Dimitrov T S, Udo E E, Emara M, Awni F, Passadilla R
Department of Laboratory Medicine, Microbiology Section, Infectious Diseases Hospital, Kuwait University, Kuwait.
Med Princ Pract. 2004 Nov-Dec;13(6):334-9. doi: 10.1159/000080470.
The aim of this study was to determine the distribution and antibiotic susceptibility patterns of bacterial strains isolated from patients with community-acquired urinary tract infections (UTIs) at the Infectious Diseases Hospital, Kuwait.
The study was conducted over a 7-year period. Patient information was obtained from medical record files. Antibiotic-sensitivity testing was performed by disk diffusion. E test and double disk diffusion methods were used to study the production of extended spectrum beta-lactamases.
Of the 14,042 urine samples processed, significant bacteriuria (>10(5) cfu/ml) was detected in 1,606 (11.4%). The majority (74.5%) of the isolates were from women while the remaining 25.5% were from men. The majority of infections (75%) were due to Enterobacteriaceae, coagulase-negative staphylococci (10.3%) and group B streptococci (8.7%). Among the gram-negative enteric bacilli high prevalence of resistance to ampicillin, amoxicillin/clavulanic acid, cephalothin, and trimethoprim/sulfamethoxazole was observed. Increasing resistance to ciprofloxacin and gentamicin was observed in E. coli isolates over the 7 years. Multiple resistance was detected in 53.8 and 41% of E. coli and Klebsiella spp. strains, respectively. No glycopeptide-resistant enterococci were isolated.
This study revealed that Enterobacteriaceae were the predominant bacterial pathogen of community-acquired UTIs in Infectious Diseases Hospital, Kuwait. It also demonstrated an increasing resistance to ciprofloxacin, gentamicin and the production of extended spectrum beta-lactamase among UTI pathogens in the community.
本研究旨在确定科威特传染病医院社区获得性尿路感染（UTI）患者分离出的细菌菌株的分布及抗生素敏感性模式。
本研究历时7年。患者信息从病历档案中获取。采用纸片扩散法进行抗生素敏感性测试。采用E试验和双纸片扩散法研究超广谱β-内酰胺酶的产生。
在处理的14042份尿液样本中，1606份（11.4%）检测到显著菌尿（>10⁵cfu/ml）。大多数分离株（74.5%）来自女性，其余25.5%来自男性。大多数感染（75%）由肠杆菌科细菌、凝固酶阴性葡萄球菌（10.3%）和B组链球菌（8.7%）引起。在革兰氏阴性肠道杆菌中，观察到对氨苄西林、阿莫西林/克拉维酸、头孢噻吩和甲氧苄啶/磺胺甲恶唑的高耐药率。在7年期间，大肠杆菌分离株对环丙沙星和庆大霉素的耐药性不断增加。分别在53.8%的大肠杆菌菌株和41%的克雷伯菌属菌株中检测到多重耐药。未分离出耐糖肽肠球菌。
本研究表明，肠杆菌科细菌是科威特传染病医院社区获得性UTI的主要病原菌。研究还表明，社区UTI病原体对环丙沙星、庆大霉素的耐药性不断增加，且超广谱β-内酰胺酶的产生情况也有所增加。
