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埃塞俄比亚南部阿尔巴明奇地区儿科患者细菌性尿路感染的发病率及相关因素

Magnitude and associated factors of bacterial urinary tract infections among paediatric patients in Arba Minch, southern Ethiopia.

作者信息

Elale Ali Kedir, Manilal Aseer, Tadesse Dagimawie, Seid Mohammed, Dubale Amanuel

机构信息

Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.

出版信息

New Microbes New Infect. 2023 Jan 6;51:101083. doi: 10.1016/j.nmni.2023.101083. eCollection 2023 Jan.

Abstract

Bacterial urinary tract infections (UTI) commonly occur in children; if left untreated, they may result in severe consequences such as uro-sepsis and renal damage. This study aimed to determine the bacterial profile, antimicrobial susceptibility patterns and associated factors among paediatric patients suspected of urinary tract infections in Arba Minch General Hospital (AMGH). An institution-based cross-sectional study was conducted from 01 October 2020 to 31 January 2021. A convenient sampling technique was used to recruit the participants; data were collected using a pre-tested questionnaire. To quantify the bacteria (as per the Kass count, >10CFU/ml), midstream urine samples were streaked onto bacteriological media. Isolates were identified by following standard procedures. The antibiotic susceptibility test was performed as per the Kirby-Bauer disc diffusion technique. Data were analyzed using SPSS software. Out of the 246 children included, 38 (15.4%) were found to be positive for significant bacteriuria. Isolates of , 9/38 (23.7%), and , 9/38 (23.7%), were the most predominant. The majority of Gram-negative bacterial (GNB) isolates showed resistance towards amoxicillin-clavulanate (89.5%), ampicillin (84.6%), and ceftazidime (81%). Likewise, 76.9 and 76.5% of Gram-positive bacteria (GPB), respectively, had shown resistance towards co-trimoxazole and tetracycline. Multi-drug and extensively drug resistance were detected respectively in the case of 68.4 and 15.8% of the total isolates; ESBL production was found in 57.1% of GNB, whereas 55.6% of were methicillin-resistant (MRSA). The process of un-circumcision was significantly associated with UTI [(adjusted odds ratio= 3.578; 95% confidence interval: 1.263 - 10.13; =0.016)].

摘要

细菌性尿路感染(UTI)在儿童中很常见;如果不治疗,可能会导致严重后果,如尿脓毒症和肾损伤。本研究旨在确定阿尔巴明奇综合医院(AMGH)疑似尿路感染的儿科患者的细菌谱、抗菌药物敏感性模式及相关因素。2020年10月1日至2021年1月31日进行了一项基于机构的横断面研究。采用方便抽样技术招募参与者;使用预先测试的问卷收集数据。为了定量细菌(根据卡斯计数,>10CFU/ml),将中段尿样本接种到细菌学培养基上。按照标准程序鉴定分离株。根据 Kirby-Bauer 纸片扩散技术进行抗生素敏感性试验。使用SPSS软件分析数据。在纳入的246名儿童中,38名(15.4%)被发现有显著菌尿阳性。大肠埃希菌分离株9/38(23.7%)和肺炎克雷伯菌分离株9/38(23.7%)最为常见。大多数革兰氏阴性菌(GNB)分离株对阿莫西林-克拉维酸(89.5%)、氨苄西林(84.6%)和头孢他啶(81%)耐药。同样,革兰氏阳性菌(GPB)分别有76.9%和76.5%对复方新诺明和四环素耐药。在所有分离株中,分别检测到68.4%和l5.8%的多重耐药和广泛耐药;在57.1%的GNB中发现产超广谱β-内酰胺酶(ESBL),而55.6%的金黄色葡萄球菌是耐甲氧西林金黄色葡萄球菌(MRSA)。未行包皮环切术的过程与UTI显著相关[调整优势比=3.578;95%置信区间:1.263 - 10.13;P=0.016]。

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