Ali Syed Asad, Mandal Snigdhendu, Georgalas Athanasios, Gilani Syed Anas D
Department of Medicine, Russells Hall Hospital Dudley, Dudley, GBR.
Department of Pharmacy/Antimicrobials Therapy, Russells Hall Hospital Dudley, Dudley, GBR.
Cureus. 2021 Jan 28;13(1):e12977. doi: 10.7759/cureus.12977.
Background and aim Gram-negative rods (GNR) are the most common pathogens associated with urinary tract infections (UTI). The resistance of these gram-negative rods to various antibiotics is increasing with time. The study aimed to determine the pattern of resistance to antibiotics in GNR causing urinary tract infection in adults. Material and methods This is a cross-sectional study conducted during six months (1st December 2019 to 1st June 2020) among adult patients admitted to Russells Hall Hospital Dudley, UK. Urine cultures of 156 patients admitted with urinary tract infection were collected and reviewed. Sources of urine included midstream urine (MSU), catheter specimen urine (CSU), and others from nephrostomy bags and urine bags. Sensitivity and resistance were checked using Clinical and Laboratory Standards Institute (CLSI) guidelines. Results were analyzed using SPSS version 13. Results Altogether 156 patients were included in the study. Males were 40.4% of the patients were males, and 59.6% were females. The mean age was 78 with a standard deviation (SD) of 13.15. Most of the samples (67.3%) were urine MSU, 23.1% catheter urine, and 9.6% were others, like from nephrostomy bags or unspecified. Resistance to amoxicillin was found in 61.7%, trimethoprim in 36.2%, nitrofurantoin in 13.2%, ciprofloxacin in 25.6%, fosfomycin in 10.7%, co-amoxiclav in 36.2%, gentamicin in 12.8%, piperacillin-tazobactam in 7.1%, cephalexin in 44.4%, and meropenem in 0% of patients. Conclusion Resistance to gram-negative rods causing urinary tract infection is increasing; a particular concern is increased resistance to beta-lactams, trimethoprim, and quinolones.
背景与目的 革兰氏阴性杆菌（GNR）是与尿路感染（UTI）相关的最常见病原体。这些革兰氏阴性杆菌对各种抗生素的耐药性正随着时间增加。本研究旨在确定导致成人尿路感染的革兰氏阴性杆菌的抗生素耐药模式。材料与方法 这是一项在六个月期间（2019年12月1日至2020年6月1日）对英国达德利拉塞尔霍尔医院收治的成年患者进行的横断面研究。收集并审查了156例因尿路感染入院患者的尿培养样本。尿液来源包括中段尿（MSU）、导尿标本尿（CSU）以及来自肾造瘘袋和尿袋的其他样本。使用临床和实验室标准协会（CLSI）指南检查敏感性和耐药性。使用SPSS 13版分析结果。结果 本研究共纳入156例患者。男性占患者总数的40.4%，女性占59.6%。平均年龄为78岁，标准差（SD）为13.15。大多数样本（67.3%）为中段尿，23.1%为导尿，9.6%为其他样本，如来自肾造瘘袋或未明确说明的样本。发现对阿莫西林耐药的患者占61.7%，对甲氧苄啶耐药的占36.2%，对呋喃妥因耐药的占13.2%，对环丙沙星耐药的占25.6%，对磷霉素耐药 的占10.7%，对阿莫西林克拉维酸耐药的占36.2%，对庆大霉素耐药的占12.8%，对哌拉西林他唑巴坦耐药的占7.1%，对头孢氨苄耐药的占44.4%，对美罗培南耐药的患者占0%。结论 导致尿路感染的革兰氏阴性杆菌的耐药性正在增加；特别令人担忧的是对β-内酰胺类、甲氧苄啶和喹诺酮类药物的耐药性增加。
