Sohail Muhammad, Khurshid Mohsin, Saleem Hafiz Ghulam Murtaza, Javed Hasnain, Khan Abdul Arif
Department of Microbiology and Molecular Genetics, Quaid-e-Azam Campus, University of the Punjab, Lahore-54590, Pakistan.
College of Allied Health Professionals, Directorate of Medical Sciences, Government College University, Faisalabad, Pakistan.
Jundishapur J Microbiol. 2015 Jul 25;8(7):e19272. doi: 10.5812/jjm.19272v2. eCollection 2015 Jul.
Urinary tract infection (UTI) is deemed the most prevalent infectious disease in that it has now touched the overall incidence of 18/1000 persons per year in the general population.
This study sought to determine the characteristics of isolates from patients with UTI and their susceptibility to commonly used antibiotics in Punjab, Pakistan.
Totally, 1429 urine samples were analyzed from UTI patients for the isolation of uropathogens at Chughtai's Lahore Lab, Lahore, Pakistan, during a period of 14 months. The antimicrobial susceptibility test was performed via the disc diffusion method for the isolates obtained from 392 (26%) positive cultures.
The highest percentage (67%) of isolates was from females in comparison to males (33%). The frequency of Escherichia coli was the highest (62%) in culture-positive urine samples, followed by E. faecalis (15%), Candida (14%), Pseudomonas (6%), Klebsiella spp. (1%), Proteus (1%), and Staphylococcus aureus (1%). E. coli was highly resistant to antimicrobial drugs, viz. cephalexin (95%), cephradine (95%), pipemidic acid (92%), amikacin (91%), and nalidixic acid (91%). Most of the routine β-lactam antibiotics like amoxicillin/clavulanic acid, ampicillin, and aztreonam were also ineffective against E. coli, with resistance rates of 84%, 84%, and 72%, correspondingly. This pathogen showed maximum susceptibility (97%) against three drugs, namely imipenem, meropenem, and cefoperazone. Piperacillin and fosfomycin also provided significant results against E. coli with respective susceptibility rates of 96% and 90%.
Our results showed that broad-spectrum antibiotics such as imipenem, meropenem, fosfomycin, cefoperazone/sulbactam, and vancomycin would be the first line and the most effective drugs for the empirical treatment of urinary tract pathogens due to their higher resistance rates against other drugs like cephalexin, cephradine, ciprofloxacin, levofloxacin, and norfloxacin.
尿路感染（UTI）被认为是最常见的传染病，目前普通人群中的年发病率为18/1000人。
本研究旨在确定巴基斯坦旁遮普邦尿路感染患者分离株的特征及其对常用抗生素的敏感性。
在14个月的时间里，从巴基斯坦拉合尔Chughtai拉合尔实验室的尿路感染患者中总共分析了1429份尿液样本，以分离尿路病原体。对从392份（26%）阳性培养物中获得的分离株通过纸片扩散法进行药敏试验。
与男性（33%）相比，分离株中女性的比例最高（67%）。在培养阳性的尿液样本中，大肠埃希菌的频率最高（62%），其次是粪肠球菌（15%）、念珠菌（14%）、铜绿假单胞菌（6%）、克雷伯菌属（1%）、变形杆菌（1%）和金黄色葡萄球菌（1%）。大肠埃希菌对抗菌药物高度耐药，即头孢氨苄（95%）、头孢拉定（95%）、吡哌酸（92%）、阿米卡星（91%）和萘啶酸（91%）。大多数常规β-内酰胺类抗生素如阿莫西林/克拉维酸、氨苄西林和氨曲南对大肠埃希菌也无效，耐药率分别为84%、84%和72%。该病原体对三种药物显示出最高敏感性（97%），即亚胺培南、美罗培南和头孢哌酮。哌拉西林和磷霉素对大肠埃希菌也有显著效果，敏感性率分别为96%和90%。
我们的结果表明，亚胺培南、美罗培南、磷霉素、头孢哌酮/舒巴坦和万古霉素等广谱抗生素因其对头孢氨苄、头孢拉定、环丙沙星、左氧氟沙星和诺氟沙星等其他药物的耐药率较高，将是经验性治疗尿路病原体的一线且最有效的药物。
