Brown B J, Asinobi A O, Fatunde O J, Osinusi K, Fasina N A
Department of Paediatrics, University College Hospital, Ibadan, Nigeria.
West Afr J Med. 2003 Jun;22(2):110-3. doi: 10.4314/wajm.v22i2.27927.
As part of a larger project on childhood urinary tract infection, antimicrobial sensitivity tests were carried out on the bacterial isolates from the urine of febrile children seen at the University College Hospital, Ibadan, Nigeria.
Midstream urine specimens were collected from 171 sickle cell anaemia children and from an equal number of haemoglobin-A controls and cultured by standard methods. Sensitivity to eleven antimicrobials was tested using the disc-diffusion technique of Stokes.
Significant bacteriuria was obtained from 37 children with sickle cell anemia and 27 controls. The isolates were Escherichia coli, Klebsiella species, Non-haemolytic streptococcus, beta-haemolytic Streptococcus, Salmonella, Proteus and Pseudomonas species. Sensitivity was highest to Pefloxacin to which over 94% of the organisms were sensitive followed by Ceftriaxone (over 85%) and ceftazidime (over 85%). Sensitivities to nalidixic acid and cefuroxime were between 67.6% and 74.1%. Most of the isolates were resistant to gentamicin, amoxycillin, cotrimoxazole and ampicillin. In general the sensitivity pattern in the sickle cell anaemia group was similar to the pattern in the control group.
Aetiological agents of childhood UTI in this environment are resistant to most of the drugs commonly recommended for its treatment. Nalixidic acid and cefuroxime are recommended as first line drugs while awaiting results of sensitivity testing. Ceftriazone and ceftazidime should be reserved for cases of non-response to first line drugs and in severe cases. Pefloxacin should be considered potential drug of treatment particularly in multi-drug resistant infections.
作为关于儿童尿路感染的一个更大项目的一部分，对在尼日利亚伊巴丹大学学院医院就诊的发热儿童尿液中的细菌分离株进行了抗菌药敏试验。
从171名镰状细胞贫血儿童和数量相等的血红蛋白A对照组儿童中采集中段尿标本，采用标准方法进行培养。使用斯托克斯纸片扩散技术检测对11种抗菌药物的敏感性。
37名镰状细胞贫血儿童和27名对照组儿童出现显著菌尿。分离株包括大肠杆菌、克雷伯菌属、非溶血性链球菌、β溶血性链球菌、沙门氏菌、变形杆菌和假单胞菌属。对培氟沙星的敏感性最高，超过94%的菌株对其敏感，其次是头孢曲松（超过85%）和头孢他啶（超过85%）。对萘啶酸和头孢呋辛的敏感性在67.6%至74.1%之间。大多数分离株对庆大霉素、阿莫西林、复方新诺明和氨苄西林耐药。总体而言，镰状细胞贫血组的药敏模式与对照组相似。
在这种环境下，儿童尿路感染的病原体对大多数通常推荐用于治疗的药物耐药。在等待药敏试验结果期间，推荐萘啶酸和头孢呋辛作为一线药物。头孢曲松和头孢他啶应保留用于对一线药物无反应的病例和严重病例。培氟沙星应被视为潜在的治疗药物，特别是在多重耐药感染中。
