Üriner sistem semptomu olan hastalarda idrarda mikroplastik varlığının piyüri ve bakteriüri üzerine etkisinin araştırılması
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Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Kırıkkale Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Üriner sistemin herhangi bir alanınına mikroorganizmanın invazyonu sonucu farklı klinik tabloları içeren üriner sistem enfeksiyonu tüm dünyada ciddi morbidite ve mortalite nedenidir. Üriner sistem enfeksiyonu hastalarında komplike edici nedenlerin varlığında tedavi zorlukları ile karşılaşılmaktadır. Bu durum gereksiz antibiyotik kullanımına ve hastada klinik yanıt alınamamasına neden olmaktadır. Plastiklerin günlük yaşamda yaygın olarak kullanılmasıyla birlikte insanların mikroplastiklere yiyecekler veya çevre yoluyla maruziyeti artmıştır. Mikroplastik parçacıklarının insan vücuduna maruziyeti sonrası gözlemlenen etkilerinde oksidatif stres ve enflamatuvar yanıtların yüksek öneme sahip olduğu görülmektedir. Üriner sistemde yoğun olarak bulunan mikroplastiklerin bakteri adezyonu ve yabancı cisim reaksiyonu nedeniyle komplike edici bir neden olabileceği düşünülmektedir. Bu çalışmada mikroplastiklerin üriner sistem üzerindeki oksidatif stres, sitotoksisite, enflamatuvar etkilerini ve bakteriüri ile ilişkisini değerlendirmek amaçlandı. Çalışma 15/09/2023-15/07/2024 tarihleri arasında yapıldı. Çalışma için, Kırıkkale Üniversitesi Tıp Fakültesi Klinik Araştırmalar Etik Kurulu'ndan onay alındı. 153 bireyi kapsayan bu çalışmada, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji polikliniğine başvuran üriner sistem yakınması olan hasta grubu ve üriner sistem yakınması olmayan kontrol grubu belirlendi. Anamnez, fizik muayane ve tetkikler sonucunda semptom ve bakteriürinin birlikte olduğu 1. çalışma grubu ve semptoma bakteriürinin eşlik etmediği 2. çalışma grubu ve semptomu olmayan kontrol grubu oluşturuldu. Tüm katılımcıların idrar örneklerindeki mikroplastikler organik uzaklaştırma ve filtreden süzme işlemlerinden sonra mikroskop altında hot needle ve Nile red boyama yöntemi ile tanımlandı. Tanımlama yapılan mikroplastikler mikroskop altında sayıldı. Hasta ve kontrol grubuna ait klinik, laboratuvar ve mikroplastik sonuçları değerlendirildi. Hastaların ve kontrol grubunun test verileri değerlendirildi. İstatistik analizler SPSS versiyon 20.0 yazılımı kullanılarak yapıldı. P değerinin 0,05'in altında olduğu durumlar istatistiksel olarak anlamlı sonuçlar olarak değerlendirildi. Çalışmada yaş, cinsiyet, eşlik eden hastalıkla ve farklı meslek gruplarında saptanan mikroplastik yoğunlukları arasında fark bulunmadı. Semptom ve bakteriürinin birlikte olduğu 1. çalışma grubu ve semptoma bakteriürinin eşlik etmediği 2. çalışma grubu ve semptomu olmayan kontrol grubu arasındaki mikroplastikler yoğunluğu farkı istatistiksel olarak anlamlı bulundu. İdrardaki mikroplastik yoğunluğu piyüri ve bakteriüri düzeylerine göre hasta bireyler ile sağlıklı bireyler arasında farklı olduğu saptandı. Piyürisi olan bireylerin idrarındaki mikroplastik yoğunluğu, piyürisi olamayan gruba göre istatitistiksel olarak anlamlı derecede daha fazlaydı. Bakteriürisi olan bireylerin idrarındaki mikroplastik yoğunluğu bakteriürisi olmayanlara göre istatistiksel olarak anlamlı derecede daha fazla saptandı. Bu veriler mikroplastiklerin üriner sistem üzerinde lokal inflamatuar yanıta neden olabileceğini destekler niteliktedir. Piyüri için net bir neden bulunamadığı durumlarda sistemik hastalık, ilaç, malignite gibi nedenlerin yanında MP maruziyetinin de göz önünde bulundurulması gerektiği düşünüldü. Mikroplastikler varlığının çok olduğu idrar numunelerinde bakteri üremesinin de yüksek olması önceki çalışmaları destekler niteliktedir. Bu veriler ÜSE hastalarında üriner sistem üzerinde mikroplastiklerin komplike edici bir neden olabileceğini düşündürmektedir. ÜSE tedavisinde kullanılan etkin antibiyoterapiye rağmen yanıt alınamayan hastalarda idrarda mikroplastik varlığının komplike edici faktör olarak değerlendirip değerlendirilemeyeceği gelecekte tartışılması muhtemel konular arasındadır.
