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Üriner Sistem İnfeksiyonlarına neden Olan Genişlemiş Spektrumlu Beta-laktamaz Üreten Escherichia coli ve Klebsiella pneumoniae İzolatlarının Fosfomisin ve Nitrofurantoine Duyarlılıkları

Yıl 2019, Cilt: 9 Sayı: 1, 55 - 58, 27.03.2019

Umut Safiye Şay Coşkun

https://doi.org/10.16899/gopctd.450476

Öz

Amaç: Üriner sistem
enfeksiyonlarına en sık neden olan etkenler Esherichia
coli ve Klebsiella
pneumoniae’dır. Genişlemiş spektrumlu beta
laktamaz üreten izolatlarının giderek
artıyor olması genişlemiş spektrumlu beta laktamaz üreten E. coli ve Klebsiella pneumoniae  izolatlarının
neden olduğu üriner sistem enfeksiyonlarının tedavisinde alternatif antibiyotik
arayışını doğurmuştur. Bu çalışmanın amacı hastanemizde yatan hastalardan
tanımlanan üriner sitem enfeksiyonuna neden olan genişlemiş spektrumlu beta laktamaz
üreten Esherichia coli ve Klebsiella pneumoniae izolatlarında fosfomisin ve nitrofurantoine duyarlılığı
tespit ederek, bu hastalarda ampirik tedavinin planlanmasına katkıda
bulunmaktır.



Gereç ve Yöntem:
Çeşitli servislerden ve yoğun bakım ünitesinden gönderilen hastalara ait idrar
kültürü örnekleri retrospektif olarak değerlendirilmiştir. İzolatların
tanımlanması ve antibiyotik duyarlılığının belirlenmesinde VITEK 2 ID
(bioMérieux, Fransa) otomatize sistemi kullanılmıştır.



Bulgular:
İzolatların en sık yoğun bakım ünitesinden (% 43.5) gelen örneklerden
tanımlandığı saptanmıştır. İzolatlara karşı en duyarlı antbiyotikler ve
duyarlılık oranları Esherichia coli ve
Klebsiella pneumoniae için sırasıyla
karbapenemlere  % 100 ve % 87 ardından
fosfomisine % 98 ve % 83, nitrofurantoine % 94 ve % 30.4 tespit edilmiştir.



Sonuç: Hastanemizde yatan
hastalarda genişlemiş spektrumlu beta laktamaz
üreten Esherichia coli ve Klebsiella pneumoniae izolatlarının
neden olduğu üriner sistem enfeksiyonlarında fosfomisinin ampirik tedavide iyi
bir alternatif bir ajan olarak kullanılabileceği düşünülmüştür. 

Anahtar Kelimeler

Esherichia coli Klebsiella pneumoniae genişlemiş spektrumlu beta-laktamaz fosfomisin

