不丹廷布吉格梅·多吉·旺楚克国家转诊医院分离出的尿路病原体的病因及抗生素敏感性模式的回顾性分析。

A retrospective analysis of the etiologic agents and antibiotic susceptibility pattern of uropathogens isolated in the Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.

作者信息

Adeep M, Nima T, Kezang W, Tshokey T

机构信息

Microbiology unit, Department of Laboratory Services, JDWNRH, Thimphu, Bhutan.

出版信息

BMC Res Notes. 2016 Jan 29;9:54. doi: 10.1186/s13104-015-1728-1.

DOI:10.1186/s13104-015-1728-1

PMID:26825932

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4733272/

Abstract

BACKGROUND

Urinary tract infection is one of the major public health problems. Specific population studies to understand the common etiologic agents and antibiotic susceptibility patterns are important to determine the empirical treatment of urinary tract infections. This is the first study in Bhutan to analyze the etiologic agents and antibiotic susceptibility pattern of uropathogens isolated from patients visiting Jigme Dorji Wangchuck National Referral Hospital with the ultimate goal of guiding empirical treatment.

METHODS

Hospital based (inpatients/outpatients) retrospective cross sectional study of 6030 clinically suspected patients with urinary tract infections who have submitted urine samples for culture in a 6 months period was done. Urine samples were collected and processed as per standard microbiological procedures and antibiotic susceptibility testing performed by CLSI guidelines.

RESULTS

Significant bacteriuria were detected in 14.9 % of the total patients. The most common uropathogens isolated were Escherichia coli (79.3 %) followed by Klebsiella pneumoniae. Females around the age group of 18-26 have the highest prevalence of urinary tract infection. The highest rate of antibiotic resistance was seen in amoxicillin (71.4 %) and nalidixic acid (80.3 %), and resistance were lower in nitrofuration (3.4 %) and gentamycin (17.5 %). The third generation cephalosporin resistance (which is a surrogate marker of ESBL) was 16.1 % in outpatient and 16.7 % approximately in inpatient setting.

CONCLUSION

Escherichia coli was the predominant uropathogen making up 79.3 % (outpatient 81.1 % and inpatient 69.5 %) of the total and its antibiotic susceptibility pattern needs to be considered for treating community-acquired UTIs empirically. The third generation cephalosporin resistance (which is a surrogate marker of ESBL) is alarmingly high among the isolates and there is need for further studies.

摘要

背景

尿路感染是主要的公共卫生问题之一。开展特定人群研究以了解常见病原体及抗生素敏感性模式对于确定尿路感染的经验性治疗至关重要。这是不丹的第一项研究，旨在分析从吉格梅·多吉·旺楚克国家转诊医院就诊患者中分离出的尿路病原体的病原体及抗生素敏感性模式，最终目标是指导经验性治疗。

方法

对6030例临床疑似尿路感染患者进行了为期6个月的基于医院（住院/门诊）的回顾性横断面研究，这些患者提交了尿液样本进行培养。按照标准微生物学程序收集和处理尿液样本，并根据CLSI指南进行抗生素敏感性测试。

结果

在所有患者中，14.9%检测到显著菌尿。分离出的最常见尿路病原体是大肠埃希菌（79.3%），其次是肺炎克雷伯菌。18 - 26岁年龄段的女性尿路感染患病率最高。阿莫西林（71.4%）和萘啶酸（80.3%）的抗生素耐药率最高，而硝呋太尔（3.4%）和庆大霉素（17.5%）的耐药率较低。第三代头孢菌素耐药率（作为ESBL的替代指标）在门诊患者中为16.1%，在住院患者中约为16.7%。