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利雅得一家社区医疗中心金黄色葡萄球菌尿路感染的分离情况

Isolation of Staphylococcus aureus Urinary Tract Infections at a Community-Based Healthcare Center in Riyadh.

作者信息

Alshomrani Mohammad K, Alharbi Ahmad A, Alshehri Abdullah A, Arshad Muhammad, Dolgum Saeed

机构信息

Microbiology, Riyadh Regional Laboratory and Blood Bank, Riyadh, SAU.

Pathology, Majmaah University, Al Majma'ah, SAU.

出版信息

Cureus. 2023 Feb 18;15(2):e35140. doi: 10.7759/cureus.35140. eCollection 2023 Feb.

Abstract

Background The aim of this study was to assess the clinical presentation, risk factors, and comorbidities of the patients with bacteriuria, and to analyze the antimicrobial susceptibility data of isolated from their urine samples. Methods A total of 90 isolates of  were collected from patients with urinary tract infections (UTIs). Urinalysis was performed manually, including macroscopic examination of color and appearance, and microscopic examination for the presence of urinary WBCs, RBCs, and bacteria. Full identification and susceptibility testing of  were performed by the VITEK 2 system (BioMérieux, Marcy-l'Étoile, France) using standard criteria. Results The majority of the patients were female (62%), with a mean age of 32.9 years. Most of the patients were outpatients (85%), and 52% were previously healthy with no underlying disease. Seventy positive urine cultures were associated with UTI symptoms, and the most common symptom was dysuria (40%). Out of 77 urinalyses performed, 58 were positive for UTI. Of the  isolated, 24% were methicillin-resistant (MRSA). Susceptibility to vancomycin, teicoplanin, and linezolid was 100%, while susceptibility to erythromycin, clindamycin, gentamicin, trimethoprim-sulfamethoxazole, fusidic acid, and tetracycline, was 86%, 93%, 97%, 91%, 68%, and 87%, respectively. Conclusion Although  UTI is known to be associated with other risk factors such as urinary catheterization, long hospital stay, or complicated UTI, our results show the community-acquired presentation of UTI. Trimethoprim-sulfamethoxazole may be used as an effective treatment for UTI caused by .  UTI could be an alarming sign of more invasive infections such as  bacteremia, though clinical evaluation and finding the source of are crucial for effective treatment and prevention of further complications.

摘要

背景 本研究旨在评估菌尿症患者的临床表现、危险因素和合并症,并分析从其尿液样本中分离出的菌株的抗菌药敏数据。方法 从尿路感染(UTI)患者中总共收集了90株菌株。手动进行尿液分析,包括颜色和外观的宏观检查,以及尿液中白细胞、红细胞和细菌的显微镜检查。使用标准标准,通过VITEK 2系统(法国马赛 - 埃托瓦勒生物梅里埃公司)对菌株进行全面鉴定和药敏试验。结果 大多数患者为女性(62%),平均年龄为32.9岁。大多数患者为门诊患者(85%),52%既往健康,无基础疾病。70例阳性尿培养与UTI症状相关,最常见的症状是排尿困难(40%)。在进行的77次尿液分析中,58次UTI呈阳性。分离出的菌株中,24%为耐甲氧西林金黄色葡萄球菌(MRSA)。对万古霉素、替考拉宁和利奈唑胺的敏感性为100%,而对红霉素、克林霉素、庆大霉素、甲氧苄啶 - 磺胺甲恶唑、夫西地酸和四环素的敏感性分别为86%、93%、97%、91%、68%和87%。结论 尽管已知UTI与其他危险因素如导尿、长期住院或复杂性UTI有关,但我们的结果显示UTI为社区获得性表现。甲氧苄啶 - 磺胺甲恶唑可作为由金黄色葡萄球菌引起的UTI的有效治疗药物。尽管临床评估和确定金黄色葡萄球菌的来源对于有效治疗和预防进一步并发症至关重要,但UTI可能是更具侵袭性感染如金黄色葡萄球菌血症的警示信号。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8064/10027110/f98f37311690/cureus-0015-00000035140-i01.jpg

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