Afriyie Daniel Kwame, Adu Linda Brakowaah, Dzradosi Marc, Amponsah Seth Kwabena, Ohene-Manu Prince, Manu-Ofei Francis
Ghana Police Hospital, Pharmacy Department, Accra, Ghana.
Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Central University, Accra, Ghana.
Pan Afr Med J. 2018 Jul 5;30:194. doi: 10.11604/pamj.2018.30.194.15457. eCollection 2018.
Studies on urinary tract infections (UTIs) in West Africa from 1990 to 2012 have showed moderate to high antimicrobial resistance to commonly prescribed antibiotics. Fluoroquinolones have been the main stay in the management of UTIs, but recent reports show emergence of resistance. Levofloxacin and ciprofloxacin still remain the commonest fluoroquinolones prescribed for UTIs in many settings. objective: this study sought to compare activity of ciprofloxacin and levofloxacin against clinical isolates obtained from patients with suspected UTI at the Ghana Police Hospital.
Midstream urine samples from 153 suspected UTI patients who visited the Ghana Police Hospital from July 2016 to March 2017 were examined. Urine samples were cultured and isolates identified by standard biochemical and serological methods. The Kirby-Bauer disc diffusion method was used to determine susceptibility of isolates to ciprofloxacin and levofloxacin.
UTI prevalence was significantly (p < 0.05) higher among female patients (74.5%) than male patients (25.5%). Clinical uropathogens isolated from urine samples were (28.1%), (43.2%), (26.1%) and (2.6%). Overall sensitivity of the uropathogens to ciprofloxacin and levofloxacin were 77.1% and 62.8%, respectively. showed greater resistance to levofloxacin (75%) compared to ciprofloxacin (25%). All Gram-negative isolates showed a higher sensitivity to ciprofloxacin compared to levofloxacin: ; 69.8% vrs 62.8%, p; 80.3% vrs 65.2%, and ; 80% vrs 62.5%.
This study revealed emergence of resistance of uropathogens to quinolones. The isolates showed higher sensitivity to ciprofloxacin compared to levofloxacin. Rational prescribing and use of these fluoroquinolones following local susceptibility data is thus recommended.
1990年至2012年在西非开展的关于尿路感染(UTIs)的研究表明,常见的处方抗生素存在中度至高度的耐药性。氟喹诺酮类药物一直是治疗尿路感染的主要药物,但最近的报告显示出现了耐药性。左氧氟沙星和环丙沙星在许多情况下仍然是治疗尿路感染最常用的氟喹诺酮类药物。目的:本研究旨在比较环丙沙星和左氧氟沙星对从加纳警察医院疑似尿路感染患者中分离出的临床菌株的活性。
对2016年7月至2017年3月前往加纳警察医院就诊的153例疑似尿路感染患者的中段尿样本进行检测。对尿样进行培养,并通过标准生化和血清学方法鉴定分离菌株。采用 Kirby-Bauer 纸片扩散法测定分离菌株对环丙沙星和左氧氟沙星的敏感性。
女性患者(74.5%)的尿路感染患病率显著高于男性患者(25.5%)(p < 0.05)。从尿样中分离出的临床尿路病原体分别为(28.1%)、(43.2%)、(26.1%)和(2.6%)。尿路病原体对环丙沙星和左氧氟沙星的总体敏感性分别为77.1%和62.8%。与环丙沙星(25%)相比,对左氧氟沙星的耐药性更高(75%)。所有革兰氏阴性分离株对环丙沙星的敏感性均高于左氧氟沙星:;69.8%对62.8%,p;80.3%对65.2%,以及;80%对62.5%。
本研究揭示了尿路病原体对喹诺酮类药物出现耐药性。与左氧氟沙星相比,分离株对环丙沙星的敏感性更高。因此,建议根据当地药敏数据合理开具和使用这些氟喹诺酮类药物。