Papava Vladimer, Didbaridze Tamar, Zaalishvili Zurabi, Gogokhia Nino, Maziashvili Giorgi
Urology, Tbilisi State Medical University, Tbilisi, GEO.
Microbiology, Tbilisi State Medical University, Tbilisi, GEO.
Cureus. 2022 Jun 17;14(6):e26032. doi: 10.7759/cureus.26032. eCollection 2022 Jun.
Objective This study aims to determine the relationship between the presence of urinary nitrite and bacterial resistance to antimicrobial therapy in patients with uncomplicated urinary tract infections. Methods During a six-month time period (April-October, 2020), we reviewed the urine samples of 59 adult outpatients from the Urology Department of Tbilisi State Medical University the First University Clinic with the diagnosis of urinary tract infection. The infecting microorganisms and the presence of urine nitrite were recorded. Resistance rates to the antibiotics were compared between the positive and negative nitrite groups. Chi-squared test was used to perform the statistical analysis using Prism software version 9.3.1 (GraphPad Software, Inc., San Diego, California). Results We examined the correlation between the nitrite-positive and -negative groups with the resistance pattern to ceftriaxone, trimethoprim/sulfamethoxazole (TMP-SMX), ampicillin-sulbactam, fosfomycin, amikacin, doxycycline, cefuroxime, cefotaxime, ceftazidime, and nitrofurantoin. A total of 59 outpatients with a mean age of 37 years met the inclusion criteria between April and October 2020. In the positive and negative nitrite groups, there were 23 and 36 patients, respectively. Three (17.6%) of the 17 gram-positive organisms and 20 (62.5%) of the 42 gram-negative organisms yielded positive nitrite results. In nitrite-positive group, resistance rates to ceftriaxone, TMP-SMX, ampicillin-sulbactam, fosfomycin, amikacin, doxycycline, cefuroxime, cefotaxime, ceftazidime, and nitrofurantoin were 52.2%, 70.8%, 63.5%, 67.7%, 25.8%, 31.9%, 29.6%, 32.5%, 22.5% and 83.8%, respectively. These values in the nitrite-negative group were 6.5%, 41.3%, 60.7%, 72.9%, 49%, 3%, 2.3%, 3.3%, 4.3% and 81.9%, respectively. Highest relative resistance rate was recorded against cefuroxime (12.9), followed by doxycycline (10.6), cefotaxime (9.8), ceftriaxone (8.03), ceftazidime (5.2), TMP-SMX (1.71), ampicillin-sulbactam (1.05), nitrofurantoin (1.02), fosfomycin (0.93), and amikacin (0.53). The most commonly isolated pathogen was , which was detected in 35 (71%) isolates. Other bacteria commonly found were spp in five (12%) isolates, spp in two (5%) isolates, and in five (12%) isolates. Conclusion The findings revealed that out of 10 antibiotics, nitrite-positive groups demonstrated higher resistance only against ceftriaxone, cefuroxime, cefotaxime, and doxycycline. Other antibiotics showed no statistically significant differences in resistance. Furthermore, the highest relative resistance rate was recorded against cefuroxime, whereas amikacin revealed the lowest. Therefore, we suggest physicians to not adjust antibiotic therapy for urinary tract infections (UTIs) based on the presence of nitrite. Urine bacteriology should be ordered.
目的 本研究旨在确定单纯性尿路感染患者尿亚硝酸盐的存在与细菌对抗菌治疗的耐药性之间的关系。方法 在六个月的时间段（2020年4月至10月）内，我们回顾了第比利斯国立医科大学第一大学诊所泌尿外科59例诊断为尿路感染的成年门诊患者的尿液样本。记录感染微生物和尿亚硝酸盐的存在情况。比较亚硝酸盐阳性和阴性组对抗生素的耐药率。使用Prism软件9.3.1版（GraphPad软件公司，加利福尼亚州圣地亚哥）进行卡方检验以进行统计分析。结果 我们检查了亚硝酸盐阳性和阴性组与对头孢曲松、甲氧苄啶/磺胺甲恶唑（TMP-SMX）、氨苄西林-舒巴坦、磷霉素、阿米卡星、多西环素、头孢呋辛、头孢噻肟、头孢他啶和呋喃妥因的耐药模式之间的相关性。2020年4月至10月期间，共有59例平均年龄为37岁的门诊患者符合纳入标准。在亚硝酸盐阳性和阴性组中，分别有23例和36例患者。17株革兰氏阳性菌中有3株（17.6%）和42株革兰氏阴性菌中有20株（62.5%）亚硝酸盐结果呈阳性。在亚硝酸盐阳性组中，对头孢曲松、TMP-SMX、氨苄西林-舒巴坦、磷霉素、阿米卡星、多西环素、头孢呋辛、头孢噻肟、头孢他啶和呋喃妥因的耐药率分别为52.2%、70.8%、63.5%、67.7%、25.8%、31.9%、29.6%、32.5%、22.5%和83.8%。亚硝酸盐阴性组中的这些值分别为6.5%、41.3%、60.7%、72.9%、49%、3%、2.3%、3.3%、4.3%和81.9%。记录到对头孢呋辛的相对耐药率最高（12.9），其次是多西环素（10.6）、头孢噻肟（9.8）、头孢曲松（8.03）、头孢他啶（5.2）、TMP-SMX（1.71）、氨苄西林-舒巴坦（1.05）、呋喃妥因（
