Türkiye'de Üçüncü Basamak Bir Hastanede İntraabdominal Apselerin Klinik ve Mikrobiyolojik Özelliklerinin Değerlendirilmesi

Yıl 2025, Cilt: 47 Sayı: 2, 277 - 284, 27.02.2025

Suzan Şahin , Bülent Kaya , Serap Demir Tekol

Öz

İntraabdominal apselerde (İAA) etken mikroorganizmaları ve mikrobiyolojik duyarlılığı bilmek, ampirik antibiyotik seçimine rehberlik eder. İAA’ de etkenler, antibiyotik duyarlılığı ve tedavi seçeneklerini araştırmayı amaçladık. Ocak 2020 ile Aralık 2022 arasında intraabdominal apse nedeniyle hastaneye yatırılan ve apse materyali kültürlerinde üreme görülen hastalar risk faktörleri, etken ajanlar, antibiyotik duyarlılıkları ve tedavi seçenekleri açısından retrospektif olarak değerlendirildi. Çalışmaya ortalama yaşı 57,2 yıl (aralığı 22-88) olan 30 erkek (%69,8) ve 13 kadın (%30,2) olmak üzere toplam 43 hasta dahil edildi. On bir hastanın altta yatan hastalığı yoktu, altta yatan hastalıkların çoğunluğunu gastrointestinal durumlar oluşturuyordu (n=11, %25,6). En sık görülen apse bölgesi karaciğerdi (n=19, %44,2), bunu intraperitoneal (n=14, %32,6), retroperitoneal (n=5, %11,6) bölgeler izledi. En sık kullanılan görüntüleme yöntemi 29 hastada (%67,5) bilgisayarlı tomografi (BT) idi. Çalışmaya dahil edilen 43 hastadan toplam 60 mikroorganizma izole edildi. İzole edilen mikroorganizmaların çoğunluğu Gram negatif bakterilerdi (n=42, %70,0). Başlangıçta ampirik antibiyotik tedavisi alan 15 hastada (%34,9), tedavi daha sonra izole edilen mikroorganizmanın direnç profiline göre geniş spektrumlu antibiyotiklere değiştirildi. İntraabdominal apse nedeniyle takip edilen hastalarda kültür sonuçları çıkıncaya kadar uygun ampirik antimikrobiyal tedavi başlanması hayati öneme sahip olabilmektedir. Enfeksiyon etkeni saptandıktan ve direnç durumu belirlendikten sonra etkene yönelik tedavi yapılabilmektedir. Her kurumun kendi antibiyotik direnç durumunu bilmesi ampirik tedavilerde yol gösterici olacaktır.

Anahtar Kelimeler

intra-abdominal apse, tedavi, direnç

Evaluation of Clinical and Microbiological Features of Intraabdominal Abscesses in A Tertiary Hospital in Türkiye

Öz

Knowing the causative agents and microbiological susceptibility in intra-abdominal abscess (IAA) cases guides empirical antibiotic selection. We aimed to investigate the causative agents, susceptibility, and treatment options in intra-abdominal abscesses. Patients hospitalized with intra-abdominal abscesses between January 2020 and December 2022, in whom abscess material cultures yielded growth, were retrospectively analyzed. Risk factors, causative agents, antibiotic susceptibilities, and treatment options were evaluated. A total of 43 patients, with a mean age of 57.2 years (range 22-88), consisting of 30 males (69.8%) and 13 females (30.2%), were included in the study. Eleven patients had no underlying diseases, while gastrointestinal conditions constituted the majority of underlying diseases (n=11, 25.6%). The most common site of abscess was the liver (n=19, 44.2%), followed by intraperitoneal (n=14, 32.6%), retroperitoneal (n=5, 11.6%) regions. The most frequently used imaging method was computed tomography (CT) in 29 patients (67.5%). A total of 60 microorganisms were isolated from the 43 patients included in the study. The majority of the isolated microorganisms were Gram-negative bacteria (n=42, 70.0%). In 15 patients (34.9%) who initially received empirical antibiotic treatment, the treatment was subsequently modified to broad-spectrum antibiotics based on the resistance profile of the isolated microorganism. In patients monitored for intra-abdominal abscesses, initiating appropriate empirical antimicrobial therapy before culture results become available can be crucial. Once the infectious agent is identified and its resistance profile determined, targeted treatment can be administered. Each institution’s awareness of its own antibiotic resistance patterns will guide empirical therapies effectively.

Anahtar Kelimeler

intra-abdominal abscesses, treatment, rezistance

Kaynakça

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