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Yıl 2022, Cilt: 75 Sayı: 3, 388 - 393, 18.10.2022

Öz

Etik Beyan

Etik Kurul Onayı: Çalışma için Ankara Şehir Hastanesi 1 no’lu Etik Kurulu’ndan 23 Mart 2022 tarih ve Etik Kurul-E1-22-2511 onay sayısı ile etik kurul onayı alınmıştır.

Proje Numarası

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Kaynakça

  • 1. Khoshnood S, Heidary M, Mirnejad R, et al. Drug-resistant gram-negativ uropathogens: A review. Biomed Pharmacother. 2017;94:982-994.
  • 2. Koksal I, Yilmaz G, Unal S, et al. Epidemiology and susceptibility of pathogens from SMART 2011-12 Turkey: evaluation of hospital-acquired versus community-acquired urinary tract infections and ICU-versus non- ICU-associated intra-abdominal infections. Journal of Antimicrobial Chemotherapy. 2017;72:1364-1372.
  • 3. Jacoby GA. Extended-spectrum β-lactamases and other enzymes providing resistance to oxyimino-β-lactams. Infect Dis Clin North Am. 1997;11:875- 887.
  • 4. Alpay Y, Yavuz M, Aslan T, et al. Can Oral Antibiotics Be an Alternative to Carbapenems in The Treatment of Non-Complicated Urinary Tract InfectionsCaused by Extended Spectrum Beta-lactamase Positive Escherichia coli.ANKEM Derg. 2017;31:85-91.
  • 5. European Committee on Antimicrobial Susceptibility Testing www.eucast.org
  • 6. Kabugo D, Kizito S, Ashok DD, et al. Factors associated with communityacquiredurinary tract infections among adults attending assessment centre, Mulago Hospital Uganda. African health sciences. 2016;16:1131-1142.
  • 7. Kang C-I, Kim J, Park DW, et al. Clinical practice guidelines for the antibiotic treatment of community-acquired urinary tract infections. Infect Chemother. 2018;50:67-100.
  • 8. Ramakrishnan K, Scheid DC. Diagnosis and management of acute pyelonephritis in adults. Am Fam Physician. 2005;71:933-942.
  • 9. Franco AVM. Recurrent urinary tract infections. Best Pract Res Clin Obstet Gynaecol. 2005;19:861-873.
  • 10. Kayaaslan B, Oktay Z, Hasanoglu I, et al. Increasing rates of extendedspectrum B-lactamase-producing Escherichia coli and Klebsiella pneumoniae in uncomplicated and complicated acute pyelonephritis and evaluation of empirical treatments based on culture results. Eur J Clin Microbiol Infect Dis. 2022;41:421-430.
  • 11. Dellit TH, Owens RC, McGowan JE, et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis. 2007;44:159-177.
  • 12. Yılmaz N, Ağuş N, Bayram A, et al. Antimicrobial susceptibilities of Escherichia coli isolates as agents of community-acquired urinary tract infection (2008-2014). Turk J Urol. 2016;42:32.
  • 13. Gözüküçük R, Çakıroğlu B, Nas Y. Toplum kaynaklı üriner sistem enfeksiyonu etkeni olarak saptanan Escherichia coli izolatlarının antibiyotik duyarlılıkları. JAREM. 2012;2:101-103.
  • 14. Şenol A, Yakupoğulları Y, Şenol FF. Toplum Kökenli Üriner Sistem İnfeksiyonlarında Genişlemiş Spektrumlu β-Laktamaz Üreten Escherichia coli ve Klebsiella spp. ve Antimikrobiyal Dirençleri. Klimik Dergisi. 2020;33:163-168.
  • 15. van Driel AA, Notermans D, Meima A, et al. Antibiotic resistance of Escherichia coli isolated from uncomplicated UTI in general practice patients over a 10-year period. Eur J Clin Microbiol Infect Dis. 2019;38:2151-2158.
  • 16. Chervet D, Lortholary O, Zahar J-R, et al. Antimicrobial resistance incommunity-acquired urinary tract infections in Paris in 2015. Med Mal Infect. 2018;48:188-192.
  • 17. Boix-Palop L, Xercavins M, Badía C, et al. Emerging extended-spectrum β-lactamase-producing Klebsiella pneumoniae causing community-onset urinary tract infections: a case-control-control study. International journal of antimicrobial agents. 2017;50:197-202.
  • 18. Coşkun Ö. Rekürren üriner sistem enfeksiyonları. Gülhane Tıp Dergisi. 2008;50:226-231.
  • 19. Peña C, Gudiol C, Tubau F, et al. Risk-factors for acquisition of extendedspectrum β-lactamase-producing Escherichia coli among hospitalised patients. Clin Microbiol Infect. 2006;12:279-284.
  • 20. Guclu E, Halis F, Kose E, et al. Risk factors of multidrug-resistant bacteria in community-acquired urinary tract infections. Afr Health Sci. 2021;21:214- 219.
  • 21. Aksoy M, Isli F, Kadi E, et al. Evaluation of more than one billion outpatient prescriptions and eight‐year trend showing a remarkable reduction in antibiotic prescription in Turkey: A success model of governmental interventions at national level. Pharmacoepidemiol Drug Saf. 2021;30:1242- 1249.
  • 22. Bastug A, Oksuz E, Kazancioglu S, et al. Efficacy and cost‐effectivity analysis of outpatient parenteral antimicrobial therapy unit in infectious disease clinical practices: Turkey perspective. Int J Clin Pract. 2021;75:e14147.
  • 23. Schutz D, Watson SC, Hayden G, et al. Outpatient Treatment of Uncomplicated Urinary Tract Infections in the Emergency Department. Adv Emerg Nurs J. 2018;40:162-170.

