Teshager Lule, Asrat Daniel, Gebre-Selassie Solomon, Tamiru Solomon
Department of Medical Microbiology, Immunology and Parasitology, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia.
Ethiop Med J. 2008 Jan;46(1):55-62.
Prospective cross sectional study was undertaken to assess the bacterial profile and antimicrobial resistance pattern of catheterized urinary tract infection in comparison with non-catheterized UTI in Jimma University Teaching Hospital, Southwest, Ethiopia.
One hundred and twenty patients, 30 catheterized (age range 20-78 years, male to female ratio 0.36:1) and 90 non-catheterized patients (age range 7-60 years, male to female ratio 2:1) with symptoms and signs of UTI were investigated for significant bacteriuria from January to March 2005.
Significant bacteruria was observed in 13/30 (43.3%) and 20/90 (22.2%) of catheterized and non-catheterized patients, respectively (p<0.05). Klebsiella spp. (33.3%) and E. coli (27.7%) were the most common bacteria pathogens isolated in both groups and followed by Enterobacter spp. (6%). Proteus spp., Pseudomonas spp. and coagulase negative Staphylococci were isolated only from catheterized patients. Gram-negative bacteria isolated in both groups showed a high level of resistance (88-100%) to ampicillin, amoxicillin carbencillin and cephalexin. and intermediate level of resistance (48-68%) to amoxicillin-clauvlanic acid, gentamicin and trimethoprim-sulphamethoxazole. Low level of resistance (16-24%) observed to amikacin, ciprofloxacin, nalidxic acid and nitrofurantoin. Similar pattern of resistance was observed in all the gram-positive isolates including for methicillin, oxacillin and vancomycin (100%). On the other hand, amoxicillin-clavulanic acid and polymixin B were found effective against all gram-positive bacteria isolated from both groups.
The present study revealed that UTIs in both catheterized and non-catheterized patients was shown very high resistance pattern to most of antibiotics in use mainly at Jimma University Teaching Hospital, southwest Ethiopia. This calls for concerted efforts at all levels including regulatory bodies and the public healthcare providers as well as private ones. Creating awareness of the community will also have a significant role to curb this problem.
开展前瞻性横断面研究，以评估埃塞俄比亚西南部吉马大学教学医院导尿管相关尿路感染与非导尿管相关尿路感染的细菌谱及抗菌药物耐药模式。
2005年1月至3月，对120例有尿路感染症状和体征的患者进行了调查，其中30例为导尿管相关患者（年龄范围20 - 78岁，男女比例0.36:1），90例为非导尿管相关患者（年龄范围7 - 60岁，男女比例2:1），以检测显著菌尿。
导尿管相关患者和非导尿管相关患者中分别有13/30（43.3%）和20/90（22.2%）检测到显著菌尿（p<0.05）。克雷伯菌属（33.3%）和大肠杆菌（27.7%）是两组中最常见的细菌病原体，其次是肠杆菌属（6%）。变形杆菌属、假单胞菌属和凝固酶阴性葡萄球菌仅从导尿管相关患者中分离出。两组中分离出的革兰氏阴性菌对氨苄西林、阿莫西林羧苄西林和头孢氨苄显示出高耐药水平（88 - 100%），对阿莫西林克拉维酸、庆大霉素和甲氧苄啶磺胺甲恶唑显示出中等耐药水平（48 - 68%）。对阿米卡星、环丙沙星、萘啶酸和呋喃妥因观察到低耐药水平（16 - 24%）。在所有革兰氏阳性分离株中观察到类似耐药模式，包括对甲氧西林、苯唑西林和万古霉素（100%）。另一方面，发现阿莫西林克拉维酸和多粘菌素B对两组中分离出的所有革兰氏阳性菌均有效。
本研究表明，在埃塞俄比亚西南部吉马大学教学医院主要使用的大多数抗生素方面，导尿管相关和非导尿管相关患者的尿路感染均显示出非常高的耐药模式。这需要包括监管机构、公共医疗服务提供者以及私立机构在内的各级共同努力。提高社区意识对遏制这一问题也将发挥重要作用。
