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埃塞俄比亚亚的斯亚贝巴孕妇无症状菌尿症:患病率、病原体及其药敏性

Asymptomatic Bacteriuria among Pregnant Women in Addis Ababa, Ethiopia: Prevalence, Causal Agents, and Their Antimicrobial Susceptibility.

作者信息

Bizuwork Ketema, Alemayehu Haile, Medhin Girmay, Amogne Wondwossen, Eguale Tadesse

机构信息

Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia.

College of Health Sciences, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia.

出版信息

Int J Microbiol. 2021 Jul 17;2021:8418043. doi: 10.1155/2021/8418043. eCollection 2021.

Abstract

Asymptomatic bacteriuria (ASBU) is an important health problem among pregnant women, particularly in low-income countries. This study aimed to estimate the prevalence of ASBU and potential risk factors among pregnant women attending antenatal care centers in Addis Ababa. It also aimed to identify causal bacterial pathogens and to assess their antimicrobial susceptibility. A health facility-based cross-sectional study was conducted from March to June 2019. Urine samples from a total of 281 pregnant women with no symptoms of urinary tract infection were tested for ASBU. Women whose urine samples carried greater than or equal to 10 colony-forming units (CFU) of bacteria per milliliter of urine when grown on plate count agar were considered positive for ASBU. Bacterial pathogens were isolated from urine samples of women with ASBU using standard microbiological techniques. Antimicrobial susceptibility of isolates was investigated using the Kirby-Bauer disk diffusion method on Muller-Hinton agar plates. Of 281 pregnant women examined, 44 (15.7%) were positive for ASBU. Logistic regression analysis of the putative risk factors tested in the current study showed that none of them were significantly associated with the occurrence of ASBU ( > 0.05). The most frequently isolated bacterial species were 17 (30.2%), 13 (23.2%), and 11 (19.6%). All of the , and isolates and 84.6% of were resistant to ampicillin. All bacterial isolates were resistant to at least one of the antimicrobials tested. Resistance to three or more antimicrobials was detected in 15 (88.2%) of , 13 (100%) of , and 8 (72.7%) of isolates. Resistance to as many as 7 antimicrobials among , 8 antimicrobials among , and 7 antimicrobials among isolates was recorded. Detection of ASBU in a substantial number of pregnant women in this study warrants the need for a detailed study on possible risks of developing symptomatic urinary tract infection (UTI) and associated complications. Multidrug resistance to several antimicrobials was observed in the majority of bacterial isolates. Regular assessment of antimicrobial susceptibility of uropathogens to commonly prescribed antimicrobials and implementation of prudent use of antimicrobials are recommended.

摘要

无症状菌尿(ASBU)是孕妇群体中一个重要的健康问题,在低收入国家尤其如此。本研究旨在估算亚的斯亚贝巴产前护理中心孕妇中ASBU的患病率及潜在风险因素。研究还旨在鉴定致病细菌病原体并评估其抗菌药敏性。2019年3月至6月开展了一项基于医疗机构的横断面研究。对总共281名无尿路感染症状的孕妇的尿液样本进行了ASBU检测。在平板计数琼脂上培养时,每毫升尿液中细菌菌落形成单位(CFU)大于或等于10个的孕妇尿液样本被视为ASBU阳性。采用标准微生物学技术从ASBU阳性孕妇的尿液样本中分离细菌病原体。在穆勒-欣顿琼脂平板上使用 Kirby-Bauer 纸片扩散法研究分离株的抗菌药敏性。在接受检查的281名孕妇中,44名(15.7%)ASBU呈阳性。对本研究中检测的假定风险因素进行逻辑回归分析表明,它们均与ASBU的发生无显著关联(P>0.05)。最常分离出的细菌种类为大肠埃希菌17株(30.2%)、肺炎克雷伯菌13株(23.2%)和奇异变形杆菌11株(19.6%)。所有大肠埃希菌、肺炎克雷伯菌和奇异变形杆菌分离株以及84.6%的产气肠杆菌对氨苄西林耐药。所有细菌分离株对至少一种测试抗菌药物耐药。在15株(88.2%)大肠埃希菌、13株(100%)肺炎克雷伯菌和8株(72.7%)奇异变形杆菌分离株中检测到对三种或更多抗菌药物耐药。记录到大肠埃希菌分离株中有多达7种抗菌药物耐药、肺炎克雷伯菌分离株中有8种抗菌药物耐药、奇异变形杆菌分离株中有7种抗菌药物耐药。本研究中大量孕妇检测出ASBU,这表明有必要对发生有症状尿路感染(UTI)及相关并发症的可能风险进行详细研究。在大多数细菌分离株中观察到对几种抗菌药物的多重耐药性。建议定期评估尿路病原体对常用抗菌药物的药敏性并谨慎使用抗菌药物。

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Asymptomatic bacteriuria among pregnant women attending antenatal care at Mbale Hospital, Eastern Uganda.
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