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尼日利亚东南部一家三级医疗机构女性患者尿路感染的细菌学及药敏谱分析

Bacteriology and Antibiogram of Urinary Tract Infection Among Female Patients in a Tertiary Health Facility in South Eastern Nigeria.

作者信息

Oli Angus N, Akabueze Vivian B, Ezeudu Chijioke E, Eleje George U, Ejiofor Obiora S, Ezebialu Ifeanyichukwu U, Oguejiofor Charlotte B, Ekejindu Ifeoma M, Emechebe George O, Okeke Kenneth N

机构信息

Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmaceutical sciences Agulu, Nnamdi Azikiwe University, Awka, Nigeria.

Department of Peadiatrics, Faculty of Medicine, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Anambra state, Nigeria.

出版信息

Open Microbiol J. 2017 Oct 31;11:292-300. doi: 10.2174/1874285801711010292. eCollection 2017.

Abstract

BACKGROUND

Urinary Tract Infection (UTI) is a common contagion among men and women with the incidence relatively higher among women due to their differing anatomy. An understanding of the kind of pathogens implicated in urinary tract infections as well as antibiotic susceptibility profiling may help the clinician make rationally correct empirical choice in their treatment.

OBJECTIVE

This study is aimed at determining the type and antibiotic susceptibility pattern of bacterial uropathogens isolated from female patients attending Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Awka, Nigeria.

METHOD

Two hundred and forty patients with clinically diagnosed UTI and who were on at least 5 days' antibiotic holiday were recruited into the study. Their demographic characteristics were captured using pre-tested questionnaire. Their clean catch mid-stream urine samples were collected using sterile universal container and sent to the Microbiology Department for processing. Within 30 minutes of samples collection, the specimens were cultured and the isolates were identified, after 24 h of incubation, using standard microbiological techniques. Antibiotic susceptibility tests were done with standard antibiotic discs using the Kirby-bauer disc diffusion method.

RESULTS

Out of the 240 urine samples, 89.17% yielded significant bacteriuria. The pathogens implicated were (28.5%), (28.0%), spp (22.8%) and (20.5%). HIV status, patients age, pregnancy status and marital status all significantly affected bacteriuria rate (p value < 0.05), while patients' location (sub-urban/rural dwelling), and level of education did not (p value > 0.05). The pattern of microbial resistance to antibiotics suggests that ceftazidime, fosfomycin and cefoxitin may not be used as first-line agents in the empirical treatment of UTIs rather; levofloxacin, meropenem or aztreonam should be considered. Levofloxacin was significantly effective against all the isolates and may be administered empirically while waiting for the culture result (Mean % susceptibility was 79.85).

CONCLUSION

and were the predominant pathogens in the study and many were resistant to the commonly prescribed antibiotics and so leave the clinicians with only few alternative drugs for UTIs treatment. Routine surveillance and monitoring studies need to be constantly conducted to update clinicians on the prevalent pathogens and the rational and empirical treatment of UTIs. Aggressive and consistent health education using every possible media is also recommended to combat the menace of drug resistance occasioned by inappropriate antibiotic use.

摘要

背景

尿路感染(UTI)是一种常见的男女传染病,由于女性解剖结构不同,其发病率相对较高。了解与尿路感染相关的病原体种类以及抗生素敏感性分析,可能有助于临床医生在治疗中做出合理正确的经验性选择。

目的

本研究旨在确定从尼日利亚阿瓦卡丘库韦梅卡·奥杜梅古·奥朱克武大学教学医院(COOUTH)就诊的女性患者中分离出的细菌性尿路病原体的类型和抗生素敏感性模式。

方法

招募了240例临床诊断为UTI且至少停用抗生素5天的患者进入研究。使用预先测试的问卷收集他们的人口统计学特征。使用无菌通用容器收集他们的清洁中段尿样本,并送至微生物科进行处理。在样本采集后30分钟内进行培养,培养24小时后,使用标准微生物技术鉴定分离株。使用柯氏纸片扩散法,用标准抗生素纸片进行抗生素敏感性试验。

结果

在240份尿液样本中,89.17%产生了显著菌尿。涉及的病原体为(28.5%)、(28.0%)、spp(22.8%)和(20.5%)。HIV状态、患者年龄、妊娠状态和婚姻状况均显著影响菌尿率(p值<0.05),而患者的居住地点(城郊/农村)和教育程度则无影响(p值>0.05)。微生物对抗生素的耐药模式表明,头孢他啶、磷霉素和头孢西丁在UTI的经验性治疗中可能不能用作一线药物;应考虑左氧氟沙星、美罗培南或氨曲南。左氧氟沙星对所有分离株均有显著疗效,在等待培养结果时可凭经验给药(平均敏感性百分比为79.85)。

结论

和是本研究中的主要病原体,许多对常用的处方抗生素耐药,因此临床医生在治疗UTI时只有少数替代药物。需要不断进行常规监测和监测研究,以使临床医生了解流行病原体以及UTI的合理和经验性治疗方法。还建议使用各种可能的媒体进行积极一致的健康教育,以应对不当使用抗生素导致的耐药性威胁。

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