Çocuklarda İdrar Yolu Enfeksiyonları: Üçüncü Basamak Bir Hastanenin Klinik ve Antibiyotik Duyarlılık Verileri

Öz

Amaç: İdrar yolu enfeksiyonları (İYE), çocuklarda en sık görülen bakteriyel enfeksiyonlar arasındadır. İdrar kültürü ve antibiyogram sonuçları çıkana kadar ampirik antibiyotik tedavisi önerilir. İYE tedavisi için kullanılabilecek en uygun ampirik antibiyotik seçeneğini belirlemek için o bölgeye özgü İYE ajanlarını ve bunların antimikrobiyal duyarlılıklarını belirlemek esastır. Bu çalışma, bölgemizde İYE tanısı alan çocuklarda etken mikroorganizmaları ve antibiyotik direnç paternlerini belirlemeyi amaçladı. Gereç ve Yöntemler: Çalışma, ilk kez İYE tanısı alan 216 çocuk ile retrospektif olarak gerçekleştirildi. Hastalar yaşlarına göre (≤1 yaş ve >1 yaş) iki gruba ayrıldı. Bu iki grup arasında demografik veriler, başvuru semptomları, görüntüleme bulguları, idrar ve kültür analiz sonuçları toplandı ve karşılaştırıldı Bulgular: Escherichia coli ve Enterococcus türlerinin neden olduğu İYE'lerin ampirik tedavisinde sefazolin ve nitrofurantoin kullanımı tercih edilebilir. Ayrıca, Enterococcus spp., Klebsiella spp. ve Proteus spp.'nin neden olduğu İYE'lerin ampirik tedavisinde amoksisilin/klavulanat önerilmiştir. E. coli'nin trimetoprim-sülfametoksazol ve nitrofurantoin direnci ≤1 yaş grubunda istatistiksel olarak anlamlı yüksek bulunurken (sırasıyla p=0,03 ve p=0,01), Klebsiella'nın nitrofurantoin direnci >1 yaş grubunda istatistiksel olarak anlamlı derecede yüksek saptandı (p=0,01). Klebsiella türlerinin gentamisin direnci ≤1 yaş grubunda istatistiksel olarak anlamlı derecede yüksek bulundu (p=0,03). Sonuç: İYE'lerin tedavisinde ve komplikasyonların önlenmesinde bölgesel antibiyotik direnç paternlerini saptamak önemlidir. Uygunsuz antibiyotik kullanımını ve antibiyotik direnç oranlarını azaltmak için antibiyotik duyarlılık çalışmaları gereklidir

Anahtar Kelimeler

• Antibiyotik
• çocuk
• idrar yolu enfeksiyonları
• direnç

Urinary Tract Infections in Children: Clinical and Antibiotic Susceptibility Data from a Tertiary Care Hospital

Öz

Aim: Urinary tract infections (UTIs) are among the most common bacterial infections in children. Empirical antibiotic treatment is recommended until the antibiogram reports of urine culture are available. It is essential to initiate local UTI agents and their antimicrobial susceptibility patterns in specific geographical regions to choose the best empirical antibiotics. The current study aimed to determine causative microorganisms and antibiotic resistance patterns in children diagnosed with UTI. Material and Methods: The study was carried out retrospectively with 216 children diagnosed with UTIs for the first time. The patients were categorized into two groups according to age (≤1 year and >1 year). Demographic data, presenting symptoms, imaging findings, and urine and culture analysis results were collected and compared between these two groups. Results: Cefazolin and nitrofurantoin use may be preferred in the empirical treatment of UTIs caused by Escherichia coli and Enterococcus spp. Additionally, amoxicillin/clavulanate was recommended in the empirical therapy of UTIs caused by Enterococcus spp., Klebsiella spp., and Proteus spp. The trimethoprim-sulfamethoxazole and nitrofurantoin resistance of E. coli was found to be statistically significantly higher in the ≤1 year group (p=0.03 and p=0.01, respectively), while the nitrofurantoin resistance of Klebsiella was statistically significantly higher in the >1 year group (p=0.01). The gentamicin resistance of Klebsiella spp. was statistically significantly higher in the ≤1 year group (p=0.03). Conclusion: It is important to detect regional antibiotic resistance patterns to manage UTIs and minimize related complications. Antibiotic susceptibility studies are necessary to reduce improper antibiotic use and resistance rates of antibiotics.

Anahtar Kelimeler

• Antibiotics
• children
• urinary tract infection
• susceptibility

Kaynakça

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