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单纯性尿路感染的细菌培养及药敏与耐药谱

Spectrum Of Bacterial Culture And Drug Sensitivity Vs Resistance In Uncomplicated Urinary Tract Infection.

作者信息

Jadoon Shakeel Ahmed, Ahmed Ashfaq, Irshad Romana

机构信息

DDepartment of Medicine, Ayub Medical College, Abbottabad, Pakistan.

Department of Community Medicine, Ayub Medical College, Abbottabad, Pakistan.

出版信息

J Ayub Med Coll Abbottabad. 2018 Jul-Sep;30(3):432-438.

Abstract

BACKGROUND

The growing antibiotic resistance against uropathogens has made its treatment a challenge for the physicians. This study was conducted to know the spectrum of bacteria responsible for urinary tract infection and their susceptibility and resistance to available antibiotics.

METHODS

This hospital based cross-sectional study was carried out from May to October 2017. All patients presenting with urinary tract infection signs and symptoms and were included in the study. A sample of 168 patients of both gender and age were recruited for the study using convenient sampling technique. Antimicrobial isolation and differentiation was determined by using Cystine-lactose Electrolyte Deficient (CLED) Agar. Susceptibility and resistance to 30 available antibiotics were determined. Data was collected on the predesigned proforma. SPSS version 16 was used for data entry and analysis.

RESULTS

There were 62 (36.9%) males and 106 (63.1%) females. Mean age of the male patients was 55.34±21.33 years whereas the mean age of the female patients was 45.8±22.07 years and the difference was statistically significant (p=0.007). Gram negative bacteria were isolated from 141 (83.9%) of the cases. Gender wise distribution of Gram negative and positive strains was found statistically significant (p=0.032). E. coli was the commonest bacterium found in 70.8% of cases. It was sensitive to only seven (23%) antibiotics in over 80% of the cases. E. faecalis, K. pneumoniae, P. aeruginosa and S. faecalis were susceptible to 13%, 26.7%, 40% and 23% of antibiotics respectively in over 60% of the cases. 90% of the cultured pathogens were susceptible to Nitrofurantoin in over 80% of the cases. Among cultured pathogens, 70% showed susceptibility to Imipenem, Meropenem, Amikacin, Doxycycline, Fosfomycin and Cefoperazone/Sulbactam in over 60% of the cases.

CONCLUSIONS

UTI is more common in women as compared men. E. coli, E. faecalis, K. pneumoniae and P. aeruginosa are the major pathogens responsible for UTI in this part of the country and in over 80% of the cases are still sensitive to Nitrofurantoin.

摘要

背景

尿路病原体对抗生素的耐药性不断增强,给医生的治疗带来了挑战。本研究旨在了解引起尿路感染的细菌种类及其对现有抗生素的敏感性和耐药性。

方法

本研究为基于医院的横断面研究,于2017年5月至10月进行。所有出现尿路感染症状和体征的患者均纳入研究。采用方便抽样技术招募了168例不同性别和年龄的患者进行研究。使用胱氨酸-乳糖电解质缺乏(CLED)琼脂进行抗菌分离和鉴别。测定对30种现有抗生素的敏感性和耐药性。在预先设计的表格上收集数据。使用SPSS 16版进行数据录入和分析。

结果

男性62例(36.9%),女性106例(63.1%)。男性患者的平均年龄为55.34±21.33岁,而女性患者的平均年龄为45.8±22.07岁,差异具有统计学意义(p=0.007)。141例(83.9%)病例分离出革兰氏阴性菌。革兰氏阴性菌和阳性菌的性别分布具有统计学意义(p=0.032)。大肠杆菌是最常见的细菌,在70.8%的病例中被发现。在超过80%的病例中,它仅对7种(23%)抗生素敏感。在超过60%的病例中,粪肠球菌、肺炎克雷伯菌、铜绿假单胞菌和屎肠球菌分别对13%、26.7%、40%和23%的抗生素敏感。在超过80%的病例中,90%的培养病原体对呋喃妥因敏感。在培养病原体中,70%在超过60%的病例中对亚胺培南、美罗培南、阿米卡星、多西环素、磷霉素和头孢哌酮/舒巴坦敏感。

结论

与男性相比,尿路感染在女性中更为常见。大肠杆菌、粪肠球菌、肺炎克雷伯菌和铜绿假单胞菌是该国该地区尿路感染的主要病原体,在超过80%的病例中仍对呋喃妥因敏感。

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