Marami Dadi, Abate Degu, Letta Shiferaw
Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
SAGE Open Med. 2022 Feb 21;10:20503121221079309. doi: 10.1177/20503121221079309. eCollection 2022.
Urinary tract infection remains one of the major public health problems among post-fistula patients worldwide, particularly in sub-Saharan Africa. Besides, antimicrobial resistance impedes the effective infection prevention and treatment of ever-increasing bacteria. There was a paucity of data on urinary tract infections and the antimicrobial susceptibility profile of bacteria among post-fistula patients.
To determine the prevalence, antimicrobial susceptibility pattern, and associated factors of urinary tract infections among women with post-fistula attending public health facilities, Harar, eastern Ethiopia.
An institutional-based cross-sectional study was conducted among 146 consecutively enrolled women with post-fistula from February 2017 to December 2018. Risk factors were collected using a structured questionnaire. The midstream urine was collected, cultured and bacteria species were identified by using standard culture methods. Antimicrobial susceptibility testing was done by the disk diffusion technique. The association between independent and outcome variables was computed by using logistic regression analysis. A -value < 0.05 was considered statistically significant.
The prevalence of urinary tract infections was 28.8% (95% confidence interval: 23.4, 33.6). (19.1%), (14.3%), and species (11.9%) were the commonest isolates. showed (75%) resistance to trimethoprim-sulfamethoxazole, amoxicillin (62.5%), and ciprofloxacin (62.5%). was shown 80% resistance to amoxicillin and erythromycin. Giving birth to a single baby (adjusted odds ratio: 0.3, 95% confidence interval: 0.1, 0.8), illness by a fistula for less than 3 years (adjusted odds ratio: 0.2, 95% confidence interval: 0.1, 0.6), and lack of a previous history of catheterization (adjusted odds ratio: 0.3, 95% confidence interval: 0.1, 0.9) decrease the odds of having urinary tract infections.
Gram-negative organisms were the commonest cause of urinary tract infections in women with post-fistula. and showed higher resistance to most antimicrobials in the panels. Fistula patients need to be screened for urinary tract infections before antimicrobial treatment is indicated.
在全球范围内，尤其是在撒哈拉以南非洲地区，尿路感染仍然是瘘管病患者面临的主要公共卫生问题之一。此外，抗菌药物耐药性阻碍了对不断增加的细菌进行有效的感染预防和治疗。关于瘘管病患者尿路感染及细菌的抗菌药物敏感性概况的数据匮乏。
确定在埃塞俄比亚东部哈勒尔市公共卫生机构就诊的瘘管病女性患者中尿路感染的患病率、抗菌药物敏感性模式及相关因素。
2017年2月至2018年12月，对146例连续入组的瘘管病女性患者进行了一项基于机构的横断面研究。使用结构化问卷收集危险因素。收集中段尿，采用标准培养方法进行培养并鉴定细菌种类。采用纸片扩散法进行抗菌药物敏感性试验。使用逻辑回归分析计算自变量与结果变量之间的关联。P值<0.05被认为具有统计学意义。
尿路感染的患病率为28.8%（95%置信区间：23.4，33.6）。大肠埃希菌（19.1%）、肺炎克雷伯菌（14.3%）和粪肠球菌（11.9%）是最常见的分离菌株。大肠埃希菌对甲氧苄啶 - 磺胺甲恶唑显示出75%的耐药率，对阿莫西林（62.5%）和环丙沙星（62.5%）也耐药。肺炎克雷伯菌对阿莫西林和红霉素显示出80%的耐药率。生育单胎（调整比值比：0.3，95%置信区间：0.1，0.8）、瘘管病患病时间少于3年（调整比值比：0.2，95%置信区间：0.1，0.6）以及既往无导尿史（调整比值比：0.3，95%置信区间：0.1，0.9）可降低尿路感染的几率。
革兰氏阴性菌是瘘管病女性患者尿路感染的最常见病因。大肠埃希菌和肺炎克雷伯菌对大多数受试抗菌药物显示出较高的耐药性。在指示进行抗菌治疗之前，需要对瘘管病患者进行尿路感染筛查。
