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

Year 2017, Volume: 2 Issue: 2, 1 - 11, 01.07.2017

Kerem Yılmaz , Şafak Ermertcan , Hüseyin Taşlı Semra Kurutepe , Tayfur Demiray

Abstract

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.

Keywords

E.coli, Virülans, PCR, Antimikrobiyal Duyarlılık

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

Abstract

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. 

Keywords

E. coli, Virulence, Antimicrobial Resistance, PCR

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