Evaluation of Community-acquired Lower Urinary Tract Infections

Yıl 2022, Cilt: 75 Sayı: 3, 388 - 393, 18.10.2022

Öz

Objectives: Antibiotic resistance has become an important problem not only for the treatment of hospital-acquired infections, but also for community-acquired infections. In this study, we aimed to investigate the microbial agents isolated from community-acquired urinary tract infections (UTI), their resistance rates and antibiotics used for treatment.

Materials and Methods: In this retrospective single-center cross-sectional study, microorganism distribution, antibiotic resistance rates and given antibiotics were evaluated in 179 patients diagnosed with community-acquired lower UTI in Ankara City Hospital Infectious Diseases OutpatientClinic.

Results: Escherichia coli (64.8%) and Klebsiella pneumoniae (11.2%) were the most frequently isolated agents in the urine culture of 179 patients included in the study. Extended-spectrum ß-lactamase (ESBL) type resistance was observed at the rate of 48.3% in E. coli and 60% in K. pneumoniae. For E. coli, amoxicillin-clavulanate resistance rate was 54.3%, trimethoprim sulfamethoxazole resistance rate was 37%, and ciprofloxacin resistance rate was 45.7%.

Conclusion: In this study, it was determined that ESBL resistance increased to 48.3% for E. coli, which we isolated most frequently in communityacquired UTIs. This shows that oral antibiotics, which we often prefer in the treatment of UTI, are not effective in almost half of the patients. Antibiotic resistance in our country has significantly limited the treatment options even in treating community acquired infections. For this reason, we think that rational antibiotic use policies should be reviewed and urgent measures should be taken.