Kaynakça

  • Referans 1. Rané A DR. Urinary Tract Infection: Clinical Perspectives on Urinary Tract Infection Elektronisk resurs, London: Springer London. 2013.
  • Referans2. Adjei O, Opoku C. Urinary tract infections in African infants. Int J Antimicrob Agents. 2004;24 (Suppl 1): S32-4. DOI:10.1016/j.ijantimicag.2004.02.007
  • Referans 3. Ronald A. The etiology of urinary tract infection: traditional and emerging pathogens. The American journal of medicine. 2002;113 (Suppl 1A):14S-9S.
  • Referans4. Yılmaz R, Karaaslan E, Özçetin M ve ark. Çocuklarda idrar yolları enfeksiyonu etkenleri ve antibiyotik duyarlılıkları. J Contemp Med 2012;2(1):17-21.
  • Referans5. Bradford PA. Extended-spectrum β-lactamases in the 21st century: characterization, epidemiology, and detection of this important resistance threat. Clin Microbiol Rev 2001;14(4):933-5. DOI:10.1128/CMR.14.4.933-951.2001
  • Referans6. Guidelines on Infection Prevention and Control 2012. ESBLs HSE South (Cork & Kerry) Community and Disability Services. Sectıon 11.1 Extended- spectrum β-lactamases (ESBL) Page 2 of 4 http://www.hse.ie/eng/about/Who/healthwellbeing/Infectcont/Sth/gl/IPCCGuidelines Section11 1.pdf.
  • Referans7. Mehrgan H, Rahbar M. Prevalence of extended-spectrum beta-lactamase-producing Escherichia coli in a tertiary care hospital in Tehran Iran . Int J Antimicrob Agents 2008;31:1471-51. DOI:10.1016/j.ijantimicag.2007.09.008.
  • Referans8. Falagas ME, Vouloumanou EK, Togias AG et al. Fosfomycin versus other antibiotics for the treatment of cystitis: a meta-analysis of randomized controlled trials. J Antimicrob Chemother 2010;65:1862–77. doi: 10.1093/jac/dkq237.
  • Referans9. Matthews PC, Barrett LK, Warren S et al. Oral fosfomycin for treatment of urinary tract infection: a retrospective cohort study. BMC Infect Dis 2016;16(1): 556.
  • Referans10. Grabe M, Bartoletti R, Bjerklund-Johansen TE et al.. Guidelines on urological infections. European Association of Urology 2014. [(accessed on 13 July 2014)]. Available online: http://www.uroweb.org/gls/pdf/19%20Urological%20infections_LR.pdf.
  • Referans11. Hooton TM. Clinical practice. Uncomplicated urinary tract infection. N Eng J Med 2012;366(11):1028-37.
  • Referans12. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. Twenty-fi rst Informational Supplement. CLSI Document M100-S21, 2011. CLSI, Wayne, PA. 5.
  • Referans13. The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 1.3, January 5, 2011. Available at: http://www.eucast.org/fileadmin/src/
  • Referans14. Livermore DM, Warner M, Mushtaq S, Doumith M, Zhang J, Woodfordet N. What remains against carbapenem-resistant Enterobacteriaceae? Evaluation of chloramphenicol, ciprofloxacin, colistin, fosfomycin, minocycline, nitrofurantoin, temocillin and tigecyclin. Int. J. Antimicrob Agents 2011;37(5):415–9.
  • Referans15. Patel B, Patel K, Shetty A, Soman R, Rodrigues C. Fosfomycin Susceptibility in Urinary Tract Enterobacteriaceae. J Assoc Physicians India 2017;65(9):14-6.
  • Referans16. Hendlin D, Stapley EO, Jackson M et al. Phosphonomycin, a new antibiotic produced by strains of Streptomyces. Science 1969;166:122–3.
  • Referans17. Bergogne-Bérézin E, Muller-Serieys C, Joly-Guillou ML, Dronne N. Trometamol-fosfomycin (Monuril) bioavailability and food-drug interaction. Eur Urol. 1987;13(1):64-8.
  • Referans18. Cassir N, Rolain JM, Brouqui P. A new strategy to fight antimicrobial resistance: the revival of old antibiotics. Front Microbiol 2014;20(5):551.
  • Referans19. Bandow JE, Brotz H, Leichert LI, Labischinski H, Hecker M. Proteomic approach to understanding antibiotic action. Antimicrob Agents Chemother 2003;47(3):948-55.
  • Referans20. Alpay Y, Yavuz MT, Aslan T, Büyükzengin B. Genişlemiş spektrumlu beta-laktamaz pozitif Escherichia coli ile oluşan komplike olmayan üriner sistem infeksiyonlarının tedavisinde oral antibiyotikler karbapenemlere alternatif olabilir mi? ANKEM 2017;31(3):85-91.
  • Referans21. Sönmezer MÇ, Tülek N, Köksal E et al. Toplum Kökenli Üriner Sistem İnfeksiyonlarında Etken Olan Genişlemiş Spektrumlu Beta-Laktamaz Üreten Escherichia coli İzolatlarında Fosfomisin Trometamolün İn Vitro Etkinliği. FLORA. 2016; 21(4): 153-8.
  • Referans22. Bollestad M, Vik I, Grude N, Blix HS, Brekke H, Lindbaek M. Bacteriology in uncomplicated urinary tract infections in Norwegian general practice from 2001–2015. BJGP Open. 2017; DOI: 10.3399/bjgpopen17X101145.
  • Referans23. Fajfr M, Louda M, Paterova P, Ryskova L, Pacovsky J, Kosina J et al. The susceptibility to fosfomycin of Gram-negative bacteria isolates from urinary tract infection in the Czech Republic: data from a unicentric study. BMC urology 2017; 17(1): 33.
  • Referans24. Córdoba G, Holm A, Hansen F, Hammerum AM, Bjerrum L. Prevalence of antimicrobial resistant Escherichia coli from patients with suspected urinary tract infection in primary care, Denmark. BMC Infect Dis 2017;17:670.
  • Referans25. Coşkun MV, Uyanık MH, Ağan İ, Huslu H, Çelebi S. Hastanede yatan hastaların üriner sistem infeksiyonlarından izole edilen genişlemiş spektrumlu beta-laktamaz üreten Klebsiella pneumoniae ve Escherichia coli suşlarının fosfomisin ve nitrofurantoine duyarlılıklarının araştırılması. ANKEM 2016;30(2):37-41.

