Infectious Disease and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Child Growth and Development Research Center, Research Institute for Primordial Prevention of non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
Arch Iran Med. 2021 Mar 1;24(3):187-192. doi: 10.34172/aim.2021.29.
Antibiotic resistance against uro-pathogens is a worldwide health concern. The aim of this study was to determine the causative bacteria and antibiotic susceptibility patterns among hospitalized patients with community acquired urinary tract infection (UTI).
This cross-sectional study was performed in 2016-2018 in Isfahan, Iran. Urine samples were examined for strain identification and antimicrobial resistance pattern using standard tests. Stratification was done based on gender and age (<20 and >20 years) groups. Chi-square and Fisher exact tests were applied to assess differences in etiology and susceptibility rates between groups.
Among 1180 patients, was the commonest pathogen (68.1%) followed by spp. (8.8%) and (8.0 %). Non- pathogens were more frequent among males (41.8% versus 24.8% in females, <0.01) and in those aged under 20 years (61.0% versus 22.2% in older than 20 years, <0.01). Isolated bacteria revealed high susceptibility to imipenem (94.9%), meropenem (92.2%), and amikacin (91.9%); moderate sensitivity to gentamicin (64.4%), cefepime (52.6%) and ceftazidime (47.2%); and low susceptibility to ceftriaxone (41.8%), cefotaxime (40.0%), ciprofloxacin (38.6%) and trimethoprim-sulfamethoxazol (31.3%). The sensitivity of isolates to ceftriaxone, ceftazidime, cefepime, imipenem, meropenem, amikacin and ciprofloxacin was significantly higher in females. Compared to the older age group, uro-pathogens were more susceptible to ciprofloxacin, ceftazidime and gentamicin in patients aged under 20 years.
We found that imipenem, meropenem and amikacin were good choices for empiric therapy of complicated or severe hospitalized patients with community acquired UTI; and gentamicin, cefepime and ceftazidime were acceptable as initial choices in non-severe infections in the area.
尿路病原体的抗生素耐药性是一个全球性的健康问题。本研究的目的是确定社区获得性尿路感染（UTI）住院患者的病原菌和抗生素敏感性模式。
本横断面研究于 2016-2018 年在伊朗伊斯法罕进行。使用标准试验对尿液样本进行菌株鉴定和抗菌药物耐药性模式检测。根据性别和年龄（<20 岁和>20 岁）分组进行分层。卡方检验和 Fisher 确切检验用于评估组间病因和敏感性率的差异。
在 1180 例患者中，最常见的病原体是 （68.1%），其次是 spp.（8.8%）和 （8.0%）。非病原菌在男性中更为常见（41.8%比女性中的 24.8%，<0.01），在 20 岁以下的人群中更为常见（61.0%比 20 岁以上的人群中的 22.2%，<0.01）。分离的细菌对亚胺培南（94.9%）、美罗培南（92.2%）和阿米卡星（91.9%）具有高度敏感性；对庆大霉素（64.4%）、头孢吡肟（52.6%）和头孢他啶（47.2%）中度敏感；对头孢曲松（41.8%）、头孢噻肟（40.0%）、环丙沙星（38.6%）和复方磺胺甲噁唑（31.3%）敏感性较低。女性分离菌对头孢曲松、头孢他啶、头孢吡肟、亚胺培南、美罗培南、阿米卡星和环丙沙星的敏感性明显高于男性。与年龄较大的年龄组相比，20 岁以下患者的尿路病原体对环丙沙星、头孢他啶和庆大霉素更敏感。
我们发现，在治疗社区获得性 UTI 的复杂或严重住院患者时，亚胺培南、美罗培南和阿米卡星是经验性治疗的良好选择；在该地区非严重感染中，庆大霉素、头孢吡肟和头孢他啶可作为初始选择。
