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Pediatrik ve Yetişkin Hastalardan İzole Edilen E. coli İzolatlarının Antimikrobiyal Duyarlılıklarının ve Virülans Faktörlerinin İrdelenmesi

Evaluation of Antimicrobial Resistance and Virulence Genes in Uropathogenic Escherichia coli in Pediatric and Adult Patients

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Abstract (2. Language): 
We aimed to evaluate the antimicrobial resistance patterns and the prevalence of certain virulence genes in uropathogenic E. coli isolated from pediatric and adult patients with uncomplicated urinary tract infection. We examined nonduplicate 83 uropathogenic E. coli isolated from mid-stream clean-catch urine samples of the pediatric and adult outpatients with the diagnosis of acute uncomplicated urinary tract infection. VITEK® 2 automated system (bioMerieux, Marcy l’Etoile, France) was used for identification and determination of antimicrobial resistance. We examined the isolates in respect to their antimicrobial resistance patterns and the presence of virulence genes (pap, aer, sfa, hly and cnf-1). Antimicrobial susceptibility testing results of the E. coli isolates revealed that commonly used empiric antimicrobials (ciprofloxacin, trimethoprim–sulfamethoxazole, gentamicin, ampicillin and cephalothin) for urinary tract infections were less effective than others. Most frequently detected virulence genes were pap and aer in both age groups. Sfa and hly genes were the least frequently detected genes in the pediatric age group; hly gene was the also the least common in the adult age group. There was no association with virulence factors and antimicrobial resistance patterns of the uropathogenic E. coli isolates in contrary to literature. More comprehensive studies with larger sample groups are needed to demonstrate the relation between virulence factors with antimicrobial drugs in different age groups.
Abstract (Original Language): 
Bu çalışmada komplike olmayan idrar yolu enfeksiyonu tanısı almış pediatrik ve yetişkin hastalardan izole edilen E. coli izolatlarında antimikrobiyal direnç paternlerini ve virülans genlerinin prevalansını saptamayı hedefledik. Akut komplike olmayan idrar yolu enfeksiyonu tanısı almış toplam 83 pediatrik ve yetişkin ayaktan hastanın orta akım idrarından izole edilmiş kökenlerin, VITEK® 2 (bioMerieux, Marcy l’Etoile, France) otomatize sistemi ile identifikasyonları ve antimikrobiyal direnç paternleri belirlendi. Bakterilerin direnç durumları dışında virülans genlerinin (pap, aer, sfa, hly ve cnf-1) prevalansı araştırıldı. Antimikrobiyal duyarlılık testleri sonucunda; sıklıkla idrar yolu enfeksiyonları için ampirik tedavide kullanılan siprofloksasin, trimetoprim-sülfametoksazol, gentamisin, ampisilin ve sefolatinin saptanan E. coli izolatlaında araştırılan diğer ajanlardan daha az duyarlı olduğu saptandı. Her iki yaş grubunda da en yüksek oranda saptnan virülans genler pap ve aer olarak bulundu. Pediatrik yaş grubunda en az oranda saptanan genler; sfa ve hly iken yetişkin yaş grubunda en az oranda saptanan gen hly olarak saptandı. Üropatojenik E. coli izolatlarında virülans faktörleri ile antimikrobiyal direnç paternleri arasında bir ikişki olduğunu gösteren yayın sayısı literatürde yok denecek kadar azdır. Antimikrobiyallere direnç ile virülans faktörlerinin ilişkisinin değerlendirilebilmesi için daha büyük çalışma grupları gerekmektedir.

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