Fosfomycin and Nitrofurantoin Susceptibilities of Escherichia coli and Klebsiella pneumoniae Isolates Producing Extanded Spectrum Beta-lactamase Causing Urinary Tract Infections

Yıl 2019, Cilt: 9 Sayı: 1, 55 - 58, 27.03.2019

Umut Safiye Şay Coşkun

https://doi.org/10.16899/gopctd.450476

Öz

Aim: The most common causative agents of urinary tract infections are Esherichia coli and Klebsiella pneumoniae. Increasing numbers of extanded spectrum beta-lactamase producing  isolates led to the search for alternative antibiotics in the treatment of urinary tract infections caused by Esherichia coli and Klebsiella pneumoniae isolates producing extanded spectrum beta-lactamase. This studies aim is to determine the sensitivity of fosfomycin and nitrofurantoin to extanded spectrum beta-lactamase producing Esherichia coli and Klebsiella pneumoniae isolates, which are defined by patients in our hospital, to contribute to the planning of empirical treatment of these patients.

Matheryals and Methods: Patients urinary specimens from various services and intensive care unit were evaluated retrospectively. Identification of isolates and antibiotic susceptibility were evaluated with the VITEK 2 ID (bioMérieux, France) automatization system.

Results: Extended spectrum β-lactamase producing 85 Esherichia coli and 23 Klebsiella pneumoniae were included in the study. The isolates were identified from the most frequent cases from the intensive care unit (43.5 %). The most sensitive antibiotics are carbapenems. Susceptibility rates to Esherichia coli and Klebsiella pneumoniae isolates were respectively 100% and 87% to carbapenems followed by 98% and 83% to fosfomycin 94% and 30.4% to nitrofurantoin.

Conclusions: Fosfomycin is seen as a good alternative agent in urinary tract infections caused by extanded spectrum beta-lactamase producing Esherichia coli and Klebsiella pneumoniae isolates in our hospital for emprical treatment.

