Eskişehir'de üçüncü basamak bir hastanedeki fungal üriner sistem enfeksiyonlarından izole edilen mayaların dağılımı

Abstract

Amaç: Mantarların neden olduğu idrar yolu enfeksiyonları kritik hastalarda son yıllarda giderek artmaktadır. Fungiüri, alt veya üst üriner sistemde kontaminasyon, kolonizasyon veya enfeksiyonun bir belirtecidir. Üriner kateterin uzun süreli kullanım, fungiüri için en önemli risk faktörüdür. Maya izolatlarının tür düzeyinde tanımlanması, enfeksiyonun uygun yönetimi için çok önemlidir. Bu çalışma fungiüri gelişen hastaların epidemiyolojik özelliklerini tanımlamak amacı ile yapıldı. Yöntem: Maya türleri, konvansiyonel yöntemler ve otomatize sistemler kullanılarak tanımlanmıştır. Demografik veriler için elektronik tıbbi kayıtlar kullanılmıştır. Bulgular: Candida albicans, non-albicans Candida türlerine ve maya benzeri mantarlara göre baskın olarak bulundu. Albicans dışı Candida türleri arasında en yaygın tür C. tropicalis ve ardından C. glabrata olarak bulundu. Fungiüri kadınlarda erkeklerden daha yaygın olarak saptandı. Hastalarda altta yatan risk faktörleri mevcuttu, en yaygın risk faktörleri; maya saptanmadan önce antibiyotik tedavisi ve idrar sondası kullanılmasıydı. Sonuç: Epidemiyolojik veriler ve ampirik antimikrobiyal tedavi üriner sistem enfeksiyonlarının tedavisinde önemli rol oynamaktadır. Bu nedenle, mantarların tür düzeyinde tanımlanması, karmaşık vakalarda antifungal tedavi kararına yardımcı olmak için kritik öneme sahiptir. İdrar kültüründe mantar üremesi olan tüm hastalarda öncelikle altta yatan risk faktörleri değerlendirilmelidir. Risk faktörlerinin düzeltilmesine bağlı olarak fungiüri kendiliğinden düzelebilir. Bu hem tedavi maliyetlerini azaltmak hem de antifungallere direnci önlemek için en iyi yaklaşım olarak görülmektedir.

Keywords

• Fungiuri
• Candiduri
• üriner sistem enfeksiyonu
• üriner kateter

Distribution of yeasts in fungal urinary tract infections from a tertiary care hospital

Abstract

Aims: Urinary tract infections caused by fungi in critically ill patients steadily increasing in recent years. Fungiuria is a marker of contamination, colonization, or infection in the lower or upper urinary tract. As urinary catheters especially long-term usage was the most important risk factor for fungiuria. The identification of yeast isolates at the species level is crucial for the appropriate management of infection. We conducted this study to describe the epidemiological features of fungiuria in patients. Methods: The yeast species were identified by using conventional methods and automated systems. Demographic data were recorded from the electronic medical records. Results: Candida albicans, were predominant compared to non-albicans Candida species and yeast-like fungi. Among non-albicans Candida, the most common species were Candida tropicalis followed by Candida glabrata complex. Fungiuria was more common in females than in males. Underlying conditions were present in patients the most common risk factors were antibiotic therapy before the detection of yeasts and using a urinary catheter. Conclusion: Epidemiological data and antimicrobial therapy play an important role in the treatment of urinary tract infections. For this reason, the identification of fungi at the species level is critical to assist the decision on antifungal therapy in complex cases. In all patients with fungal growth in urine culture, the underlying risk factors should be evaluated first. Depending on the correction of risk factors, fungiuria may resolve spontaneously. This is seen as the best approach both to reduce treatment costs and to prevent resistance to antifungals.

Keywords

• Fungiuria
• Candiduria
• urinary tract infection
• urinary catheter

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