尼日利亚导尿的中年及老年膀胱出口梗阻患者尿路病原体及抗生素敏感性模式的比较
Comparison of uropathogens and antibiotic susceptibility patterns in catheterized ambulant middle-aged and elderly Nigerian patients with bladder outlet obstruction.
作者信息
Adegun Patrick Temi, Odimayo Michael Simidele, Olaogun Julius Gbenga, Emmanuel Eyitayo Ebenezer
机构信息
Department of Surgery, Ekiti State University, Ado-Ekiti, Nigeria.
Department of Medical Microbiology, Ekiti State University, Ado-Ekiti, Nigeria.
出版信息
Turk J Urol. 2018 Jun 5;45(1):48-55. doi: 10.5152/tud.2018.25588. Print 2019 Nov.
OBJECTIVE
Advanced age is one of the notable risk factors for catheter-associated urinary tract infections (CAUTIs), and differences between middle aged and elderly men with CAUTIs is poorly understood. This study aimed at comparing the pattern of urinary pathogens and antibiotic susceptibility in ambulant catheterized middle-aged and elderly Nigerian men.
MATERIAL AND METHODS
One hundred and fifty-four patients catheterized for >48 hours had provided clean catch mid-stream urine samples for microscopic analysis, culture and sensitivity tests. Eighty-two men aged <65, and 72 men aged ≥65 years matched for age, level of education, occupation and marital status were compared.
RESULTS
Prevalence of CAUTIs among middle-aged men was middle-aged men was higher than the elderly (90.2% and 80.6% respectively) but this was not statistically significant (p=0.086). CAUTIs in middle-aged men with suprapubic catheters were significantly more frequent than those with urethral catheters (p=0.000). The prevalence of CAUTIs in middle-aged men with urethral stricture was different from other causes of bladder outlet obstruction (p=0.004). Men with indwelling catheters longer than 2 weeks had higher CAUTIs (p=0.000). Escherichia coli was the commonest pathogen in both groups while nitrofurantoin was the most sensitive drug.
CONCLUSION
There are differential rates of CAUTIs in both the middle-aged men and the elderly with bladder outlet obstruction in our environment. The knowledge of the common pathogens and the antibiotic susceptibility will prevent irrational antibiotic use. Middle-aged men had higher prevalence of CAUTIs when Proteus spp. was the infectious agent. However, E. coli was the commonest pathogen of CAUTIs in all men. Also, middle- aged men with suprapubic catheters had higher rates of CAUTIs. Nitrofurantoin was the best drug in all men with CAUTIs but elderly men had higher rates of multi-resistance.
目的
高龄是导管相关尿路感染（CAUTIs）的显著危险因素之一，而中年和老年CAUTIs男性之间的差异尚不清楚。本研究旨在比较尼日利亚门诊导尿的中年和老年男性尿路病原体模式及抗生素敏感性。
材料与方法
154例导尿超过48小时的患者提供了清洁中段尿样本用于显微镜分析、培养和药敏试验。比较了82名年龄<65岁的男性和72名年龄≥65岁的男性，两组在年龄、教育程度、职业和婚姻状况方面相匹配。
结果
中年男性CAUTIs的患病率高于老年人（分别为90.2%和80.6%），但差异无统计学意义（p=0.086）。耻骨上导管导尿的中年男性CAUTIs发生率显著高于尿道导管导尿者（p=0.000）。尿道狭窄的中年男性CAUTIs患病率与膀胱出口梗阻的其他原因不同（p=0.004）。留置导管超过2周的男性CAUTIs发生率更高（p=0.000）。两组中大肠埃希菌是最常见的病原体，而呋喃妥因是最敏感的药物。
结论
在我们的环境中，膀胱出口梗阻的中年男性和老年男性CAUTIs发生率存在差异。了解常见病原体和抗生素敏感性将防止不合理使用抗生素。当变形杆菌属为感染病原体时，中年男性CAUTIs患病率较高。然而，大肠埃希菌是所有男性CAUTIs最常见的病原体。此外，耻骨上导管导尿的中年男性CAUTIs发生率更高。呋喃妥因是所有CAUTIs男性中最好的药物，但老年男性多重耐药率更高。
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