Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
PLoS One. 2022 Dec 30;17(12):e0279887. doi: 10.1371/journal.pone.0279887. eCollection 2022.
The emergence of drug-resistant Gram-negative bacterial uropathogens poses a grave threat worldwide, howbeit studies on their magnitude are limited in most African countries, including Ethiopia. Therefore, measuring the extent of their drug resistance is essential for developing strategies to confine the spread. A cross-sectional study was conducted at title hospital from 01 June to 31 August 2020. Midstream urine specimens were collected and inoculated onto MacConkey agar. Positive urine cultures showing significant bacteriuria as per the Kass count (>105 CFU/mL) were further subjected to biochemical tests to identify the type of uropathogens. Antimicrobial susceptibility testing was performed by the Kirby-Bauer disk diffusion technique, and potential carbapenemase producers were phenotypically determined by the modified carbapenem inactivation method as per the CLSI guidelines. Data were analyzed using SPSS version 26; P-value <0.05 was considered statistically significant. Totally, 422 patients were included, and the majority were females (54.7%). The prevalence of carbapenem-resistant Gram-negative uropathogens was 12.9%, and 64.7% of them were carbapenemase producers. Klebsiella pneumoniae (n = 5) was the predominant carbapenemase producer, followed by Pseudomonas aeruginosa (n = 4). Consumption of antibiotics prior to six months of commencement of the study, the presence of chronic diseases and hospitalizations were statistically associated with UTI caused by carbapenem-resistant Gram-negative uropathogens. Carbapenemase producers were resistant to most of the antibiotics tested. Our findings highlight the need for periodic regional bacteriological surveillance programs to guide empirical antibiotic therapy of UTI.
耐碳青霉烯类革兰氏阴性尿路病原体的出现对全球构成了严重威胁,但在包括埃塞俄比亚在内的大多数非洲国家,对其严重程度的研究有限。因此,衡量其耐药程度对于制定策略来限制其传播至关重要。一项横断面研究于 2020 年 6 月 1 日至 8 月 31 日在标题医院进行。采集中段尿标本并接种于 MacConkey 琼脂上。阳性尿液培养物显示根据 Kass 计数(> 105 CFU/mL)有明显菌尿的,进一步进行生化试验以鉴定尿路病原体的类型。采用 Kirby-Bauer 纸片扩散法进行抗菌药物敏感性试验,根据 CLSI 指南,采用改良碳青霉烯灭活法表型测定潜在的碳青霉烯酶产生菌。使用 SPSS 版本 26 进行数据分析;P 值<0.05 被认为具有统计学意义。总共纳入 422 例患者,其中大多数为女性(54.7%)。耐碳青霉烯类革兰氏阴性尿路病原体的患病率为 12.9%,其中 64.7%为碳青霉烯酶产生菌。产碳青霉烯酶的肺炎克雷伯菌(n = 5)是主要的碳青霉烯酶产生菌,其次是铜绿假单胞菌(n = 4)。在研究开始前六个月内使用抗生素、存在慢性疾病和住院与耐碳青霉烯类革兰氏阴性尿路病原体引起的 UTI 有统计学关联。碳青霉烯酶产生菌对大多数测试的抗生素均有耐药性。我们的研究结果强调了需要定期进行区域细菌学监测计划,以指导 UTI 的经验性抗生素治疗。