Mohammed Isra, Abass Elfadil
Isra Mohammed, College of Graduate Studies, Sudan University of Science and Technology, P.O. Box 407, Khartoum, Sudan.
Elfadil Abass, Department of Clinical Laboratory Science, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, P.O. Box 2435, Dammam, Saudi Arabia.
Pak J Med Sci. 2019 Jul-Aug;35(4):1104-1109. doi: 10.12669/pjms.35.4.207.
We aimed to determine antibiotic susceptibility patterns of ESBL- and non-ESBL bacteria isolated from pregnant women with UTI in antenatal wards in Khartoum State, Sudan.
This cross-sectional study was conducted during April-July 2016 at different hospitals in Khartoum State. Mid-stream urine samples were obtained from 150 hospitalized pregnant women and cultured on CLED (Cystine Lactose Electrolyte Deficient) agar. Microorganisms were identified using standard microbiological procedures. Isolated Gram-negative bacteria were tested for antibiotic susceptibility and ESBL screening using modified Kirby- Bauer method and Double Disc Synergy Test (DDST) respectively.
Urine culture revealed positive results in 33/150 (22%) and the most prevalent isolates were Gram negative bacteria (18/33, 54.5%). Among gram-negative bacteria, isolates of were the most prevalent accounting 66.6% (12/18) followed by (4/18, 22.2%) and (2/18, 11.1%). ESBL was detected in 8/18 (44.4%) of the Gram-negative isolates. Of note, imipenem was the most susceptible antibiotic for ESBL-producer and non-ESBL producer Gram negative isolates, accounting 100% susceptibility for both bacterial groups. Overall susceptibility rates were also high for ciprofloxacin (13/18, 72.2%). In other hand, co-trimoxazole and amoxicillin showed high resistance pattern for ESBL-producer and non-ESBL producer isolates; 27.8%, 44.4% and 38.9%, 38.9% susceptibility rates of co-trimoxazole and amoxicillin for ESBL-producer and non-ESBL producer isolates, respectively.
Imipenem remains the most powerful option for ESBL- and non-ESBL bacteria causing UTIs in pregnant women. However, due to tremendous increase of antibiotic-resistant, antibiotic-susceptibility testing is recommended as a routine investigation for admitted pregnant women.
我们旨在确定从苏丹喀土穆州产前病房患有泌尿道感染（UTI）的孕妇中分离出的产超广谱β-内酰胺酶（ESBL）和非产ESBL细菌的抗生素敏感性模式。
这项横断面研究于2016年4月至7月在喀土穆州的不同医院进行。从150名住院孕妇中获取中段尿样本，并在胱氨酸乳糖电解质缺乏（CLED）琼脂上培养。使用标准微生物学程序鉴定微生物。分别使用改良的 Kirby-Bauer 方法和双纸片协同试验（DDST）对分离出的革兰氏阴性菌进行抗生素敏感性测试和ESBL筛查。
尿液培养显示33/150（22%）呈阳性结果，最常见的分离株是革兰氏阴性菌（18/33，54.5%）。在革兰氏阴性菌中，大肠杆菌分离株最为常见，占66.6%（12/18），其次是肺炎克雷伯菌（4/18，22.2%）和奇异变形杆菌（2/18，11.1%）。在18株革兰氏阴性分离株中，有8株（44.4%）检测到ESBL。值得注意的是，亚胺培南是对产ESBL菌和非产ESBL菌革兰氏阴性分离株最敏感的抗生素，两组细菌的敏感性均为100%。环丙沙星的总体敏感率也很高（13/18，72.2%）。另一方面，复方新诺明和阿莫西林对产ESBL菌和非产ESBL菌分离株显示出高耐药模式；复方新诺明对产ESBL菌和非产ESBL菌分离株的敏感率分别为27.8%、44.4%，阿莫西林的敏感率分别为38.9%、38.9%。
亚胺培南仍然是治疗孕妇由产ESBL菌和非产ESBL菌引起的UTI的最有效选择。然而，由于抗生素耐药性的大幅增加，建议对入院孕妇进行抗生素敏感性测试作为常规检查。