Anahtar Kelimeler

Esherichia coli Klebsiella pneumoniae extended spectrum β-lactamase fosfomycin

Kaynakça

  • Referans 1. Rané A DR. Urinary Tract Infection: Clinical Perspectives on Urinary Tract Infection Elektronisk resurs, London: Springer London. 2013.
  • Referans2. Adjei O, Opoku C. Urinary tract infections in African infants. Int J Antimicrob Agents. 2004;24 (Suppl 1): S32-4. DOI:10.1016/j.ijantimicag.2004.02.007
  • Referans 3. Ronald A. The etiology of urinary tract infection: traditional and emerging pathogens. The American journal of medicine. 2002;113 (Suppl 1A):14S-9S.
  • Referans4. Yılmaz R, Karaaslan E, Özçetin M ve ark. Çocuklarda idrar yolları enfeksiyonu etkenleri ve antibiyotik duyarlılıkları. J Contemp Med 2012;2(1):17-21.
  • Referans5. Bradford PA. Extended-spectrum β-lactamases in the 21st century: characterization, epidemiology, and detection of this important resistance threat. Clin Microbiol Rev 2001;14(4):933-5. DOI:10.1128/CMR.14.4.933-951.2001
  • Referans6. Guidelines on Infection Prevention and Control 2012. ESBLs HSE South (Cork & Kerry) Community and Disability Services. Sectıon 11.1 Extended- spectrum β-lactamases (ESBL) Page 2 of 4 http://www.hse.ie/eng/about/Who/healthwellbeing/Infectcont/Sth/gl/IPCCGuidelines Section11 1.pdf.
  • Referans7. Mehrgan H, Rahbar M. Prevalence of extended-spectrum beta-lactamase-producing Escherichia coli in a tertiary care hospital in Tehran Iran . Int J Antimicrob Agents 2008;31:1471-51. DOI:10.1016/j.ijantimicag.2007.09.008.
  • Referans8. Falagas ME, Vouloumanou EK, Togias AG et al. Fosfomycin versus other antibiotics for the treatment of cystitis: a meta-analysis of randomized controlled trials. J Antimicrob Chemother 2010;65:1862–77. doi: 10.1093/jac/dkq237.
  • Referans9. Matthews PC, Barrett LK, Warren S et al. Oral fosfomycin for treatment of urinary tract infection: a retrospective cohort study. BMC Infect Dis 2016;16(1): 556.
  • Referans10. Grabe M, Bartoletti R, Bjerklund-Johansen TE et al.. Guidelines on urological infections. European Association of Urology 2014. [(accessed on 13 July 2014)]. Available online: http://www.uroweb.org/gls/pdf/19%20Urological%20infections_LR.pdf.
  • Referans11. Hooton TM. Clinical practice. Uncomplicated urinary tract infection. N Eng J Med 2012;366(11):1028-37.
  • Referans12. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. Twenty-fi rst Informational Supplement. CLSI Document M100-S21, 2011. CLSI, Wayne, PA. 5.
  • Referans13. The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 1.3, January 5, 2011. Available at: http://www.eucast.org/fileadmin/src/
  • Referans14. Livermore DM, Warner M, Mushtaq S, Doumith M, Zhang J, Woodfordet N. What remains against carbapenem-resistant Enterobacteriaceae? Evaluation of chloramphenicol, ciprofloxacin, colistin, fosfomycin, minocycline, nitrofurantoin, temocillin and tigecyclin. Int. J. Antimicrob Agents 2011;37(5):415–9.
  • Referans15. Patel B, Patel K, Shetty A, Soman R, Rodrigues C. Fosfomycin Susceptibility in Urinary Tract Enterobacteriaceae. J Assoc Physicians India 2017;65(9):14-6.
  • Referans16. Hendlin D, Stapley EO, Jackson M et al. Phosphonomycin, a new antibiotic produced by strains of Streptomyces. Science 1969;166:122–3.
  • Referans17. Bergogne-Bérézin E, Muller-Serieys C, Joly-Guillou ML, Dronne N. Trometamol-fosfomycin (Monuril) bioavailability and food-drug interaction. Eur Urol. 1987;13(1):64-8.
  • Referans18. Cassir N, Rolain JM, Brouqui P. A new strategy to fight antimicrobial resistance: the revival of old antibiotics. Front Microbiol 2014;20(5):551.
  • Referans19. Bandow JE, Brotz H, Leichert LI, Labischinski H, Hecker M. Proteomic approach to understanding antibiotic action. Antimicrob Agents Chemother 2003;47(3):948-55.
  • Referans20. Alpay Y, Yavuz MT, Aslan T, Büyükzengin B. Genişlemiş spektrumlu beta-laktamaz pozitif Escherichia coli ile oluşan komplike olmayan üriner sistem infeksiyonlarının tedavisinde oral antibiyotikler karbapenemlere alternatif olabilir mi? ANKEM 2017;31(3):85-91.
  • Referans21. Sönmezer MÇ, Tülek N, Köksal E et al. Toplum Kökenli Üriner Sistem İnfeksiyonlarında Etken Olan Genişlemiş Spektrumlu Beta-Laktamaz Üreten Escherichia coli İzolatlarında Fosfomisin Trometamolün İn Vitro Etkinliği. FLORA. 2016; 21(4): 153-8.
  • Referans22. Bollestad M, Vik I, Grude N, Blix HS, Brekke H, Lindbaek M. Bacteriology in uncomplicated urinary tract infections in Norwegian general practice from 2001–2015. BJGP Open. 2017; DOI: 10.3399/bjgpopen17X101145.
  • Referans23. Fajfr M, Louda M, Paterova P, Ryskova L, Pacovsky J, Kosina J et al. The susceptibility to fosfomycin of Gram-negative bacteria isolates from urinary tract infection in the Czech Republic: data from a unicentric study. BMC urology 2017; 17(1): 33.
  • Referans24. Córdoba G, Holm A, Hansen F, Hammerum AM, Bjerrum L. Prevalence of antimicrobial resistant Escherichia coli from patients with suspected urinary tract infection in primary care, Denmark. BMC Infect Dis 2017;17:670.
  • Referans25. Coşkun MV, Uyanık MH, Ağan İ, Huslu H, Çelebi S. Hastanede yatan hastaların üriner sistem infeksiyonlarından izole edilen genişlemiş spektrumlu beta-laktamaz üreten Klebsiella pneumoniae ve Escherichia coli suşlarının fosfomisin ve nitrofurantoine duyarlılıklarının araştırılması. ANKEM 2016;30(2):37-41.
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Orjinal Çalışma
Yazarlar

