Hemodiyaliz Hastalarında Rektal Sürüntü Örneklerinde Genişlemiş Spektrumlu Beta-laktamaz Taşıyıcılığı Oranlarının ve Risk Faktörlerinin Belirlenmesi
Yükleniyor...
Tarih
2015
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmanın amacı hemodiyaliz tedavisi gören hastalarında rektal sürüntü örneklerinde genişlemiş spektrumlu betalaktamaz (GSBL) üreten Enterobacteriacea sıklığı ve GSBL taşıyıcılığı ile ilişkili risk faktörlerinin belirlenmesi idi. Yöntem ve Gereçler: Çalışmaya kronik böbrek yetmezliği nedeniyle hemodiyaliz tedavisi gören 78 hasta ( 43 kadın (yaş ortalaması 46 3,6) 35 erkek (yaş ortalaması 55 4.3) dahil edildi. Hastalarda GSBL rektal taşıyıcılığı ile ilişkili risk faktörleri (cinsiyet, yaş ortalaması, hemodiyaliz süresi ve son 6 ay içinde antibiyotik kullanımı) araştırıldı. P 0.05 istatistiksel olarak anlamlı kabul edildi. Bulgular: Çalışmaya alınan toplam 78 hastanın 30 (%38)unda çift disk sinerji testi ile GSBL pozitif (üreten) Enterobacteriacea türleri (spp.) rektal taşıyıcılığı saptanırken, ESBL kromojenik agar besiyeri ile 26 (%33.3)ında GSBL pozitifliği saptandı. Hemodiyaliz hastalarının rektal sürüntü örneğinde üreyen Enterobacteriacea sppnin 20si (%66.6) GSBL pozitif E.coli, 7si (%23.3) GSBL pozitif Klebsiella spp., 3ü (%10) GSBL pozitif Proteus spp. olarak belirlendi. Hemodiyaliz hastalarında GSBL Enterobacteriacea spp. rektal taşıyıcılığı ile son 6 ayda antibiyotik kullanımı arasında istatistiksel olarak anlamlı ilişki saptandı (P0.001) Sonuç: Hemodiyaliz hastalarında GSBL pozitif Enterobacteriacea spp. rektal taşıyıcılığı için son 6 ayda antibiyotik kullanımı önemli bir risk faktörü olup, taşıyıcılık riskini yaklaşık 17 kat arttırmaktadır. Bu nedenle hemodiyaliz hastalarında GSBL pozitif Enterobacteriacea spp.e türlerine bağlı olarak gelişebilecek enfeksiyonları önleme açısından gereksiz antibiyotik kullanımından kaçınılmalıdır.
Aim: The aim of the current study is to determine the incidence of extended spectrum beta lactamase producing Enterobacteriaceae (ESBL) in rectal swab samples of patients who are under hemodialysis treatment and to determine the risk factors related to ESBL carrier state. Material and Methods: Seventy-eight patients (43 female (mean age: 46± 3.6 years) and 35 male (mean age: 55± 4.3 years) who are under hemodialysis treatment due to chronic renal failure were included to the study. The risk factors related to the ESBL rectal carriage in the patients (gender, mean age, duration of hemodialysis, and antibiotic use during last 6 months) were investigated. P≤ 0.05 was accepted as statistically significant. Results: While rectal carriage of ESBL-positive (producing) Enterobacteriaceae species was detected by double disc synergy test in 30 (38%) of a total of 78 patients included in the study, ESBL positivity was found in 26 (33.3%) of patients with ESBL chromogenic agar medium. ESBL-positive E.coli was isolated in 20 (66.6%) of the hemodialysis patients and ESBL positive Klebsiella species was isolated in seven (23.3%) cases, and ESBL-positive Proteus species was isolated in three (10%) cases. While there was a history of antibiotic use within last six months in 20 (66.7%) of the patients in which ESBL- positive Enterobacteriaceae spp. was detected, there was a history of antibiotic use within last six months in five (10.4%) ESBL-negative patients. A statistically significant correlation was found between rectal carriage of ESBL positive Enterobacteriaceae spp. and antibiotic use within last six months in hemodialysis patients (p<0.001). Conclusion: Antibiotic use within the last six months is an important risk factor for rectal carrier of ESBL-positive Enterobacteriaceae spp. in hemodialysis patients and it increases the risk of carrier state approximately 17-fold. Therefore, unnecessary antibiotic use should be avoided in hemodialysis patients for the prevention of infections caused by ESBL-positive Enterobacteriaceae spp.
Aim: The aim of the current study is to determine the incidence of extended spectrum beta lactamase producing Enterobacteriaceae (ESBL) in rectal swab samples of patients who are under hemodialysis treatment and to determine the risk factors related to ESBL carrier state. Material and Methods: Seventy-eight patients (43 female (mean age: 46± 3.6 years) and 35 male (mean age: 55± 4.3 years) who are under hemodialysis treatment due to chronic renal failure were included to the study. The risk factors related to the ESBL rectal carriage in the patients (gender, mean age, duration of hemodialysis, and antibiotic use during last 6 months) were investigated. P≤ 0.05 was accepted as statistically significant. Results: While rectal carriage of ESBL-positive (producing) Enterobacteriaceae species was detected by double disc synergy test in 30 (38%) of a total of 78 patients included in the study, ESBL positivity was found in 26 (33.3%) of patients with ESBL chromogenic agar medium. ESBL-positive E.coli was isolated in 20 (66.6%) of the hemodialysis patients and ESBL positive Klebsiella species was isolated in seven (23.3%) cases, and ESBL-positive Proteus species was isolated in three (10%) cases. While there was a history of antibiotic use within last six months in 20 (66.7%) of the patients in which ESBL- positive Enterobacteriaceae spp. was detected, there was a history of antibiotic use within last six months in five (10.4%) ESBL-negative patients. A statistically significant correlation was found between rectal carriage of ESBL positive Enterobacteriaceae spp. and antibiotic use within last six months in hemodialysis patients (p<0.001). Conclusion: Antibiotic use within the last six months is an important risk factor for rectal carrier of ESBL-positive Enterobacteriaceae spp. in hemodialysis patients and it increases the risk of carrier state approximately 17-fold. Therefore, unnecessary antibiotic use should be avoided in hemodialysis patients for the prevention of infections caused by ESBL-positive Enterobacteriaceae spp.
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
ORTADOĞU TIP DERGİSİ
WoS Q Değeri
Scopus Q Değeri
Cilt
7
Sayı
2
Künye
Çifci, A., Tosun, İ., Erol, Ö., Kılıçarslan, E. E., Cesur, S. (2015). Hemodiyaliz Hastalarında Rektal Sürüntü Örneklerinde Genişlemiş Spektrumlu Beta-laktamaz Taşıyıcılığı Oranlarının ve Risk Faktörlerinin Belirlenmesi. ORTADOĞU TIP DERGİSİ, 7(2), 56 - 59.