Arzu Doğru1, Belma Karatoka2, Pınar Ergen1, Özlem Şen Aydın1, Elif Tükenmez Tigen3. 1. Deparment of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, İstanbul Medeniyet University, İstanbul, Turkey. 2. Deparment of Microbiology, Faculty of Medicine, İstanbul Medeniyet University, İstanbul, Turkey. 3. Deparment of Infectious Diseases and Clinical Microbiology, Marmara University Pendik Training and Research Hospital, İstanbul, Turkey.
Abstract
OBJECTIVE: More than 95% of all urinary tract infections are caused by a single bacterium. Although E. coli is the most common bacterium causing community-acquired infections, Klebsiella spp., enteric gram-negative bacteria and S. saprophyticus have been also identified. This study evaluated the microorganisms isolated from the urine cultures of patients admitted to our outpatient clinics in 2010 and assessed E. coli resistance and the frequency of extended-spectrum beta lactamase (ESBL)-producing bacteria. MATERIAL AND METHODS: In total, 7145 urine cultures were obtained from patients admitted to all clinics between 1 January 2010 and 31 December 2010. The double-disk synergy test was used to identify the presence of ESBL producers. RESULTS: The most frequently isolated microorganisms were E. coli (60.6%), Enterococcus spp. (10.3%), Klebsiella spp. (7.3%), Pseudomonas spp. (4.8%), and Streptococcus spp. (3.3%). E. coli strains were more resistant to ciprofloxacin (45.12%), trimethoprim-sulfamethoxazole (44.8%) and amoxicillin-clavulanate (31.6%), but they were less likely to be resistant to meropenem (0%), imipenem (0.2%), and amikacin (0.7%). The frequency of ESBL-producing E. coli strains was 14%. CONCLUSION: The choice of antibiotic treatment influences the overall success of treatment and the development of resistance, and it is also closely related to the cost of the treatment. As a result, there is a need to review the current treatment protocols. As resistance rates show regional differences, it is necessary to regularly examine regional resistance rates to determine the appropriate empiric antibiotic treatment and reduce costs.
OBJECTIVE: More than 95% of all urinary tract infections are caused by a single bacterium. Although E. coli is the most common bacterium causing community-acquired infections, Klebsiella spp., enteric gram-negative bacteria and S. saprophyticus have been also identified. This study evaluated the microorganisms isolated from the urine cultures of patients admitted to our outpatient clinics in 2010 and assessed E. coli resistance and the frequency of extended-spectrum beta lactamase (ESBL)-producing bacteria. MATERIAL AND METHODS: In total, 7145 urine cultures were obtained from patients admitted to all clinics between 1 January 2010 and 31 December 2010. The double-disk synergy test was used to identify the presence of ESBL producers. RESULTS: The most frequently isolated microorganisms were E. coli (60.6%), Enterococcus spp. (10.3%), Klebsiella spp. (7.3%), Pseudomonas spp. (4.8%), and Streptococcus spp. (3.3%). E. coli strains were more resistant to ciprofloxacin (45.12%), trimethoprim-sulfamethoxazole (44.8%) and amoxicillin-clavulanate (31.6%), but they were less likely to be resistant to meropenem (0%), imipenem (0.2%), and amikacin (0.7%). The frequency of ESBL-producing E. coli strains was 14%. CONCLUSION: The choice of antibiotic treatment influences the overall success of treatment and the development of resistance, and it is also closely related to the cost of the treatment. As a result, there is a need to review the current treatment protocols. As resistance rates show regional differences, it is necessary to regularly examine regional resistance rates to determine the appropriate empiric antibiotic treatment and reduce costs.
Entities:
Keywords:
E. coli; extended-spectrum beta lactamase; urine culture