Habte T M, Dube S, Ismail N, Hoosen A A
Department of Microbiological Pathology, University of Limpopo, Medunsa Campus, Pretoria.
S Afr Med J. 2009 Aug;99(8):584-7.
To investigate the profile of common uropathogens isolated from urine specimens submitted to the diagnostic microbiology laboratory at a tertiary teaching hospital and assess their antimicrobial susceptibility patterns to commonly used antimicrobial agents.
We conducted a retrospective analysis of laboratory reports for all urine specimens submitted for investigations over a 1-year period. Isolates were tested by means of the Kirby-Bauer disc diffusion method for susceptibility to amoxicillin, ciprofloxacin, gentamicin, co-trimoxazole and nitrofurantoin, and for extended-spectrum beta-lactamase (ESBL) production.
Out of the total specimens (N=2,203) received over the 1-year study period, 51.1% (1,126) of the urine samples were culture-positive, the majority (65.4%) having come from females. The most common isolate was Escherichia coli (39.0%) followed by Klebsiella species (20.8%) and Enterococcus faecalis (8.2%). The Gram-negative isolates displayed a very high level of resistance to amoxicillin (range 43 - 100%) and co-trimoxazole (range 29 - 90%), whereas resistance to gentamicin (range 0 - 50%) and ciprofloxacin (range 0 - 33%) was lower. E. coli isolates were susceptible to nitrofurantoin (94%), and ESBL production was significantly higher (p=0.01) in the hospital isolates, compared with those from the community referral sites.
The culture-positive rate for uropathogens was high, with a greater incidence among females. E. coli was the most common aetiological agent identified, and remained susceptible to nitrofurantoin. Resistance levels to amoxicillin and co-trimoxazole were very high for all Gram-negative isolates, and it is recommended that these antibiotics should not be used for the empiric treatment of urinary tract infections.
调查一所三级教学医院诊断微生物实验室接收的尿液标本中常见尿路病原体的情况，并评估它们对常用抗菌药物的药敏模式。
我们对1年期间提交进行检测的所有尿液标本的实验室报告进行了回顾性分析。采用 Kirby-Bauer 纸片扩散法检测分离株对阿莫西林、环丙沙星、庆大霉素、复方新诺明和呋喃妥因的敏感性以及超广谱β-内酰胺酶（ESBL）的产生情况。
在1年研究期间收到的全部标本（N = 2203）中，51.1%（1126）的尿液样本培养呈阳性，其中大多数（65.4%）来自女性。最常见的分离株是大肠埃希菌（39.0%），其次是克雷伯菌属（20.8%）和粪肠球菌（8.2%）。革兰阴性菌分离株对阿莫西林（耐药率范围为43% - 100%）和复方新诺明（耐药率范围为29% - 90%）显示出很高的耐药性，而对庆大霉素（耐药率范围为0 - 50%）和环丙沙星（耐药率范围为0 - 33%）的耐药性较低。大肠埃希菌分离株对呋喃妥因敏感（94%），与社区转诊点分离株相比，医院分离株中ESBL的产生显著更高（p = 0.01）。
尿路病原体的培养阳性率很高，女性发病率更高。大肠埃希菌是鉴定出的最常见病原体，并对呋喃妥因保持敏感。所有革兰阴性菌分离株对阿莫西林和复方新诺明的耐药水平都很高，建议不将这些抗生素用于尿路感染的经验性治疗。
