Böbrek Nakli Alıcılarında İdrar Yolu Enfeksiyonlarının Epidemiyolojisi, Enfeksiyon Etkenleri ve Tedavi Profilleri: Retrospektif Tanımlayıcı Kohort Çalışması

Öz

Böbrek transplantasyonu sonrası sık görülen komplikasyonlardan olan idrar yolu enfeksiyonları (İYE), hasta ve greft sağkalımını önemli ölçüde etkilemektedir. Bu çalışmada, böbrek nakli alıcılarındaki İYE'lerin epidemiyolojik özellikleri, etken patojenleri ve antibiyotik tedavi uygulamaları detaylı olarak incelenmiştir. Ocak 2006 - Mayıs 2019 tarihleri arasında tek bir transplant merkezinde böbrek nakli yapılan 550 hasta, retrospektif olarak incelendi. Hastaların demografik ve klinik verileri ile mikrobiyolojik bulguları ve antibiyotik duyarlılık sonuçları sistematik olarak analiz edildi. İncelenen 550 hastanın 200'ünde en az bir İYE atağı gözlendi. Tanımlanan toplam 633 İYE atağında en sık saptanan etken, %64,9 oranıyla Escherichia coli idi. Bu izolatların %51,6'sında GSBL (Genişlemiş Spektrumlu Beta-Laktamaz) pozitifliği tespit edildi. İYE, böbrek nakli alıcıları arasında yaygın ve yönetimi zor bir komplikasyon olmaya devam etmektedir. Riskleri en aza indirmek ve hasta sağkalımını iyileştirmek için spesifik önleyici stratejilerin uygulanması ve dikkatli antibiyotik politikalarının sürdürülmesi şarttır. İYE vakalarındaki GSBL pozitiflik oranının dikkat çekici yüksekliği, son yıllarda hem yerel hem de küresel olarak gözlenen artan antibiyotik direnci eğilimiyle paralellik göstermektedir. Bu bulgu, mevcut antibiyotik seçim protokollerinin gözden geçirilmesi için kritik bir uyarı niteliğindedir.

Anahtar Kelimeler

• Böbrek transplantasyonu
• İdrar yolu enfeksiyonları
• Epidemiyoloji
• Escherichia coli
• Antibiyotik direnci

Epidemiology, Infectious Agents and Treatment Profiles of Urinary Tract Infections in Kidney Transplant Recipients: A Retrospective Analysis

Öz

Urinary tract infections (UTIs) are common complications after kidney transplantation, significantly affecting patient and graft outcomes. This study presents a thorough examination of the epidemiological features, causative pathogens, and antibiotic treatment patterns among kidney transplant recipients. A retrospective review was conducted involving 550 kidney transplant patients at a single transplant center, between January 2006 and May 2019. Patient demographics, clinical data, microbiological findings, and antibiotic susceptibility results were systematically analyzed. Among 550 transplant patients, at least one episode of UTI was observed in 200. Out of 633 UTI episodes identified, Escherichia coli was the most common causative microorganism, representing 64.9%. Among these, ESBL (Extended-Spectrum Beta-Lactamase) positivity was found in 51.6%. UTIs continue to be a common and challenging complication among kidney transplant recipients. Implementing specific preventive strategies and maintaining careful antibiotic policies are essential to minimize risks and enhance patient outcomes. The notably higher rate of ESBL positivity in UTI cases, which exceeds typical levels, aligns with the rising trend of antibiotic resistance observed both locally and globally in recent years. This finding serves as a crucial warning, prompting a review of antibiotic selection practices.

Anahtar Kelimeler

• Kidney transplantation
• Urinary tract infections
• Epidemiology
• Escherichia coli
• Antibiotic resistance

Kaynakça

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