Yenidoğan Yoğun Bakım Ünitesinde İdrar Yolu Enfeksiyonuna Yol Açan Mikroorganizmalar ve Antimikrobiyal Direnç Dağılımı: 5 Yıllık Deneyim

Yıl 2024, Cilt: 4 Sayı: 1, 188 - 197, 03.05.2024

Nurgül Ataş , Mehmet Çelik

https://doi.org/10.56061/fbujohs.1224981

Öz

Yenidoğan döneminde idrar yolu enfeksiyonu önemli bir klinik problemdir. Bu çalışmada, kliniğimizde İYE tanısı alan yenidoğan bebeklerin idrar kültürlerinde üreyen mikroorganizmalar ve antibiyotik direnç paternlerinin belirlenmesi amaçlandı. Ocak 2017-Aralık 2021 tarihleri arasında yenidoğan yoğun bakım ünitemizde İYE tanısı alan 126 hastanın retrospektif olarak demografik verileri, idrar kültüründe üreyen mikroorganizmalar ve antimikrobiyal duyarlılık sonuçları kaydedildi. Hastaların 58’i (%46) kız, gestasyon yaşları ortanca 38 hafta idi. Hastaların %38.1’i prematüre iken sezeryan oranı %68.3 idi. İdrar kültüründe; K. pneumonia (%52.4) en sık üreyen mikroorganizma iken, E. coli (%19) ve Enterococcus spp (%15.9) diğer sık saptanan mikroorganizmalar oldu. Ampisilin direnci; K. pneumoniae’da (%100), Enterococcus spp’de (%85.7) ve E. coli’de (%71.4) amikasin direnci; K. pneumoniae’da %54.7 ve E. coli’de %25 bulundu. K. pneumoniae’da meropenem direnci %61.5 ve imipenem direnci %42.2 oranında görülürken E. coli’de meropenem direnci %11.1 ve imipenem direnci %7.1 oranında görüldü. Çalışmamızda K. pneumoniae ve E. coli en sık görülen bakterilerdi. İzole edilen bakterilerde karbapenemler dahil antimikrobiyallere karşı yüksek direnç görüldü. Özellikle yenidoğanlarda İYE’nin ampirik tedavisinde ampisilin, amoksisilin-klavulonat ve TMP-SMX’in yüksek direnç oranı nedeniyle kullanılmasının uygun olmayacağı düşüncesindeyiz.

Anahtar Kelimeler

Antimikrobiyal direnç, idrar yolu enfeksiyonu, yenidoğan

Microorganisms Causing Urinary Tract Infection and Distribution of Antimicrobial Resistance in the Neonatal Intensive Care Unit: 5 Years of Experience

Öz

Urinary tract infection is an important clinical problem in the neonatal period. In this study, it was aimed to determine the microorganisms grown in urine cultures and antibiotic resistance patterns of newborn babies diagnosed with UTI in our clinic. Demographic data, microorganisms grown in urine culture and antimicrobial susceptibility results of 126 patients diagnosed with UTI in our neonatal intensive care unit between January 2017 and December 2021 were recorded retrospectively. 58 (46%) of the patients were girls and their median gestational age was 38 weeks. While 38.1% of the patients were premature, the rate of cesarean section was 68.3%. In urine culture; While K. pneumonia (52.4%) was the most common microorganism, E. coli (19%) and Enterococcus spp (15.9%) were other frequently detected microorganisms. Ampicillin resistance; amikacin resistance in K. pneumoniae (100%), Enterococcus spp (85.7%), and E. coli (71.4%); It was found in 54.7% in K. pneumoniae and 25% in E. coli. While meropenem resistance was seen in 61.5% and imipenem resistance in 42.2% in K. pneumoniae, meropenem resistance was seen in 11.1% and imipenem resistance in 7.1% in E. coli. K. pneumoniae and E. coli were the most common bacteria in our study. High resistance to antimicrobials including carbapenems was seen in isolated bacteria. We think that it would not be appropriate to use ampicillin, amoxicillin-clavulanate and TMP-SMX in the empirical treatment of UTI, especially in newborns, due to their high resistance rate.

Anahtar Kelimeler

Antimicrobial resistance, newborn, urinary tract infection

Kaynakça

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