Kronik Süpüratif Otitis Medialı Hastalarda Mikrobiyal Ajanların Değerlendirilmesi
Özet Görüntüleme: 221 / PDF İndirme: 198
DOI:
https://doi.org/10.5281/zenodo.7927145Anahtar Kelimeler:
Antibiotic Susceptibility, Chronic Suppurative Otitis Media, Microbial AgentsÖzet
Amaç: Kronik süpüratif otitis media (KSOM), akut otitis media vakalarının kronikleşmesi sonucu ortaya çıkan mikroorganizmaların neden olduğu bir hastalıktır. Çalışmamız, KOSM'lu hastalardan alınan kulak kültürleri ile etken mikroorganizmaları belirlemeyi ve çeşitli antibiyotiklere duyarlılıklarını karşılaştırmayı amaçlamaktadır.
Yöntem: KSOM tanısı almış 155 hasta dahil edildi. Kulak akıntısı steril plastik sürüntülerle örneklendi. Alınan örnekler kanlı agar, eozin metilen mavisi agar, sabouraud dekstroz agar, çikolatalı agar, Mueller-Hinton agar ve üçlü şekerli demir agar besiyerlerine inoküle edildi. İzole edilen patojenlerin antibiyotik duyarlılık profilleri Vitek 2 ve disk difüzyon yöntemi kullanılarak değerlendirildi.
Bulgular: Çalışmamızda incelenen örneklerin 28'inde (%25,9) Staphylococcus aureus, 25'inde (%23,1) Pseudomonas aeruginosa, 8'inde (%7,4) Proteus mirabilis ve 12'sinde (%11,1) Klebsiella spp üredi. Ayrıca 14 (%13) hastada enfeksiyon kaynağı olarak mantar etkeni olduğu belirlendi. Antimikrobiyal duyarlılık testlerinde S. aureus vankomisin ve tigesiklin için sırasıyla %100 ve %96 duyarlı bulunmuş; P. mirabilis için ise meropenem ve amikasin duyarlılığı %100 bulunmuştur; Klebsiella pneumoniae için ise imipenem ve amikasinin %100 duyarlılığı saptandı.
Sonuç: Yetersiz ve yanlış tedaviler kültür ve antibiyoGram sonuçlarına dayanmayan tedavilerdir. Bu nedenle mikrobiyoloji laboratuvarında etken patojenin saptanması, antibiyoGram üretilmesi ve klinisyenlere en uygun tedavi seçeneklerinin sunulması bu hastalığın tedavisi açısından hastaya yol açacağı zaman kaybını önleyecek ve daha akılcı tedavilerin önünü açacaktır. KSOM hastalarında antibiyotiğe dirençli bakterilerin ortaya çıkmasını önlemek için bu hastaların mikrobiyolojik profilinin ve antibiyotik duyarlılık profilinin değerlendirilmesi önerilir.
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