Olaru Ioana D, Yeung Shunmay, Ferrand Rashida A, Stabler Richard, Chonzi Prosper, Mabey David, Hopkins Heidi, Bradley John, Masunda Kudzai P E, Munyati Shungu, Kranzer Katharina
Clinical Research Department, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK.
Biomedical Research and Training Institute, Harare, Zimbabwe.
Wellcome Open Res. 2020 Jun 12;5:140. doi: 10.12688/wellcomeopenres.15977.1. eCollection 2020.
Antimicrobial resistance (AMR) is compromising our ability to successfully treat infections. There are few data on gram-negative AMR prevalence in sub-Saharan Africa especially from the outpatient setting. This study aims to investigate the prevalence of and underlying molecular mechanisms for AMR in gram-negative bacilli causing urinary tract infections (UTIs) in Zimbabwe. Risk factors for AMR and how AMR impacts on clinical outcomes will also be investigated. Adults presenting with UTI symptoms at primary health clinics in Harare will be included. A questionnaire will be administered, and urine samples will be collected for culture. Participants with positive urine cultures will be followed up at 7-14 days post-enrolment. All participants will also be followed by telephone at 28 days to determine clinical outcomes. Bacterial identification and antibiotic susceptibility testing will be performed on positive cultures. The results from this study will be used to inform policy and development of treatment recommendations. Whole genome sequencing results will provide a better understanding of the prevalent resistance genes in Zimbabwe, of the spread of successful clones, and potentially will contribute to developing strategies to tackle AMR.
抗菌药物耐药性（AMR）正在损害我们成功治疗感染的能力。关于撒哈拉以南非洲革兰氏阴性菌AMR流行情况的数据很少，尤其是来自门诊环境的数据。本研究旨在调查津巴布韦引起尿路感染（UTIs）的革兰氏阴性杆菌中AMR的流行情况及其潜在分子机制。还将调查AMR的危险因素以及AMR如何影响临床结果。将纳入在哈拉雷初级卫生诊所出现UTI症状的成年人。将发放问卷，并收集尿液样本进行培养。尿液培养呈阳性的参与者将在入组后7至14天进行随访。所有参与者还将在28天时通过电话随访以确定临床结果。将对阳性培养物进行细菌鉴定和抗生素敏感性测试。本研究的结果将用于为政策制定和治疗建议的制定提供信息。全基因组测序结果将有助于更好地了解津巴布韦普遍存在的耐药基因、成功克隆的传播情况，并有可能为制定应对AMR的策略做出贡献。
