Oumer Yisiak, Regasa Dadi Belayneh, Seid Mohamed, Biresaw Gelila, Manilal Aseer
Department of Medical Microbiology, Arba Minch University, Arba Minch, Ethiopia.
Department of Hematology and Immunohematology, Arba Minch University, Arba Minch, Ethiopia.
Infect Drug Resist. 2021 Jul 24;14:2883-2894. doi: 10.2147/IDR.S311229. eCollection 2021.
Catheter-associated urinary tract infections (CAUTIs) are the most common nosocomial infection and a leading cause of morbidity. The aim of this study was to determine the prevalence, associated factors and antibiogram of the bacterial isolates among CAUTIs patients.
A facility-based, cross-sectional study was conducted from March to December 2019 at Arba Minch General Hospital, Southern Ethiopia. Clinical and socio-demographic data were obtained using a questionnaire. Clean catch midstream urine samples were collected and inoculated onto blood agar, MacConkey agar, and cysteine lactose electrolyte deficient agar (CLED). The inoculated culture media were incubated in an aerobic atmosphere at 37°C for 24 h. After overnight incubation, the bacterial growth on the respective media was inspected visually and graded for the presence of significant bacteriuria. A significant bacteriuria was considered, if pure culture at a concentration of ≥10 colony forming unit (CFU)/mL. All isolates were further identified using colony morphology and biochemical tests. Antimicrobial sensitivity was determined by modified Kirby-Bauer disc diffusion method. Data were analyzed using SPSS version 25. P-value less than 0.05 was used as statistical significance.
The overall incidence of symptomatic CAUTIs was 39/231 (16.8%). Independent predictors of CAUTIs were prolonged (≥7 days) catheterization (AOR = 3.6, 95% CI = 1.0-12.2), diabetes mellitus (AOR = 5.3, 95% CI = 1.4-19.6) and insertion of catheter in surgical ward (AOR = 3.6, 95% CI = 1.08-12.28). The most common bacterial isolates were 17/42 (40.5%), species 9/42 (21.4%) and species 5/42 (11.9%). High (>80%) drug resistance was observed against cotrimoxazole, cefoxitin and tetracycline. Ciprofloxacin and nitrofurantoin were the most active drugs. The overall prevalence of MDR among isolates was 37/42 (88.1%). Most bacterial isolates 30/42 (71.4%) were biofilm producers.
High levels of drug resistance were observed to commonly used antibiotics. In our study, biofilm-producing bacterial isolates were the predominant cause of CAUTIs. Therefore, continuous surveillance of antimicrobial resistance patterns is necessary to help physicians in treatment and management of CAUTIs.
导尿管相关尿路感染（CAUTIs）是最常见的医院感染，也是发病的主要原因。本研究的目的是确定CAUTIs患者中细菌分离株的患病率、相关因素及抗菌谱。
2019年3月至12月在埃塞俄比亚南部的阿尔巴明奇综合医院进行了一项基于机构的横断面研究。使用问卷获取临床和社会人口学数据。收集清洁中段尿样本并接种到血琼脂、麦康凯琼脂和半胱氨酸乳糖电解质缺乏琼脂（CLED）上。接种后的培养基在37°C有氧环境中孵育24小时。过夜孵育后，目视检查各培养基上的细菌生长情况，并对显著菌尿的存在进行分级。如果纯培养物浓度≥10菌落形成单位（CFU）/mL，则认为存在显著菌尿。所有分离株均通过菌落形态和生化试验进一步鉴定。采用改良的 Kirby-Bauer 纸片扩散法测定抗菌敏感性。使用SPSS 25版软件进行数据分析。P值小于0.05被用作具有统计学意义。
有症状的CAUTIs的总体发病率为39/231（16.8%）。CAUTIs的独立预测因素为长期（≥7天）导尿（比值比[AOR]=3.6，95%置信区间[CI]=1.0-12.2）、糖尿病（AOR=5.3，95%CI=1.4-19.6）以及在外科病房插入导尿管（AOR=3.6，95%CI=1.08-12.28）。最常见的细菌分离株为 17/42（40.5%）、 菌属9/42（21.4%）和 菌属5/42（11.9%）。观察到对复方新诺明、头孢西丁和四环素的耐药率较高（>80%）。环丙沙星和呋喃妥因是最有效的药物。分离株中多重耐药（MDR）的总体患病率为37/42（88.1%）。大多数细菌分离株30/42（71.4%）是生物膜产生菌。
观察到常用抗生素的耐药水平较高。在我们的研究中，产生生物膜的细菌分离株是CAUTIs的主要原因。因此，持续监测抗菌耐药模式对于帮助医生治疗和管理CAUTIs是必要的。
