印度阿里格尔J N M C医院社区获得性尿路感染的病因及抗生素耐药模式
Etiology and antibiotic resistance patterns of community-acquired urinary tract infections in J N M C Hospital Aligarh, India.
作者信息
Akram Mohammed, Shahid Mohammed, Khan Asad U
机构信息
Interdisciplinary Biotechnology Unit, Aligarh Muslim University Aligarh 202002 India.
出版信息
Ann Clin Microbiol Antimicrob. 2007 Mar 23;6:4. doi: 10.1186/1476-0711-6-4.
BACKGROUND
Urinary tract infections (UTIs) remain the common infections diagnosed in outpatients as well as hospitalized patients. Current knowledge on antimicrobial susceptibility pattern is essential for appropriate therapy. Extended-Spectrum beta-Lactamase (ESBL) producing bacteria may not be detected by routine disk diffusion susceptibility test, leading to inappropriate use of antibiotics and treatment failure. 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 Aligarh hospital in India as well as identification of ESBL producers in the population of different uropathogens.
METHODS
Urinary isolates from symptomatic UTI cases attending to the JN Medical College and hospital at Aligarh were identified by conventional methods. Antimicrobial susceptibility testing was performed by Kirby Bauer's disc diffusion method. Isolates resistant to third generation cephalosporin were tested for ESBL production by double disk synergy test method.
RESULTS
Of the 920 tested sample 100 samples showed growth of pathogens among which the most prevalent were E. coli (61%) followed by Klebsiella spp (22%). The majority (66.66%) of the isolates were from female while the remaining were from male. Among the gram-negative enteric bacilli high prevalence of resistance was observed against ampicillin and co-trimoxazole. Most of the isolates were resistant to 4 or more number of antibiotics. Forty two percent of isolates were detected to produce ESBL among which 34.42 % were E. coli isolates.
CONCLUSION
This study revealed that E. coli was the predominant bacterial pathogen of community acquired UTIs in Aligarh, India. It also demonstrated an increasing resistance to Co-trimoxazole and production of extended spectrum beta-lactamase among UTI pathogens in the community. This study is useful for clinician in order to improve the empiric treatment.
背景
尿路感染（UTIs）仍然是门诊患者和住院患者中诊断出的常见感染。目前关于抗菌药物敏感性模式的知识对于适当的治疗至关重要。产超广谱β-内酰胺酶（ESBL）的细菌可能无法通过常规纸片扩散药敏试验检测到，从而导致抗生素使用不当和治疗失败。本研究的目的是确定从印度阿里格尔医院社区获得性尿路感染（UTIs）患者中分离出的细菌菌株的分布和抗生素敏感性模式，以及在不同尿路病原体群体中鉴定产ESBL的菌株。
方法
通过常规方法对阿里格尔JN医学院及医院有症状UTI病例的尿液分离株进行鉴定。采用 Kirby Bauer 纸片扩散法进行抗菌药物敏感性试验。对耐第三代头孢菌素的分离株采用双纸片协同试验法检测ESBL的产生。
结果
在920份检测样本中，100份样本显示有病原菌生长，其中最常见的是大肠杆菌（61%），其次是克雷伯菌属（22%）。大多数（66.66%）分离株来自女性，其余来自男性。在革兰氏阴性肠道杆菌中，观察到对氨苄西林和复方新诺明的耐药率很高。大多数分离株对4种或更多种抗生素耐药。检测到42%的分离株产ESBL，其中34.42%是大肠杆菌分离株。
结论
本研究表明，大肠杆菌是印度阿里格尔社区获得性UTIs的主要病原菌。它还表明社区中UTI病原体对复方新诺明的耐药性增加以及超广谱β-内酰胺酶的产生。这项研究对临床医生改善经验性治疗很有用。
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