Somashekara Saligrama Chikkannasetty, Deepalaxmi Salmani, Jagannath Narumalla, Ramesh Bannaravuri, Laveesh Madathil Ravindran, Govindadas Damodaram
Department of Pharmacology, Malabar Medical College and Research Centre, Modakkallur, Kozhikode, Kerala, India.
Department of Anatomy, Malabar Medical College and Research Centre, Modakkallur, Kozhikode, Kerala, India.
J Basic Clin Pharm. 2014 Sep;5(4):105-8. doi: 10.4103/0976-0105.141948.
The distribution of uropathogens and their susceptibility pattern to antibiotics vary regionally and even in the same region, they change over time. Therefore, the knowledge on the frequency of the causative microorganisms and their susceptibility to various antibiotics are necessary for a better therapeutic outcome.
The aim was to study the frequency and distribution of uropathogens and their resistance pattern to antibiotics in a tertiary care hospital.
Retrospective study for a period of 1 year from January 2011 to December 2011 in a tertiary care hospital.
The culture and sensitivity data of the uropathogens from suspected cases of UTI were collected from the records of Microbiology Department for study period. Midstream urine samples were processed for microscopy and culture, and the organisms were identified by standard methods. Antibiotic susceptibility was carried out by Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute guidelines. Descriptive statistics were used to analyze the data.
Of 896 urine samples, 348 (38.84%) samples were positive for urine culture. Escherichia coli (52.59%) was the most common organism followed by Klebsiella. E. coli was least resistant to imipenem (8%) and amikacin (16%) and was highly resistant to co-trimoxazole (69%) and ampicillin (86%). Klebsiella species were least resistant to amikacin (26%) and were highly resistant to ampicillin (92%). The overall resistance pattern of antibiotics to uropathogens was the highest to nalidixic acid (79%) followed by co-trimoxazole (75%) and ampicillin (72%). Good susceptibility was seen with imipenem and cephalosporins.
E. coli is still the most common uropathogen. Nalidixic acid, ampicillin, co-trimoxazole, and first-generation fluoroquinolones have limited value for the treatment of UTI. Sensitivity to imipenem and amikacin are still retained and may be prescribed for complicated UTI. Routine monitoring of drug resistance pattern will help to identify the resistance trends regionally. This will help in the empirical treatment of UTIs to the clinicians.
尿路病原体的分布及其对抗生素的敏感性模式因地区而异，甚至在同一地区，它们也会随时间变化。因此，了解致病微生物的频率及其对各种抗生素的敏感性对于获得更好的治疗效果是必要的。
本研究旨在探讨某三级医院尿路病原体的频率、分布及其对抗生素的耐药模式。
对一家三级医院2011年1月至2011年12月为期1年的回顾性研究。
从微生物科记录中收集研究期间疑似尿路感染病例的尿路病原体培养及药敏数据。对中段尿样本进行显微镜检查和培养，并采用标准方法鉴定微生物。根据临床和实验室标准协会指南，采用 Kirby-Bauer 纸片扩散法进行抗生素敏感性试验。使用描述性统计分析数据。
在896份尿样中，348份（38.84%）尿培养呈阳性。大肠埃希菌（52.59%）是最常见的病原体，其次是克雷伯菌属。大肠埃希菌对亚胺培南（8%）和阿米卡星（16%）耐药性最低，对复方新诺明（69%）和氨苄西林（86%）耐药性高。克雷伯菌属对阿米卡星（26%）耐药性最低，对氨苄西林（92%）耐药性高。抗生素对尿路病原体的总体耐药模式最高的是萘啶酸（79%），其次是复方新诺明（75%）和氨苄西林（72%）。亚胺培南和头孢菌素显示出良好的敏感性。
大肠埃希菌仍然是最常见的尿路病原体。萘啶酸、氨苄西林、复方新诺明和第一代氟喹诺酮类药物对尿路感染的治疗价值有限。对亚胺培南和阿米卡星仍保持敏感性，可用于复杂性尿路感染的治疗。定期监测耐药模式将有助于确定区域耐药趋势。这将有助于临床医生对尿路感染进行经验性治疗。
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