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    Distribution of Urinary System Infection Agents in Children and Evaluation of Their Susceptibility to Antibiotics
    (Galenos Publ House, 2024) Kafa, Ayse Huemeyra Taskin; Cubuk, Fatih; Akbulut, Resul Ekrem; Hasbek, Muersit; Tastanoglu, Hueseyin
    Introduction: Urinary tract infection (UTI) is among the common bacterial infections in pediatric patients. These infections are more common in girls over one year old. This study aimed to investigate the bacterial distribution and drug resistance status in urine cultures of pediatric patients in our center. Materials and Methods: Urine culture results of patients who were presented to the outpatient clinics or were admitted to the Sivas Cumhuriyet University hospital between January 2017 and December 2022 were included in the study. The hospital automation system, patient files, and laboratory information management system were examined retrospectively. Statistical analysis was performed using the SPSS 22.0 software. A P -value of <0.05 was deemed significant. Results: Significant growth was observed in the urine cultures of a total of 1287 pediatric patients, 889 (69.1%) girls and 398 boys (30.9%). The patients included in the study were between the ages of 0-17, and children aged 1-6 (37.6%) were diagnosed with UTI more frequently than other ages. The most common UTI agent in the pediatric age group was Escherichia coli (56.6%). The first agent isolated in girls and boys is E.coli . Additionally, the prevalence of K. pneumoniae, P. mirabilis and K. oxytoca bacteria was higher in boys (p < 0.05). E. coli isolates showed minimal resistance to such as amikacin (0.6%), fosfomycin (1.0%), nitrofurantoin (1.4%), ertapenem (2.4%), imipenem (0.7%) and meropenem (0.9%). Conclusion: In this study, low resistance levels were detected for amikacin, fosfomycin, nitrofurantoin and carbapenem group antibiotics, which are important alternatives in the empirical treatment of UTI. On the other hand, due to the high resistance levels detected, it is thought that more caution should be exercised in the empirical use of amoxicillin-clavulanate, trimethoprimsulfamethoxazole and cefixime. If these antibiotics are to be preferred, waiting for the antibiogram results is an appropriate approach.
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    Resistance rates to antituberculosis drugs in Sivas province
    (ANKARA MICROBIOLOGY SOC, 2007) Goenlueguer, Ugur; Bakici, Mustafa Zahir; E., Tanseli Goenlueguer; Hasbek, Muersit
    Infections caused by drug-resistant Mycobacterium tuberculosis strains represent a serious public health problem in recent years. The aim of this retrospective study was to investigate the resistance rates of M.tuberculosis complex strains isolated from clinical specimens in the laboratories of Cumhuriyet University and Numune State Hospitals in Sivas province (located in the middle Anatolia), between May 2004-May 2006 period, to the major antituberculous drugs. A total of 158 M.tuberculosis complex strains which were isolated from sputum, bronchial lavage fluid, stomach fluid, urine, pus, peritoneal fluid and cerebrospinal fluid samples, each of which from different patients were included to the study. The identification of the isolates and antituberculosis drug susceptibility testing were performed by MGIT (Mycobacteria Growth Indicator Tube) 960 system in both of the laboratories. Of 158 isolates 42 (26.6%) were found resistant to at least one of the drugs, while 116 (73.4%) were susceptible to all of the tested antimycobacterials. The overall resistance rates were found as 17.7% (28/153) for isoniazid, 11.4% (18/153) for streptomycin, 4.4% (7/153) for rifampicin, and 5.1% (8/153) for ethambutol. The rate of multidrug resistant isolates characterized with resistance to isoniazid+rifampicin were 3.8% (6/158). As a result, the most common resistance patterns observed in our region were found as single isoniazid resistance (13/158; 8.2%), single streptomycin resistance (8/158; 5.1%) and combined isoniazid+streptomycin resistance (8/158; 5.1%), respectively, with lower resistance rate to rifampicin (4.4%) in comparison to the previous results reported from Turkey.
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    Sternal tuberculosis
    (ANKARA MICROBIOLOGY SOC, 2008) Sapmaz, Feride; Katrancioglu, Oezguer; Goenlueguer, Tanseli; Goenlueguer, Ugur; Hasbek, Muersit
    Isolated involvement of the sternum is rare, representing less than 1% of tuberculous osteomyelitis. In this report, a 51-years-old woman who was admitted to the hospital with a localized solid mass in the sternum has been presented. A soft, painful mass measuring 3 cm in diameter in the lower sternum was detected during physical examination. Radiological investigation revealed presternal soft tissue and bone expansion in the posterior side of lower sternum. The patient was treated with non-specific antibiotics for a suspected diagnosis of osteomyelitis but the lesion did not show any regression. Since the microbiological analysis of fine needle aspiration fluid demonstrated acid-fast bacilli in direct microscopy and Mycobocterium tuberculosis was isolated from the culture, anti-tuberculous therapy consisting of isoniazid (INH), rifampicin (RIF), pyrazinamide (PZA), and ethambutol (ETM) was started. Sputum and urine cultures of the patient yielded negative results in terms of tuberculosis. After the first month of the therapy, her skin lesion was completely healed. Since the strain was found to be resistant to isoniazid, the maintenance therapy has been applied as INH + RIF + PZA for nine months. The history of the patient indicated that one of her relatives had skin tuberculosis on the face. As a result the patient has been successfully treated with anti-tuberculosis combination therapy together with surgical debridement.