Parajuli Narayan Prasad, Maharjan Pooja, Parajuli Hridaya, Joshi Govardhan, Paudel Deliya, Sayami Sujan, Khanal Puspa Raj
Department of Clinical Laboratory Services, Manmohan Memorial Medical College and Teaching Hospital, P.O.B.: 15201, Swayambhu, Kathmandu, Nepal ; Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal.
Department of Clinical Laboratory Services, Manmohan Memorial Medical College and Teaching Hospital, P.O.B.: 15201, Swayambhu, Kathmandu, Nepal.
Antimicrob Resist Infect Control. 2017 Jan 11;6:9. doi: 10.1186/s13756-016-0168-6. eCollection 2017.
Emergence of Extended-spectrum beta-lactamase producing causing urinary tract infections (UTI) among pediatric patients is an increasing problem worldwide. However, very little is known about pediatric urinary tract infections and antimicrobial resistance trend from Nepal. This study was conducted to assess the current antibiotic resistance rate and ESBL production among uropathogenic in pediatric patients of a tertiary care teaching hospital of Nepal.
A total of 5,484 urinary tract specimens from children suspected with UTI attending a teaching hospital of Nepal over a period of one year were processed for the isolation of bacterial pathogens and their antimicrobial susceptibility testing. ( = 739), the predominant isolate in pediatric UTI, was further selected for the detection of ESBL-production by phenotypic combination disk diffusion test.
Incidence of urinary tract infection among pediatric patients was found to be 19.68% and (68.4%) was leading pathogen involved. Out of 739 isolates, 64.9% were multidrug resistant (MDR) and 5% were extensively drug resistant (XDR). Extended spectrum beta lactamase (ESBL) was detected in 288 (38.9%) of the isolates.
Alarming rate of drug resistance among pediatric uropathogens and high rate of ESBL-producing was observed. It is extremely necessary to routinely investigate the drug resistance among all isolates and formulate strict antibiotics prescription policy in our country.
在全球范围内，产超广谱β-内酰胺酶的细菌导致儿科患者尿路感染的情况日益严重。然而，对于尼泊尔儿科尿路感染及抗菌药物耐药性趋势却知之甚少。本研究旨在评估尼泊尔一家三级护理教学医院儿科患者中尿路致病性细菌的当前抗生素耐药率及超广谱β-内酰胺酶（ESBL）的产生情况。
对尼泊尔一家教学医院一年内收治的疑似尿路感染儿童的5484份尿液标本进行处理，以分离细菌病原体并进行抗菌药物敏感性测试。大肠埃希菌（n = 739）是儿科尿路感染中最主要的分离菌株，进一步通过表型组合纸片扩散试验对其进行ESBL产生情况的检测。
发现儿科患者尿路感染的发生率为19.68%，大肠埃希菌（68.4%）是主要的致病病原体。在739株大肠埃希菌分离株中，64.9%为多重耐药（MDR），5%为广泛耐药（XDR）。在288株（38.9%）大肠埃希菌分离株中检测到超广谱β-内酰胺酶（ESBL）。
观察到儿科尿路致病菌的耐药率令人担忧，且产ESBL的大肠埃希菌比例较高。在我国，常规调查所有分离株的耐药情况并制定严格的抗生素处方政策极为必要。