Destekleyen Kurum

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Proje Numarası

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Teşekkür

-

Kaynakça

  • 1. Khoshnood S, Heidary M, Mirnejad R, et al. Drug-resistant gram-negativ uropathogens: A review. Biomed Pharmacother. 2017;94:982-994.
  • 2. Koksal I, Yilmaz G, Unal S, et al. Epidemiology and susceptibility of pathogens from SMART 2011-12 Turkey: evaluation of hospital-acquired versus community-acquired urinary tract infections and ICU-versus non- ICU-associated intra-abdominal infections. Journal of Antimicrobial Chemotherapy. 2017;72:1364-1372.
  • 3. Jacoby GA. Extended-spectrum β-lactamases and other enzymes providing resistance to oxyimino-β-lactams. Infect Dis Clin North Am. 1997;11:875- 887.
  • 4. Alpay Y, Yavuz M, Aslan T, et al. Can Oral Antibiotics Be an Alternative to Carbapenems in The Treatment of Non-Complicated Urinary Tract InfectionsCaused by Extended Spectrum Beta-lactamase Positive Escherichia coli.ANKEM Derg. 2017;31:85-91.
  • 5. European Committee on Antimicrobial Susceptibility Testing www.eucast.org
  • 6. Kabugo D, Kizito S, Ashok DD, et al. Factors associated with communityacquiredurinary tract infections among adults attending assessment centre, Mulago Hospital Uganda. African health sciences. 2016;16:1131-1142.
  • 7. Kang C-I, Kim J, Park DW, et al. Clinical practice guidelines for the antibiotic treatment of community-acquired urinary tract infections. Infect Chemother. 2018;50:67-100.
  • 8. Ramakrishnan K, Scheid DC. Diagnosis and management of acute pyelonephritis in adults. Am Fam Physician. 2005;71:933-942.
  • 9. Franco AVM. Recurrent urinary tract infections. Best Pract Res Clin Obstet Gynaecol. 2005;19:861-873.
  • 10. Kayaaslan B, Oktay Z, Hasanoglu I, et al. Increasing rates of extendedspectrum B-lactamase-producing Escherichia coli and Klebsiella pneumoniae in uncomplicated and complicated acute pyelonephritis and evaluation of empirical treatments based on culture results. Eur J Clin Microbiol Infect Dis. 2022;41:421-430.
  • 11. Dellit TH, Owens RC, McGowan JE, et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis. 2007;44:159-177.
  • 12. Yılmaz N, Ağuş N, Bayram A, et al. Antimicrobial susceptibilities of Escherichia coli isolates as agents of community-acquired urinary tract infection (2008-2014). Turk J Urol. 2016;42:32.
  • 13. Gözüküçük R, Çakıroğlu B, Nas Y. Toplum kaynaklı üriner sistem enfeksiyonu etkeni olarak saptanan Escherichia coli izolatlarının antibiyotik duyarlılıkları. JAREM. 2012;2:101-103.
  • 14. Şenol A, Yakupoğulları Y, Şenol FF. Toplum Kökenli Üriner Sistem İnfeksiyonlarında Genişlemiş Spektrumlu β-Laktamaz Üreten Escherichia coli ve Klebsiella spp. ve Antimikrobiyal Dirençleri. Klimik Dergisi. 2020;33:163-168.
  • 15. van Driel AA, Notermans D, Meima A, et al. Antibiotic resistance of Escherichia coli isolated from uncomplicated UTI in general practice patients over a 10-year period. Eur J Clin Microbiol Infect Dis. 2019;38:2151-2158.
  • 16. Chervet D, Lortholary O, Zahar J-R, et al. Antimicrobial resistance incommunity-acquired urinary tract infections in Paris in 2015. Med Mal Infect. 2018;48:188-192.
  • 17. Boix-Palop L, Xercavins M, Badía C, et al. Emerging extended-spectrum β-lactamase-producing Klebsiella pneumoniae causing community-onset urinary tract infections: a case-control-control study. International journal of antimicrobial agents. 2017;50:197-202.
  • 18. Coşkun Ö. Rekürren üriner sistem enfeksiyonları. Gülhane Tıp Dergisi. 2008;50:226-231.
  • 19. Peña C, Gudiol C, Tubau F, et al. Risk-factors for acquisition of extendedspectrum β-lactamase-producing Escherichia coli among hospitalised patients. Clin Microbiol Infect. 2006;12:279-284.
  • 20. Guclu E, Halis F, Kose E, et al. Risk factors of multidrug-resistant bacteria in community-acquired urinary tract infections. Afr Health Sci. 2021;21:214- 219.
  • 21. Aksoy M, Isli F, Kadi E, et al. Evaluation of more than one billion outpatient prescriptions and eight‐year trend showing a remarkable reduction in antibiotic prescription in Turkey: A success model of governmental interventions at national level. Pharmacoepidemiol Drug Saf. 2021;30:1242- 1249.
  • 22. Bastug A, Oksuz E, Kazancioglu S, et al. Efficacy and cost‐effectivity analysis of outpatient parenteral antimicrobial therapy unit in infectious disease clinical practices: Turkey perspective. Int J Clin Pract. 2021;75:e14147.
  • 23. Schutz D, Watson SC, Hayden G, et al. Outpatient Treatment of Uncomplicated Urinary Tract Infections in the Emergency Department. Adv Emerg Nurs J. 2018;40:162-170.
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Tıbbi Enfeksiyon Ajanları
Bölüm Makaleler
Yazarlar

Belgin Coşkun 0000-0002-9884-9859

Proje Numarası -
Yayımlanma Tarihi 18 Ekim 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 75 Sayı: 3

Kaynak Göster

APA Coşkun, B. (2022). Evaluation of Community-acquired Lower Urinary Tract Infections. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 75(3), 388-393. https://doi.org/10.4274/atfm.galenos.2022.76598
AMA Coşkun B. Evaluation of Community-acquired Lower Urinary Tract Infections. Ankara Üniversitesi Tıp Fakültesi Mecmuası. Ekim 2022;75(3):388-393. doi:10.4274/atfm.galenos.2022.76598
Chicago Coşkun, Belgin. “Evaluation of Community-Acquired Lower Urinary Tract Infections”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 75, sy. 3 (Ekim 2022): 388-93. https://doi.org/10.4274/atfm.galenos.2022.76598.
EndNote Coşkun B (01 Ekim 2022) Evaluation of Community-acquired Lower Urinary Tract Infections. Ankara Üniversitesi Tıp Fakültesi Mecmuası 75 3 388–393.
IEEE B. Coşkun, “Evaluation of Community-acquired Lower Urinary Tract Infections”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, c. 75, sy. 3, ss. 388–393, 2022, doi: 10.4274/atfm.galenos.2022.76598.
ISNAD Coşkun, Belgin. “Evaluation of Community-Acquired Lower Urinary Tract Infections”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 75/3 (Ekim 2022), 388-393. https://doi.org/10.4274/atfm.galenos.2022.76598.
JAMA Coşkun B. Evaluation of Community-acquired Lower Urinary Tract Infections. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2022;75:388–393.
MLA Coşkun, Belgin. “Evaluation of Community-Acquired Lower Urinary Tract Infections”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, c. 75, sy. 3, 2022, ss. 388-93, doi:10.4274/atfm.galenos.2022.76598.
Vancouver Coşkun B. Evaluation of Community-acquired Lower Urinary Tract Infections. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2022;75(3):388-93.