Al Wutayd Osama, Al Nafeesah Abdullah, Adam Ishag, Babikir Ibrahim
Unaizah College of Medicine, Qassim University, Unaizah, Saudi Arabia.
College of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan.
J Infect Dev Ctries. 2018 Nov 30;12(11):946-952. doi: 10.3855/jidc.10553.
Antimicrobial resistance is a global health problem. The present study was carried out to determine the prevalence and antibiotic resistance of uropathogens in the outpatient departments (OPDs) at the clinics of Qassim University, Saudi Arabia.
A cross-sectional study was conducted from January to December 2016. Nonrepetitive midstream urine samples (1273) were cultured on standard culture media. Identification and susceptibility testing of causative microorganisms was performed using the fully automated VITEK 2 Compact system.
Out of the 1273 nonrepetitive urine samples, 418 (32.8%) exhibited significant growth of UTI-causing microbes, 377 (90.2%) of which were Gram-negative bacilli. The commonly isolated microorganisms were Escherichia coli (157, 37.6%), Klebsiella pneumoniae (70, 16.7%), Proteus mirabilis (17, 4.1%), Pseudomonas aeruginosa (24, 5.8%), Enterobacter cloacae (11, 2.6%), Enterococcus faecalis (12, 2.9%), and Staphylococcus aureus (14, 3.3%). Overall, drug resistance was observed in 91.3% (n=381/418) of the samples, with a majority (80%) exhibiting resistance to at least 2 drugs. Drug resistance was commonly observed against ampicillin (89.9%), oxacillin (75.6%), piperacillin (85.4%), clindamycin (56.1%), amoxicillin/clavulanic acid (74.5%) and trimethoprim/sulfamethoxazole (50.4%).
The uropathogens E. coli, K. pneumoniae and P. aeruginosa and multidrug resistance pose serious therapeutic threats in the setting of this study. A concerted and systematic effort is required to rapidly identify high-risk patients and to reduce the burden of antimicrobial resistance in this region.
抗菌药物耐药性是一个全球性的健康问题。本研究旨在确定沙特阿拉伯卡西姆大学诊所门诊患者中尿路病原体的流行情况及抗生素耐药性。
于2016年1月至12月进行了一项横断面研究。将1273份非重复的中段尿样本接种于标准培养基上培养。使用全自动VITEK 2 Compact系统对致病微生物进行鉴定和药敏试验。
在1273份非重复尿样本中，418份（32.8%）显示出引起尿路感染的微生物显著生长，其中377份（90.2%）为革兰氏阴性杆菌。常见分离出的微生物有大肠埃希菌（157株，37.6%）、肺炎克雷伯菌（70株，16.7%）、奇异变形杆菌（17株，4.1%）、铜绿假单胞菌（24株，5.8%）、阴沟肠杆菌（11株，2.6%）、粪肠球菌（12株，2.9%）和金黄色葡萄球菌（14株，3.3%）。总体而言，91.3%（n = 381/418）的样本观察到耐药性，其中大多数（80%）对至少2种药物耐药。常见的耐药药物有氨苄西林（89.9%）、苯唑西林（75.6%）、哌拉西林（85.4%）、克林霉素（56.1%）、阿莫西林/克拉维酸（74.5%）和甲氧苄啶/磺胺甲恶唑（50.4%）。
在本研究背景下，尿路病原体大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌以及多重耐药性构成了严重的治疗威胁。需要齐心协力并系统地努力，以快速识别高危患者并减轻该地区抗菌药物耐药性的负担。
