尿液作为临床儿科病例替代疗法的微生物评估及公共卫生影响：尿疗对健康的影响

Microbial evaluation and public health implications of urine as alternative therapy in clinical pediatric cases: health implication of urine therapy.

作者信息

Ogunshe Adenike Adedayo O, Fawole Abosede Oyeyemi, Ajayi Victoria Abosede

机构信息

Applied Microbiology and Infectious Diseases Unit, Department of Botany and Microbiology, University of Ibadan, Ibadan, Oyo State, Nigeria.

出版信息

Pan Afr Med J. 2010 May 25;5:12. doi: 10.4314/pamj.v5i1.56188.

DOI:10.4314/pamj.v5i1.56188

PMID:21293739

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3032614/

Abstract

BACKGROUND

Cultural means of pediatric treatment during ill health is a mainstay in Africa, and though urine has been known to contain enteric pathogens, urine therapy is still culturally applicable in some health conditions and also advocated as alternative therapy. The study therefore, is to evaluate the microbial contents and safety of urine.

METHODS

Urinary bacteria from cows and healthy children aged 5-11 years were identified by conventional phenotypic methods and antimicrobial susceptibility testing was performed using modified agar disc and well-diffusion methods.

RESULTS

A total of 116 bacterial isolates (n = 77 children; n = 39 cows) were identified as Bacillus (10.4%; 5.1%)), Staphylococcus (2.6%; 2.6%), Citrobacter (3.9%; 12.8%), Escherichia coli (36.4%; 23.1%), Klebsiella (7.8%; 12.8%), Proteus (18.2%; 23.1%), Pseudomonas (9.1%; 2.6%), Salmonella (3.9%; 5.1%) and Shigella (7.8%; 12.8%) spp. Antibiotic resistance rates of the Gram-positive bacteria were high (50.0100%), except in Bacillus strains against chloramphenicol, gentamicin and tetracycline (14.3%), while higher resistance rates were recorded among the Gram-negative bacteria except in Citrobacter (0.0%) and Proteus (8.5%) spp. against gentamicin and tetracycline respectively. The Gram-negative bacteria from ito malu (cow urine) were more resistant bacteria except in Citrobacter (20.0%) and Shigella spp. (0.0%) against tetracycline and Proteus spp. (11.1%), (22.2%) against amoxicillin and tetracycline respectively. Multiple antibiotic resistance (MAR) rates recorded in children urinal bacterial species were 37.5-100% (Gram-positive) and 12.5-100% (Gram-negative), while MAR among the cow urinal bacteria was 12.5-75.0% (Gram-positive) and 25.0-100% (Gram-negative). Similar higher resistance rates were also recorded among the Gram-negative bacterial species from urine specimens against the pediatric antibiotic suspensions.

CONCLUSION

The study reported presence of multiple antibiotic-resistant indicator bacteria in human urine and ito malu used as alternative remedy in pediatric health conditions like febrile convulsion.

摘要

背景

在非洲，儿童患病期间的传统治疗方法是主要手段，尽管已知尿液中含有肠道病原体，但在某些健康状况下，尿疗在文化上仍然适用，并且也被倡导为替代疗法。因此，本研究旨在评估尿液中的微生物成分和安全性。

方法

通过传统表型方法鉴定来自奶牛和5至11岁健康儿童的尿液细菌，并使用改良琼脂平板扩散法和试管扩散法进行抗菌药物敏感性测试。

结果

共鉴定出116株细菌分离株（儿童77株；奶牛39株），分别为芽孢杆菌属（10.4%；5.1%）、葡萄球菌属（2.6%；2.6%）、柠檬酸杆菌属（3.9%；12.8%）、大肠杆菌（36.4%；23.1%）、克雷伯菌属（7.8%；12.8%）、变形杆菌属（18.2%；23.1%）、假单胞菌属（9.1%；2.6%）、沙门菌属（3.9%；5.1%）和志贺菌属（7.8%；12.8%）。革兰氏阳性菌的抗生素耐药率较高（50.0%-100%），但芽孢杆菌属菌株对氯霉素、庆大霉素和四环素的耐药率为14.3%；革兰氏阴性菌的耐药率较高，但柠檬酸杆菌属（0.0%）和变形杆菌属（8.5%）分别对庆大霉素和四环素的耐药率除外。来自伊托马鲁（牛尿）的革兰氏阴性菌耐药性更强，但柠檬酸杆菌属（20.0%）和志贺菌属（0.0%）对四环素的耐药率，以及变形杆菌属（11.1%）、（22.2%）分别对阿莫西林和四环素的耐药率除外。儿童尿液细菌种类的多重耐药（MAR）率为37.5%-100%（革兰氏阳性）和12.5%-100%（革兰氏阴性），而牛尿液细菌中的MAR率为12.5%-75.0%（革兰氏阳性）和25.0%-100%（革兰氏阴性）。尿液标本中的革兰氏阴性菌对儿科抗生素混悬液的耐药率也较高。