Beyene Getenet, Tsegaye Wondewosen
Department of Laboratory Sciences and Pathology, College of Public Health and Medical Sciences, Jimma University.
Ethiop J Health Sci. 2011 Jul;21(2):141-6. doi: 10.4314/ejhs.v21i2.69055.
Urinary tract infection (UTI) is one of the most common bacterial infections encountered by clinicians in developing countries. Area-specific monitoring studies aimed to gain knowledge about the type of pathogens responsible for urinary tract infections and their resistance patterns may help the clinician to choose the correct empirical treatment. Therefore, the aim of this study was to determine the type and antibiotic resistance pattern of the urinary pathogens isolated from patients attending Jimma University Specialized Hospital from April to June 2010.
A hospital based cross sectional stud was conducted and urine samples were collected using the mid-stream "clean catch" method from 228 clinically-suspected cases of urinary tract infections and tested bacteriologically using standard procedures. Antimicrobial susceptibility test was performed for the isolated pathogens using Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute guidelines.
Significant bacteria were detected from 9.2% of the total patients. The most common pathogens isolated were Escherichia coli (33.3%), Klebsiella pneumoniae (19%) and S. saprophyticus (14.3%). E. coli and Klebsiella pneumoniae showed the highest percentage of resistance to ampicillin and amoxacillin (100%) however, all isolates of E. coli and K. pneumoniae were susceptible to ciprofloxacin. S. saprophyticus and S. aureus were resistant to ampicillin (100%) and amoxicillin (66.7%). For all UTI isolates, least resistance was observed against drugs such as ceftriaxone, gentamycin and chloramphenicol.
This study finding showed that E. coli isolates were the predominant pathogens and the presence of bacterial isolates with very high resistance to the commonly prescribed drugs that in turn leaves the clinicians with very few alternative options of drugs for the treatment of UTIs. As drug resistance among bacterial pathogens is an evolving process, routine surveillance and monitoring studies should be conducted to provide physicians knowledge on the updated and most effective empirical treatment of UTIs.
尿路感染（UTI）是发展中国家临床医生遇到的最常见细菌感染之一。旨在了解引起尿路感染的病原体类型及其耐药模式的特定地区监测研究，可能有助于临床医生选择正确的经验性治疗方法。因此，本研究的目的是确定2010年4月至6月在吉马大学专科医院就诊患者中分离出的尿路病原体的类型和抗生素耐药模式。
进行了一项基于医院的横断面研究，采用中段“清洁中段尿”法从228例临床疑似尿路感染病例中收集尿液样本，并使用标准程序进行细菌学检测。根据临床和实验室标准协会指南，采用 Kirby-Bauer 纸片扩散法对分离出的病原体进行药敏试验。
在所有患者中，9.2%检测到有意义的细菌。分离出的最常见病原体为大肠埃希菌（33.3%）、肺炎克雷伯菌（19%）和腐生葡萄球菌（14.3%）。大肠埃希菌和肺炎克雷伯菌对氨苄西林和阿莫西林的耐药率最高（100%），然而，所有大肠埃希菌和肺炎克雷伯菌分离株对环丙沙星敏感。腐生葡萄球菌和金黄色葡萄球菌对氨苄西林（100%）和阿莫西林（66.7%）耐药。对于所有尿路感染分离株，对头孢曲松、庆大霉素和氯霉素等药物的耐药性最低。
本研究结果表明，大肠埃希菌分离株是主要病原体，并且存在对常用处方药耐药性极高的细菌分离株，这使得临床医生在治疗尿路感染时几乎没有其他药物选择。由于细菌病原体中的耐药性是一个不断演变的过程，应开展常规监测研究，为医生提供有关尿路感染最新和最有效经验性治疗的知识。
