埃塞俄比亚西北部贡德尔大学医院产科瘘患者的尿路感染。
Urinary tract infection among obstetric fistula patients at Gondar University Hospital, northwest Ethiopia.
机构信息
School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P,O, Box 196, Gondar, Ethiopia.
出版信息
BMC Womens Health. 2014 Jan 17;14:12. doi: 10.1186/1472-6874-14-12.
BACKGROUND
Many women die from complications related to pregnancy and childbirth. In developing countries particularly in sub-Saharan Africa and Asia, where access to emergency obstetrical care is often limited, obstetric fistula usually occurs as a result of prolonged obstructed labour. Obstetric fistula patients have many social and health related problems like urinary tract infections (UTIs). Despite this reality there was limited data on prevalence UTIs on those patients in Ethiopia. Therefore, the aim of this study was to determine the prevalence, drug susceptibility pattern and associated risk factors of UTI among obstetric fistula patients at Gondar University Hospital, Northwest Ethiopia.
METHODS
A cross sectional study was conducted from January to May, 2013 at Gondar University Hospital. From each post repair obstetric fistula patients, socio-demographic and UTIs associated risk factors were collected by using a structured questionnaire. After the removal of their catheters, the mid-stream urine was collected and cultured on CLED. After overnight incubation, significant bacteriuria was sub-cultured on Blood Agar Plate (BAP) and MacConkey (MAC). The bacterial species were identified by series of biochemical tests. Antibiotic susceptibility test was done by disc diffusion method. Data was entered and analyzed by using SPSS version 20.
RESULTS
A total of 53 post repair obstetric fistula patients were included for the determination of bacterial isolate and 28 (52.8%) of them had significant bacteriuria. Majority of the bacterial isolates, 26 (92.9%), were gram negative bacteria and the predominant ones were Citrobacter 13 (24.5%) and E. coli 6 (11.3%). Enterobacter, E.coli and Proteus mirabilis were 100% resistant to tetracycline. Enterobacter, Proteus mirabilis, Klebsella pneumonia, Klebsella ozenae and Staphylococcus aureus were also 100% resistant to ceftriaxone.
CONCLUSION
The prevalence of bacterial isolates in obstetric fistula patients was high and majority of the isolates were gram negative bacteria. Even thought the predominant bacterial isolates were Citrobacter and E. coli, all of the bacterial isolates had multiple antibiotic resistance patterns which alert health profession to look better treatment for these patients.
背景
许多妇女死于与妊娠和分娩相关的并发症。在发展中国家，特别是在撒哈拉以南非洲和亚洲，紧急产科护理的获取往往受到限制，产科瘘通常是由于长时间的梗阻性分娩引起的。产科瘘患者存在许多与社会和健康相关的问题，如尿路感染（UTI）。尽管如此，在埃塞俄比亚，关于这些患者尿路感染患病率的数据有限。因此，本研究旨在确定在埃塞俄比亚贡德尔大学医院接受产科瘘修补术后患者中尿路感染的患病率、药敏模式和相关危险因素。
方法
本横断面研究于 2013 年 1 月至 5 月在贡德尔大学医院进行。从每位修复后的产科瘘患者中，通过使用结构化问卷收集社会人口统计学和与 UTI 相关的危险因素。在拔出导尿管后，收集中段尿液并在 CLED 上培养。过夜孵育后，将显著的菌尿进行次培养到血琼脂平板（BAP）和 MacConkey（MAC）上。通过一系列生化试验鉴定细菌种类。药敏试验采用纸片扩散法进行。数据采用 SPSS 20 版进行录入和分析。
结果
共纳入 53 例修复后的产科瘘患者进行细菌分离物的测定，其中 28 例（52.8%）有显著菌尿。大多数细菌分离物（26 个，92.9%）为革兰氏阴性菌，其中以柠檬酸杆菌 13 个（24.5%）和大肠杆菌 6 个（11.3%）为主。肠杆菌属、大肠杆菌和奇异变形杆菌对四环素完全耐药。肠杆菌属、奇异变形杆菌、肺炎克雷伯菌、奥氏克雷伯菌和金黄色葡萄球菌对头孢曲松也完全耐药。
结论
产科瘘患者的细菌分离物患病率较高，且大多数分离物为革兰氏阴性菌。尽管主要的细菌分离物是柠檬酸杆菌和大肠杆菌，但所有的细菌分离物都有多种抗生素耐药模式，这提醒卫生专业人员为这些患者寻找更好的治疗方法。
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