Kidwai Saera Suhail, Nageen Ayesha, Ghaznavi Samina, Bashir Farhat, Ara Jamal
Saera Suhail Kidwai, Associate Professor, United Medical and Dental College - Creek General Hospital, Karachi, Pakistan.
Ayesha Nageen, Assistant Professor, United Medical and Dental College - Creek General Hospital, Karachi, Pakistan.
Pak J Med Sci. 2017 Mar-Apr;33(2):254-259. doi: 10.12669/pjms.332.11569.
Urinary tract infection is one of the commonest infections seen in clinical practice. Lack of compliance and unjustified antibiotic prescriptions has resulted in bacterial resistance and is proving as a major challenge in the management of these infections. Our aim was to identify the sensitivity pattern of commonly used antibiotics against urinary tract infections so as to suggest an improvised line of action against bacteria causing urinary tract infections'.
This was a hospital based cross sectional study extended over a period of four months. Patients were recruited from outpatients department of a tertiary care hospital in an industrial area of Karachi. Adult patients with symptomatic and documented UTI in urine detailed report (pus cells >10) were enrolled after informed consent. A clean catch midstream urine was collected for culture and sensitivity testing using the standard microbiological procedure. Data is analyzed on SPSS 16.
A total of 184 samples were collected in 4 months. The Male to Female ratio was 1:2 (n=58/126) with mean age 48.5±12 years. 83(45.6%) patients were between 45-60 years. Most common isolated pathogen was Eschericia coli 108(59%) followed by staphylococcus aureus 30(16.4%) and Klebsiella 20(11%). 55(30%) pathogens showed sensitivity to 4-6 antibiotics, 22(12%) strains to 7-9 antibiotics, 33(18%) were sensitive to ≤3 drugs and in 3(1.6%) patients resistance to all antibiotics is seen. The more resistant pathogens were sensitive to intravenous antibiotics alone.
In this low socioeconomic cohort with UTI nearly half the isolated pathogens has shown resistance to most of the commonly used antibiotics recommended in the guidelines especially the floxacin group probably because of its unwarranted use. Therefore, a revised line of management should be developed locally in accordance with the susceptibility pattern of the urinary pathogens to avoid further resistance as well as morbidity of the patient.
尿路感染是临床实践中最常见的感染之一。患者依从性差以及不合理的抗生素处方导致了细菌耐药性，这已成为这些感染治疗中的一项重大挑战。我们的目的是确定常用抗生素对尿路感染的敏感性模式，以便针对引起尿路感染的细菌提出改进的治疗方案。
这是一项基于医院的横断面研究，为期四个月。研究对象从卡拉奇工业区一家三级护理医院的门诊部招募。在获得知情同意后，纳入有症状且尿液详细报告中记录有UTI（脓细胞>10）的成年患者。采用标准微生物学程序收集清洁中段尿进行培养和药敏试验。数据在SPSS 16上进行分析。
4个月内共收集了184份样本。男女比例为1:2（n = 58/126），平均年龄为48.5±12岁。83名（45.6%）患者年龄在45至60岁之间。最常见的分离病原体是大肠杆菌108株（59%），其次是金黄色葡萄球菌30株（16.4%）和克雷伯菌20株（11%）。55株（30%）病原体对4至6种抗生素敏感，22株（12%）菌株对7至9种抗生素敏感，33株（18%）对≤3种药物敏感，3名（1.6%）患者的病原体对所有抗生素均耐药。耐药性更强的病原体仅对静脉用抗生素敏感。
在这个社会经济水平较低的UTI队列中，近一半分离出的病原体对指南中推荐的大多数常用抗生素耐药，尤其是氟喹诺酮类药物，这可能是由于其不合理使用所致。因此，应根据尿路病原体的药敏模式在当地制定修订后的治疗方案，以避免进一步的耐药性以及患者的发病情况。