Umut Safiye Şay Coşkun

Yayımlanma Tarihi 27 Mart 2019
Kabul Tarihi 20 Şubat 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 9 Sayı: 1

Kaynak Göster

APA Şay Coşkun, U. S. (2019). Fosfomycin and Nitrofurantoin Susceptibilities of Escherichia coli and Klebsiella pneumoniae Isolates Producing Extanded Spectrum Beta-lactamase Causing Urinary Tract Infections. Çağdaş Tıp Dergisi, 9(1), 55-58. https://doi.org/10.16899/gopctd.450476
AMA Şay Coşkun US. Fosfomycin and Nitrofurantoin Susceptibilities of Escherichia coli and Klebsiella pneumoniae Isolates Producing Extanded Spectrum Beta-lactamase Causing Urinary Tract Infections. J Contemp Med. Mart 2019;9(1):55-58. doi:10.16899/gopctd.450476
Chicago Şay Coşkun, Umut Safiye. “Fosfomycin and Nitrofurantoin Susceptibilities of Escherichia Coli and Klebsiella Pneumoniae Isolates Producing Extanded Spectrum Beta-Lactamase Causing Urinary Tract Infections”. Çağdaş Tıp Dergisi 9, sy. 1 (Mart 2019): 55-58. https://doi.org/10.16899/gopctd.450476.
EndNote Şay Coşkun US (01 Mart 2019) Fosfomycin and Nitrofurantoin Susceptibilities of Escherichia coli and Klebsiella pneumoniae Isolates Producing Extanded Spectrum Beta-lactamase Causing Urinary Tract Infections. Çağdaş Tıp Dergisi 9 1 55–58.
IEEE U. S. Şay Coşkun, “Fosfomycin and Nitrofurantoin Susceptibilities of Escherichia coli and Klebsiella pneumoniae Isolates Producing Extanded Spectrum Beta-lactamase Causing Urinary Tract Infections”, J Contemp Med, c. 9, sy. 1, ss. 55–58, 2019, doi: 10.16899/gopctd.450476.
ISNAD Şay Coşkun, Umut Safiye. “Fosfomycin and Nitrofurantoin Susceptibilities of Escherichia Coli and Klebsiella Pneumoniae Isolates Producing Extanded Spectrum Beta-Lactamase Causing Urinary Tract Infections”. Çağdaş Tıp Dergisi 9/1 (Mart 2019), 55-58. https://doi.org/10.16899/gopctd.450476.
JAMA Şay Coşkun US. Fosfomycin and Nitrofurantoin Susceptibilities of Escherichia coli and Klebsiella pneumoniae Isolates Producing Extanded Spectrum Beta-lactamase Causing Urinary Tract Infections. J Contemp Med. 2019;9:55–58.
MLA Şay Coşkun, Umut Safiye. “Fosfomycin and Nitrofurantoin Susceptibilities of Escherichia Coli and Klebsiella Pneumoniae Isolates Producing Extanded Spectrum Beta-Lactamase Causing Urinary Tract Infections”. Çağdaş Tıp Dergisi, c. 9, sy. 1, 2019, ss. 55-58, doi:10.16899/gopctd.450476.
Vancouver Şay Coşkun US. Fosfomycin and Nitrofurantoin Susceptibilities of Escherichia coli and Klebsiella pneumoniae Isolates Producing Extanded Spectrum Beta-lactamase Causing Urinary Tract Infections. J Contemp Med. 2019;9(1):55-8.