Carrasco Calzada Félix, Aguilera-Correa John Jairo, Cuadros González Juan, Esteban Moreno Jaime, Roca Biosca David, Pérez-Tanoira Ramón
Health Sciences Department, Faculty of Med, Universidad de Alcalá de Henares, 28805 Alcalá de Henares, Spain.
Clinical Microbiology Department, Hospital Universitario Príncipe de Asturias, 28805 Alcalá de Henares, Spain.
Antibiotics (Basel). 2022 Apr 11;11(4):504. doi: 10.3390/antibiotics11040504.
A cross-sectional study of microorganisms isolated from mid-stream urine samples obtained from 139 patients with suspected urinary tract infection (UTI) who presented leukocyturia was conducted from April to June 2019 at Saint Joseph Kitgum Hospital (Uganda). All microorganisms were identified by MALDI-TOF mass spectrometry in a laboratory in Spain. Antimicrobial susceptibility was determined on site using the disc diffusion method (Kirby-Bauer test) and these results were subsequently compared with those obtained in Spain using the Becton Dickinson Phoenix M50 device. The overall prevalence of UTI with bacterial growth was 64.0% ( = 89) (95% CI, 56.1-72.0), and 11 presented mixed infection. As a result, 100 microorganisms were isolated. The most common uropathogens were spp. (57%) and (28%). Nitrofurantoin was the most effective drug (81.7% in Gram-positive and 87.3% in Gram-negative bacteria), followed by imipenem (94.2% and 74.5%, respectively). The highest resistance rates were observed for amoxicillin and ciprofloxacin (66.2% and 44.6%, respectively). Given the increasing trend toward antibiotic resistance, there is a need for bacteriological cultures and continuous surveillance of uropathogen antibiotic susceptibility. Use of amoxicillin and ciprofloxacin as empirical treatments for UTIs should be discontinued in Uganda. The findings of this study may be useful for clinicians, as they may improve empirical treatment.
2019年4月至6月，在乌干达基特古姆圣约瑟夫医院对139例疑似尿路感染（UTI）且伴有白细胞尿的患者的中段尿样本中分离出的微生物进行了横断面研究。所有微生物均在西班牙的一个实验室中通过基质辅助激光解吸电离飞行时间质谱法（MALDI-TOF）进行鉴定。现场使用纸片扩散法（Kirby-Bauer试验）测定抗菌药物敏感性，随后将这些结果与在西班牙使用贝克曼库尔特Phoenix M50仪器获得的结果进行比较。UTI细菌生长的总体患病率为64.0%（n = 89）（95%CI，56.1 - 72.0），11例出现混合感染。结果，共分离出100种微生物。最常见的尿路致病菌是大肠埃希菌属（57%）和肺炎克雷伯菌（28%）。呋喃妥因是最有效的药物（革兰氏阳性菌中为81.7%，革兰氏阴性菌中为87.3%），其次是亚胺培南（分别为94.2%和74.5%）。阿莫西林和环丙沙星的耐药率最高（分别为66.2%和44.6%）。鉴于抗生素耐药性呈上升趋势，需要进行细菌培养并持续监测尿路致病菌的抗生素敏感性。在乌干达应停止使用阿莫西林和环丙沙星作为UTIs的经验性治疗药物。本研究结果可能对临床医生有用，因为它们可能改善经验性治疗。
