Dr Mohammad Rafiqul Islam, Associate Professor of Medicine, Shaheed Suhrawardy Medical College, Dhaka, Bangladesh; E-mail:
Mymensingh Med J. 2022 Jan;31(1):180-185.
Rapid spread of multidrug resistant microorganisms is a matter of great concern throughout the glove including Bangladesh. The objective was to identify the causative organisms for urinary tract infection (UTI) and their sensitivity patterns to antibiotics. This descriptive cross-sectional study was conducted on patients admitted with UTI (n=60) at a tertiary level hospital in Dhaka, Bangladesh from March 2019 to September 2019. Data were collected through clinical record reviews. Data of all these 60 cases were analyzed for socio-demographic characteristics. Of the 60 patients, culture and sensitivity report was available for 42 patients. Therefore, data were further analyzed for these 42 cases. Median age of patients was 35 years and 80% were female. The main organisms isolated from urine culture of UTI patients were E. coli (64%), Klebsiella (12%) and Enterococci species (10%). Susceptibility to antibiotics was analyzed only for E. coli (n=27) since the number of isolates of other organisms were small. E. coli was found to be resistant to most of the first- and second-line antibiotics, such as Amoxicillin (100%), Amoxyclav (72%), Co-trimoxazole (89%), Nalidixic acid (78%), Ceftazidim (94%), Ceftriaxone (73%), Cefuroxime (100%), Ciprofloxacin (59%), Cephotaxime (80%), Cefixime (100%) and Moxifloxacin (100%). E. coli was the predominant organism responsible for UTI and was resistant to most of the first- and second-line antibiotics. Immediate action is needed to develop empirical guideline for empirical management of UTI and establish surveillance system for monitoring.
多药耐药微生物的快速传播是整个全球范围内包括孟加拉国在内的一个非常关注的问题。本研究旨在确定尿路感染(UTI)的病原体及其对抗生素的敏感性模式。这是一项在孟加拉国达卡的一家三级医院对因 UTI 入院的患者(n=60)进行的描述性横断面研究。研究于 2019 年 3 月至 9 月进行,通过临床病历回顾收集数据。对所有 60 例患者的社会人口学特征进行了数据分析。在这 60 例患者中,有 42 例患者的培养和药敏报告可用。因此,对这 42 例患者的数据进行了进一步分析。患者的中位年龄为 35 岁,80%为女性。从 UTI 患者的尿液培养中分离出的主要病原体是大肠埃希菌(64%)、肺炎克雷伯菌(12%)和肠球菌属(10%)。由于其他病原体的分离株数量较少,仅对大肠埃希菌(n=27)进行了抗生素敏感性分析。大肠埃希菌对大多数一线和二线抗生素均具有耐药性,如阿莫西林(100%)、阿莫西林克拉维酸(72%)、复方磺胺甲噁唑(89%)、萘啶酸(78%)、头孢他啶(94%)、头孢曲松(73%)、头孢呋辛(100%)、环丙沙星(59%)、头孢噻肟(80%)、头孢克肟(100%)和莫西沙星(100%)。大肠埃希菌是引起 UTI 的主要病原体,对大多数一线和二线抗生素均具有耐药性。需要立即采取行动,制定 UTI 经验性管理的经验性指南,并建立监测系统以进行监测。