Microbial colonization and antimicrobial susceptibility of the nose and external ear canal in hemodialysis patients
Öz
Aim:
The effect of normal
bacterial flora on the immune system is to make it more effective against
harmful micro-organisms and to maintain it in readiness for a more rapid
response. The purpose of this study was to
determine the bacterial flora in the external ear canal and nasal cavities in
hemodialysis patients, to compare this with the normal population and to show
the microorganisms’ antibiotic susceptibilities.
Materials
and Methods: Patients receiving hemodialysis
therapy for at least 3 years were included in the study. A control group (n=62)
was established consisting of patients with no immune-suppressive condition and
presenting to hospital with non-ear symptoms. Swab specimens were taken from
all subjects’ external ear canals and nasal cavities. Results of the cultures
were recorded and antimicrobial susceptibility test was performed.
Results: The most commonly isolated micro-organisms in the study group were
MRCoNS (41%), followed by MSCoNS (15.5%) and diphtheroids (9.8%). The
micro-organism most commonly isolated from the nasal cavity in the study group
was CoNS (52.7%), of which MRCoNS constituted 69.2%.
Conclusion:
We think that infections that play a major role in
mortality and morbidity in hemodialysis patients may originate from the
external ear canal as much as the nasal cavity, for this reason it is important
for micro-organisms colonizing these regions to be eliminated with appropriate
treatment on the basis of antibiotic susceptibility tests.
Anahtar Kelimeler
Hemodialysis external ear nasal cavity immune suppression antimicrobial susceptibility.
Kaynakça
- 1. Stroman DW, Roland PS, Dohar J, Burt W. Microbiology of normal external auditory canal. Laryngoscope 2001;111(11):2054-9.
- Ucuncu H, Uslu H, Ozbek A, Aktan B, Sutbeyaz Y, Altas E. Comparison of the bacterial flora of the nasal vestibule and cavity in haemodialysis patients. Acta Otorhinolaryngol Ital 2009;29(5):251-4.
- Celik G, Gülcan A, Dikici N, Gülcan E. Prevalence of nasal Staphylococcus aureus carriage in the patients undergoing hemodialysis and evaluation of risk factors and laboratory parameters. Ren Fail 2011;33(5):494-8.
- Brook I. Microbiological studies of the bacterial flora of the external auditory canal in children. Acta Otolaryngol 1981;91(3-4):285-7.
- Wright DN, Alexander JM. Effect of water on the bacterial flora of swimmer’s ears. Arch Otolaryngol 1974;99(1):15-8.
- Salit IE, Miller B, Wigmore M, Smith JA. Bacterial flora of the external canal in diabetics and non-diabetics. Laryngoscope 1982;92(6Pt1):672-3.
- European Committee on Antimicrobial Susceptibility Testing. Clinical Breakpoints tables of interpretation of MIC’s and zone diameters. Version 6.0, (Dec.31,2016). Available from: http//www.eucast.org
- Ostfeld E, Rubinstein E, Gazit E, Smetana Z. Effect of systemic antibiotics on the microbial flora of the external ear canal in hospitalized children. Pediatrics 1977;60(3):364-6.
- Hoen B, Kessler M, Hestin D, Mayeux D. Risk factors for bacterial infections in chronic haemodialysis adult patients: A multicentre prospective survey. Nephrol Dial Transplant 1995;10(3);377-81.
- Alcelik A, Apuhan T, Kocoglu E, Eroglu M, Necati Hakyemez I, Duran A. Microbial colonization of the external auditory canal and nose in hemodialysis patients. Med Glas 2012;9(2):330-3.
- Lai CF, Liao CH, Pai MF, et al. Nasal carriage of methicillin-resistant Staphylococcus aureus is associated with higher all-cause mortality in hemodialysis patients. Clin J Am Soc Nephrol 2011;6(1):167-74.
- Zimakoff J, Bangsgaard Pedersen F, Bergen L, et al. Staphylococcus aureus carriage and infections among patients in four haemo- and peritoneal-dialysis centres in Denmark. The Danish Study Group of Peritonitis in Dialysis (DASPID). J Hosp Infect 1996;33(4):289-300.
- Motamedifar M, Hassanzadeh P, Ghafari N. Relative frequency of Staphylococcal carriage and antibiotic sensitivity of isolated Staphylococci in hemodialysis patients in Shiraz, Iran. Med Princ Pract 2010;19(5):379-83.
Hemodiyaliz hastalarında dış kulak yolu ve nazal kavitede mikrobiyal kolonizasyon ve antimikrobiyal duyarlılık
Öz
Amaç: Normal bakteriyel floranın
bağışıklık üzerindeki etkisi onu mikroorganizmaların zararlı etkilerine karşı
daha etkili hale getirmek ve hızlı bir cevap oluşturacak şekilde hazır
tutmaktır. Bu çalışmanın amacı hemodiyaliz hastalarında nazal kavite ve dış
kulak yolundaki bakteriyel florayı tespit etmek, bunu normal populasyonla
karşılaştırmak ve mikroorganizmaların antimikrobiyal duyarlılığını ortaya
koymaktı.
