Background: Urinary tract infections are common during childhood. The etiologic agents and empirical antibiotics may vary due to age and geographic area. Objectives: This study was designed to investigate the urinary tract infection pathogens, their antibiotic resistance profile and risk factors in a sample of well-child population. Materials and Methods: This retrospective study was conducted in the pediatric clinics of a secondary health-care centre in a one-year period. The source of data was hospital and laboratory records. Toilet trained children and adolescents aged between 5-17 years old with positive urine culture were enrolled into the study. Microbiological studies were conducted ac- cording to international guidelines. Results: During the study 3640 urine samples were analyzed and 342(9.4%) had significant growth. Gram negative en- terobacteria were the most common infectious agents. Antibiotic susceptibility tests showed low cephalosporine resistance unless ESBL was positive. Multi drug resistance was remarkable. Extended beta lactamase resistance rate was 17%. Previous history of antibiotic use before the present administration was the only significant risk factor for ESBL positivity. Conclusion: Treating urinary tract infections may become an emerging problem soon. Unless there are risk factors, cepha- losporines are good options, but if so nitrofurantoin or carbapanems should be preferred for treatment in this population. Keywords: Urinary tract infections; antibiotics; susceptibility.

Giriş: Enfeksiyon hastalıkları pediatri pratiğinde sık rastlanan hastalıklardır. Tanı ve tedavi yönetiminde kültür tetkikleri oldukça önemlidir. Pediatri kliniği ve mikrobiyoloji laboratuvarı iş birliği kurumların akılcı ilaç kullanımı politikasının belirlenmesinde vazgeçilmezdir. Bu yazıda bir il merkezinde pediatrik hasta grubunda kültür tetkiklerinin kullanım sıklığı ve etkinliğinin değerlendirilmesi, kültür materyali alım tekniklerinin okuyucuya hatırlatılması amaçlanmıştır. Gereç ve Yöntem: 1 Nisan 2016-31 Mart 2017 tarihleri arasında mikrobiyoloji laboratuvarına kabul edilen tüm kaliteli kültür örnekleri hastane ve laboratuvar kayıt sistemi üzerinden retrospektif olarak değerlendirilmiştir. Her örnek için uygun kültür alma, işleme ve değerlendirme yöntemi kullanılmıştır. Bulgular: Çalışma süresince 515 kan, 3640 idrar, 209 konjonktiva, 32 yara, 143 göbek sürüntüsü, 220 boğaz, 69 solunum yolu sekresyonu ve 65 gaita örneği kültür yöntemleriyle değerlendirilmiştir. Üreme sonuçlarında mikroorganizma dağılımı ve antibiyogram duyarlılıkları pediatrik yaş grubuna uygun seçeneklerle belirtilmiştir. Üremelerin %18'inde çoklu dirençli mikroorganizmalar söz konusudur. Sonuç: Pediatri kliniği ve mikrobiyoloji laboratuvarı iş birliğinin arttırılması, güçlendirilmesi için deneyimlerin paylaşılması gereklidir. Belli aralıklarla tekrarlanan surveyans çalışmaları etkin ampirik tedavilerin belirlenmesini sağlamaktadır. Özellikle pediatrik yaş grubunda akılcı ilaç kullanımı gelecek nesillerin daha sağlıklı olmasında önemlidir. Böylelikle antibiyotik direnç sorununun azaltılmasına katkıda bulunulabilir.

Acinetobacter baumannii, one of the most important infectious agents spread in hospitals, is an opportunistic, Gram-negative, aerobic and nonfermentative pathogen causing outbreaks often in ICUs and difficulties in treatments due to multiple antibiotic resistance characteristics. Carbapenem resistance in A. baumannii is a growing public health concern and most often mediated by oxacillinases carbapenemases. Carbapenems are significant representatives of the group β-lactamases that are used in the treatment of A. baumannii. OXA-23, OXA-24, OXA-51 and OXA-58 are the most common type of OXA gene family members which are responsible for carbapenem resistance. This study aimed to identify the carbapenem resistant A. baumannii isolates in ICU and analyse OXA-23, OXA-24, OXA-51 and OXA-58 genes’ expressions by using reverse transcritptase-PCR. In this study, A. baumannii isolates collected from the respiratory tract samples obtained from the patients receiving treatment between June 2017 and January 2018 at the ICU in Amasya University Sabuncuoğlu Serefeddin Education and Research Hospital. Collected samples identified by VITEK-2 device. Resistance profiles of carbapenem-resistant strains against to cefepime, ceftazidime, ciprofloxacin, levofloxacin, amikacin, gentamicin, tetracycline, tigecycline and colistin antibiotics were determined by disk diffusion and minimum inhibition concentration tests. Moreover, OXA-23, OXA-24, OXA-51 and OXA-58 genes were investigated by reverse transcritptase-PCR. Identified 50 A. baumannii isolates were found to be 100% resistant to imipenem, meropenem, cefepime, ceftazidime and ciprofloxacin, 94% for levofloxacin, 68% for amikacin, 78% for gentamicin, 88% for tetracycline and 6% for tigecycline. It was detected that all samples are susceptible to colistin and showed multiple antibiotic resistance. As a result of molecular analyses, it was also determined that the expressions of only OXA-23 and OXA-51 genes in all isolates. This study is one of the first reports to analyse A. baumannii isolated from respiratory tract samples in terms of microbiological and molecular analyses.