Department of Medical Laboratory Techniques, Al-Kunooze University College, Basrah, Iraq.
Department of Nephrology, College of Medicine, University of Basrah, Basrah, Iraq.
J Clin Lab Anal. 2022 Sep;36(9):e24619. doi: 10.1002/jcla.24619. Epub 2022 Jul 23.
Urinary tract infections (UTIs) and bacterial resistance to antibiotics is global health problem and a threat to public health in many countries.
The study aimed to determine the prevalence of MDR Escherichia coli and Klebsiella pneumoniae in UTI patients.
MATERIALS & METHODS: The midstream urine samples of 120 patients were collected and cultured as described by the protocols at the respective sample collection sites on MacConkey Blood agar. Samples were tested by using the fully automated VITEK 2 Compact system for Gram-negative identification and detection of antimicrobial susceptibility of microorganisms.
The most prevalent pathogen was E. coli, which was found in 82 (68.3%) urine samples, followed by K. pneumonia, found in 38 (31.7%) urine samples. As far as antibiotic resistance is concerned, E. coli isolates were found to be highly resistant for ceftriaxone (89.0% of the isolates), ampicillin (86.6%), levofloxacin (82.9%), cefotaxime (79.3%), aztreonam (74.4%), ceftazidime (68.3%) and gentamicin, piperacillin, and trimethoprim-sulfamethoxazole, 54.9 and 53.7%, respectively. The E. coli isolates were found to be relatively less resistant to imipenem (2.4%), cefepime (34.1%), and ciprofloxacin (35.4%). For K. pneumonia isolates, high resistance rates were observed for piperacillin (81.6%), levofloxacin (78.9%), ampicillin (76.3%), cefotaxime (73.7%), trimethoprim-sulfamethoxazole (71.1%), ceftazidime (65.8%), gentamicin (63.2%), cefepime (50.0%), and aztreonam (44.7%). However, moderate resistance rates were detected for these were found to be less resistant for imipenem (13.2%), ceftriaxone (31.6%), and ciprofloxacin (36.8%).
E. coli and K. pneumoniae from the clinical isolates displayed high resistance to many antibiotics in UTI patients.
尿路感染（UTIs）和细菌对抗生素的耐药性是全球健康问题，也是许多国家公共卫生的威胁。
本研究旨在确定尿路感染患者中多药耐药大肠埃希菌和肺炎克雷伯菌的流行情况。
按照各自样本采集地点的方案，采集 120 例患者的中段尿液样本并进行培养。使用全自动 VITEK 2 Compact 系统对革兰氏阴性菌进行鉴定，并对微生物的抗菌药物敏感性进行检测。
最常见的病原体是大肠埃希菌，在 82 份（68.3%）尿液样本中发现，其次是肺炎克雷伯菌，在 38 份（31.7%）尿液样本中发现。就抗生素耐药性而言，发现大肠埃希菌分离株对头孢曲松（89.0%的分离株）、氨苄西林（86.6%）、左氧氟沙星（82.9%）、头孢噻肟（79.3%）、氨曲南（74.4%）、头孢他啶（68.3%）和庆大霉素、哌拉西林和复方新诺明的耐药性较高，分别为 54.9%和 53.7%。大肠埃希菌分离株对亚胺培南（2.4%）、头孢吡肟（34.1%）和环丙沙星（35.4%）的耐药性相对较低。肺炎克雷伯菌分离株对哌拉西林（81.6%）、左氧氟沙星（78.9%）、氨苄西林（76.3%）、头孢噻肟（73.7%）、复方新诺明（71.1%）、头孢他啶（65.8%）、庆大霉素（63.2%）、头孢吡肟（50.0%）和氨曲南（44.7%）的耐药率较高。然而，这些分离株对亚胺培南（13.2%）、头孢曲松（31.6%）和环丙沙星（36.8%）的耐药率较低。
尿路感染患者的临床分离株中，大肠埃希菌和肺炎克雷伯菌对许多抗生素表现出高度耐药性。
