In-vitro activity of fosfomycin trometamol and some other antibiotics against Escherichia coli strains isolated from urinary tract infections

Amac: Son yillarda ulkemizde ve dunyada uropatojen E.coli suslarinda uriner sistem infeksiyonu tedavisinde sik kullanilan antibiyotiklere karsi duyarlilikta azalma go­rulmektedir. Direnc nedeniyle tedavi yetersizligi ve ampi­rik tedavinin degistirilmesi ihtiyaci, recete maliyetlerinde artis, hastanede kalma suresinde uzama, sosyal maliyet, morbidite ve mortalitede artis ortaya cikmaktadir. Bu ca­lismada, uriner sistem infeksiyon etkeni olan E.coli\'nin bazi antibiyotiklere ve fosfomisine olan duyarliliginin arastirilmasi amaclanmistir. Gerec ve yontem: Kiziltepe Devlet Hastanesi Merkez laboratuarina Agustos 2010-Aralik 2010 tarihleri arasin­da polikliniklerden gelen idrar orneklerinden izole edilen E.coli izolatlari calismaya alinmistir. Bu izolatlar idrar mik­roskobisinde 10/mm3 lokositi olup uriner sistem infeksi­yonu dusundugumuz hastalarin idrar kulturlerinden elde edilmistir. Bu calismada uropatojen E.coli infeksiyonlarin­da FOT (fosfomisin), CIP (Siprofloksasin), IP (Imipenem), TZP (Piperasilin-Tazobactam), CAZ (Ceftazidim)\'in duyar­liliklarina bakilmistir. Antibiotik duyarliliklari CLSI (Clinical Laboratory Standards Institute) onerileri dogrultusunda Kirby-Bauer disk difuzyon yontemi ile degerlendirilmistir. Kontrol susu olarak E.coli ATCC 25922 kullanilmistir. Bulgular: Agustos 2010-Aralik 2010 tarihleri arasinda in­celenen idrar orneklerinden izole edilen E.coli suslarinin hepsi fosfomisine duyarli bulunmustur. Siprofloksasine, Imipenem, Piperasilin-Tazobaktam, Seftazidime karsi di­renc oranlari sirasiyla; %33,3, %49,1, %36,8, %45,6 ola­rak belirlenmistir. Sonuc: Toplum kokenli uriner sistem infeksiyonlarinda fosfomisin; yuksek duzey duyarlilik oranlari nedeni ile non-komplike uriner sistem enfeksiyonlarinda tercih edi­lebilir bir antimikrobiyal ajandir.

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