic region. Methods: 343 stool samples were collected from the pa­tients who were diarrhea. Stool samples were subjected to macroscopic and microscopic examinations, and then were cultured into EMB Agar, MacConkey Agar and Sel­enite F to isolate and distinguish E.coli from other intes­tinal pathogens. Finally, all isolated E.coli species were identified by using specific antisera. Results: 343 (156 female, 187 male) stool samples were bacteriologically and parasitologically examined. Only E. coli presence was detected in 262 (76.4%) samples. 77 (29.4%) of total isolated 262 E.coli strains were identified with latex agglutination test. Most common EHEC, EPEC, ETEC and EIEC strains were detected as following; O26, O55, O128 and O152 respectively. E.coli O157:H7 se­rovar was not detected. Conclusion: As a consequent, just usage of O antisera (except H7) is not adequate to detect all the pathogenic bacteria. However, determination of bacterial serogroups which often seen in a region may lead to draw the atten­tion of the clinicians on these bacteria and provide an op­portunity for more accurate diagnosis and treatment. The main way to prevent diarrheal E. coli infections is to obey the hygiene rules.

Anahtar Kelimeler

Diyare, E.coli, O ve H antijenleri

Kaynakça

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