Gereç ve Yöntem: Çalışmaya en az 3 yıldır
hemodiyaliz alan hastalar dâhil edildi. Herhangi bir immunsupresyon durumu olmayan
ve kulak hastalıkları dışı sebeplerle hastaneye başvuran hastalardan da kontrol
grubu oluşturuldu (n=62). Tüm katılımcıların nazal kavite ve dış kulak
yollarından kültür çubuğu ile kültür örnekleri alındı. Kültür sonuçları ile
antimikrobiyal duyarlılık test sonuçları kaydedildi.
Bulgular: Çalışma grubunda dış kulak
yolundan en çok izole edilen bakteri MRCoNS (%41) iken bunu MSCoNS (%15,5) ve
Difteroidler (%9,8) izlemekteydi. Nazal kaviteden ise en sık izole edilen
bakteri CoNS olup (%52,7) bunun %69,2’sini MRCoNS oluşturmaktaydı.
Sonuç: Hemodiyaliz hastalarında
mortalite ve morbiditede önemli rol oynayan enfeksiyonların nazal kavite kadar
dış kulak yolundan da kaynaklanabileceğini, bu nedenle antimikrobiyal
duyarlılık testleri ile belirlenen uygun antibiyoterapi ile bu bölgedeki
mikroorganizmaların da elimine edilmesinin önemli olduğunu düşünmekteyiz.
Anahtar Kelimeler
Hemodiyaliz dış kulak yolu nazal kavite immün süpresyon antimikrabiyal duyarlılık.
Kaynakça
- 1. Stroman DW, Roland PS, Dohar J, Burt W. Microbiology of normal external auditory canal. Laryngoscope 2001;111(11):2054-9.
- Ucuncu H, Uslu H, Ozbek A, Aktan B, Sutbeyaz Y, Altas E. Comparison of the bacterial flora of the nasal vestibule and cavity in haemodialysis patients. Acta Otorhinolaryngol Ital 2009;29(5):251-4.
- Celik G, Gülcan A, Dikici N, Gülcan E. Prevalence of nasal Staphylococcus aureus carriage in the patients undergoing hemodialysis and evaluation of risk factors and laboratory parameters. Ren Fail 2011;33(5):494-8.
- Brook I. Microbiological studies of the bacterial flora of the external auditory canal in children. Acta Otolaryngol 1981;91(3-4):285-7.
- Wright DN, Alexander JM. Effect of water on the bacterial flora of swimmer’s ears. Arch Otolaryngol 1974;99(1):15-8.
- Salit IE, Miller B, Wigmore M, Smith JA. Bacterial flora of the external canal in diabetics and non-diabetics. Laryngoscope 1982;92(6Pt1):672-3.
- European Committee on Antimicrobial Susceptibility Testing. Clinical Breakpoints tables of interpretation of MIC’s and zone diameters. Version 6.0, (Dec.31,2016). Available from: http//www.eucast.org
- Ostfeld E, Rubinstein E, Gazit E, Smetana Z. Effect of systemic antibiotics on the microbial flora of the external ear canal in hospitalized children. Pediatrics 1977;60(3):364-6.
- Hoen B, Kessler M, Hestin D, Mayeux D. Risk factors for bacterial infections in chronic haemodialysis adult patients: A multicentre prospective survey. Nephrol Dial Transplant 1995;10(3);377-81.
- Alcelik A, Apuhan T, Kocoglu E, Eroglu M, Necati Hakyemez I, Duran A. Microbial colonization of the external auditory canal and nose in hemodialysis patients. Med Glas 2012;9(2):330-3.
- Lai CF, Liao CH, Pai MF, et al. Nasal carriage of methicillin-resistant Staphylococcus aureus is associated with higher all-cause mortality in hemodialysis patients. Clin J Am Soc Nephrol 2011;6(1):167-74.
- Zimakoff J, Bangsgaard Pedersen F, Bergen L, et al. Staphylococcus aureus carriage and infections among patients in four haemo- and peritoneal-dialysis centres in Denmark. The Danish Study Group of Peritonitis in Dialysis (DASPID). J Hosp Infect 1996;33(4):289-300.
- Motamedifar M, Hassanzadeh P, Ghafari N. Relative frequency of Staphylococcal carriage and antibiotic sensitivity of isolated Staphylococci in hemodialysis patients in Shiraz, Iran. Med Princ Pract 2010;19(5):379-83.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 28 Haziran 2019 |
| Gönderilme Tarihi | 5 Ocak 2018 |
| Yayımlandığı Sayı | Yıl 2019 |