AI Summary & Key Takeaways
AI InsightDisuria and pollakiuria are the only symptoms that give statistically significant results to predict positive culture results.
📌 3 Key Takeaways
Abstract
Introduction: Urinary tract infections are second mast frequent community infections after respiratory tract infections. Prevalence and clinical consequences of the infections show differences in different populations. In the epidemiology of the infections, some major predisposition factors are discussed such as sex, age, urinary tract abnormalities or symptoms of the infection. In this study we aimed to detect the antibiotic sensitivity profile of the urinary tract infection causing bacteria in our district and find out the cut-off values of laboratory and clinical findings in predicting positive urine culture results. Material and methods: We retrospectively evaluated 180 patients who applied to our clinic for urinary tract symptoms. Medical history and physical examination findings, clinical laboratory examinations and urine culture results were evaluated. A full-automated urinalysis system, which uses flowcytometric analysis of the particles in the urine, Sysmex UF-100 (Sysmex Corporation, Japan), was used to standardize the analysis results. Results were reported as number per (J.1 or HPF (high power field). Samples were collected in the morning hours; if this was not possible, urine samples were collected after 4 hours of holding back. Urine cultures were evaluated after 48 hours of incubation using 5% blood agar and EMB agar (Oxoid, UK). Results: Mean ages of the patients were 52,9±17,9 (mean±SD) for men and 44,04±17,9 (mean±SD) for women. There was no difference in isolation of bacterial from men and women (p>0.05). The following bacteria were isolated and reported from the urine cultures of 117 patients: E. coli (66,2%), Klebsiella sp (14,6%), Streptococcus sp (7,9%), Enterococcus sp (4,5%), Pseudomonas (3,4%) and Proteus sp (3,4%). Aminoglycosides are the most effective group in E. coli and in Klebsiella cultures, and augmented penicillin, 3rd generation cephalosporins and quinolos are the most effective groups in Streptococcus species. It did not seem possible to predict the result of the urine culture according to symptoms of the patients and physical examination findings (p>0.05). Parameters of the urinalysis from 117 culture positive patients were compared with that of 63 culture positive patients. Cut-off values for culture positive results for leukocyte, erythrocyte, the number of bacteria and urine pH were $geq$ 23$mu$l, $geq$ 19$mu$l, 4293 $mu$l and $geq$ 6,5 respectively. Conclusion: We detected increased resistance urinary tract microorganisms to antibiotics in general. Twenty-three or more leukocytes in per $mu$I of urine is found to be the cut-off value to predict the urinary culture outcome. Disuria and pollakiuria are the only symptoms that give statistically significant results to predict positive culture results.
Özet
Bu çalışmada bölgemizde üriner sistem enfeksiyonuna neden olan bakterilerin antibiyotik duyarlılık profilini tespit etmek, laboratuar ve klinik bulguların kültür pozitifliği açısından kestirim değerinin araştırmak amaçlanmıştır. Haziran 2000-Ağustos 2001 tarihleri arasında üriner sistem şikayetleri ile başvuran 180 hastanın retrospektif olarak değerlendirilmiştir. Hastalara ait anamnez ve fizik muayene bulguları, klinik laboratuar değerlendirmeleri, idrar kültürü sonuçlan değerlendirilmiştir. İdrar kültürlerinde üreme tespit edilen 117 hastada rastlanan bakteriler sıklık sırasına göre E. coli (%66.2), Klebsiella sp. (%14,6), Streptokok (%7,9), Enterokoklar (%4,5), Pseudomonas (%3,4) ve Proteus türleri (%3.4) olmuştur. E.coli'nin ve Klebsiella sp.'in antibiyogramında aminoglikozitler en etkili antibiyotik grubu ve Streptokok sp.'in antibiyogramında augmente penisilinler, 3. kuşak sefalosporinler ve kinolon türevleri en etkili antibiyotik grupları olarak tespit edilmiştir. İdrar kültüründe üreme tespit edilen 117 hastanın idrar analizi parametreleri de üreme tespit edilmeyen 63 hastanın aynı parametreleri karşılaştırılmıştır. İdrardaki lokosıt, eritrosit, bakteri sayısı ve pH gibi parametrelerde kültür pozitifliği yönünden kestirim değerleri sırası ile $geq$ 23$mu$l, $geq$ 19$mu$l, 4293 $mu$l ve $geq$ 6,5 olarak hesaplanmıştır. Bölgemizde, üriner sistem bakterilerinde genel olarak antibiyotiklere yüksek rezistans tespit edilmiştir. İdrardaki >23 lökosit / $mu$l değeri kültürde üreme tespit edilebileceğini gösterebilmesi yönünden kestirim değeri olarak bulunmuştur. Dizüri ve pollakiüri pozitif kültür sonuçlarını predikte etmede istatistiksel açıdan anlamlı bulunmuştur.