Urinary tract infections, which include different clinical presentations as a result of microorganism invasion into any part of the urinary tract, are a serious cause of morbidity and mortality worldwide. Treatment difficulties are encountered in the presence of complicating causes in urinary tract infection patients. This leads to unnecessary antibiotic use and lack of clinical response in the patient. With the widespread use of plastics in daily life, human exposure to microplastics through food or the environment has increased. Oxidative stress and inflammatory responses are of high importance in the effects of microplastic particles after exposure to the human body. It is thought that microplastics in the urinary system may be a complicating cause of bacterial adhesion and foreign body reaction. In this study, we aimed to evaluate the oxidative stress, cytotoxicity, inflammatory effects of microplastics on the urinary system and their relationship with bacteriuria. The study was conducted between 15/09/2023 and 15/07/2024. Approval for the study was obtained from Kırıkkale University Faculty of Medicine Clinical Research Ethics Committee. In this study of 153 individuals, a group of patients with urinary system complaints and a control group without urinary system complaints who applied to the Infectious Diseases and Clinical Microbiology outpatient clinic were determined. As a result of anamnesis, physical examination and tests, the first study group with symptoms and bacteriuria together, the second study group with symptoms without bacteriuria and the control group without symptoms were formed. Microplastics in urine samples of all participants were identified by hot needle and Nile red staining method under microscope after organic removal and filtering. Identified microplastics were counted under the microscope. Clinical, laboratory and microplastic results of the patients and the control group were evaluated. Test data of the patients and the control group were evaluated. Statistical analyses were performed using SPSS version 20.0 software. P values below 0.05 were considered as statistically significant results. There were no differences in microplastic densities between age, gender, comorbidities and different occupational groups. The difference in microplastic density between the 1st study group with symptoms and bacteriuria, the 2nd study group with symptoms without bacteriuria and the control group without symptoms was statistically significant. The microplastic density in urine was found to be different between patients and healthy individuals according to pyuria and bacteriuria levels. The microplastic concentration in the urine of individuals with pyuria was statistically significantly higher than the group without pyuria. The MP denne of individuals with bacteriuria was significantly higher than that of those without bacteriuria. These data support that microplastics may cause a local inflammatory response in the urinary system. In cases where no clear cause for pyuria was found, it was thought that MP exposure should be considered in addition to systemic diseases, drugs, malignancy. The high bacterial growth in urine samples with high microplastic presence supports previous studies. These data suggest that microplastics may be a complicating factor on the urinary system in urinary tract infection patients. Whether the presence of microplastics in urine can be considered as a complicating factor in patients who do not respond to effective antibiotherapy used in the treatment of urinary tract infection is among the possible topics to be discussed in the future.
Urinary tract infections, which include different clinical presentations as a result of microorganism invasion into any part of the urinary tract, are a serious cause of morbidity and mortality worldwide. Treatment difficulties are encountered in the presence of complicating causes in urinary tract infection patients. This leads to unnecessary antibiotic use and lack of clinical response in the patient. With the widespread use of plastics in daily life, human exposure to microplastics through food or the environment has increased. Oxidative stress and inflammatory responses are of high importance in the effects of microplastic particles after exposure to the human body. It is thought that microplastics in the urinary system may be a complicating cause of bacterial adhesion and foreign body reaction. In this study, we aimed to evaluate the oxidative stress, cytotoxicity, inflammatory effects of microplastics on the urinary system and their relationship with bacteriuria. The study was conducted between 15/09/2023 and 15/07/2024. Approval for the study was obtained from Kırıkkale University Faculty of Medicine Clinical Research Ethics Committee. In this study of 153 individuals, a group of patients with urinary system complaints and a control group without urinary system complaints who applied to the Infectious Diseases and Clinical Microbiology outpatient clinic were determined. As a result of anamnesis, physical examination and tests, the first study group with symptoms and bacteriuria together, the second study group with symptoms without bacteriuria and the control group without symptoms were formed. Microplastics in urine samples of all participants were identified by hot needle and Nile red staining method under microscope after organic removal and filtering. Identified microplastics were counted under the microscope. Clinical, laboratory and microplastic results of the patients and the control group were evaluated. Test data of the patients and the control group were evaluated. Statistical analyses were performed using SPSS version 20.0 software. P values below 0.05 were considered as statistically significant results. There were no differences in microplastic densities between age, gender, comorbidities and different occupational groups. The difference in microplastic density between the 1st study group with symptoms and bacteriuria, the 2nd study group with symptoms without bacteriuria and the control group without symptoms was statistically significant. The microplastic density in urine was found to be different between patients and healthy individuals according to pyuria and bacteriuria levels. The microplastic concentration in the urine of individuals with pyuria was statistically significantly higher than the group without pyuria. The MP denne of individuals with bacteriuria was significantly higher than that of those without bacteriuria. These data support that microplastics may cause a local inflammatory response in the urinary system. In cases where no clear cause for pyuria was found, it was thought that MP exposure should be considered in addition to systemic diseases, drugs, malignancy. The high bacterial growth in urine samples with high microplastic presence supports previous studies. These data suggest that microplastics may be a complicating factor on the urinary system in urinary tract infection patients. Whether the presence of microplastics in urine can be considered as a complicating factor in patients who do not respond to effective antibiotherapy used in the treatment of urinary tract infection is among the possible topics to be discussed in the future.
Açıklama
Tıp Fakültesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Ana Bilim Dalı
Anahtar Kelimeler
Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji, Infectious Diseases and Clinical Microbiology
