Firissa Yared Boru, Shelton Dominick, Azazh Aklilu, Engida Hywet, Kifle Fitsum, Debebe Finot
Emergency Medicine and Critical Care Department, ALERT Hospital, Addis Ababa, Ethiopia.
Emergency Medicine Department, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
Infect Drug Resist. 2023 Mar 23;16:1649-1656. doi: 10.2147/IDR.S402472. eCollection 2023.
Empirical treatment of infections remains a major contributing factor to the emergence of pathogens that are resistant to antibiotics. The study aimed to assess the prevalence and anti-microbial sensitivity patterns of uropathogens in the Emergency Medicine Department of Tikur Anbessa Hospital, Ethiopia.
Urine sample data collected over two years from January 2015 to January 2016 at Tikur Anbessa Hospital's laboratory were retrospectively analyzed for bacterial pathogens, and their antimicrobial susceptibility. Antimicrobial sensitivity tests were done using the disc diffusion technique as per the standard of the Kirby-Bauer method.
Of the total 220 samples that were collected, 50 (22.7%) were culture-positive. Male to female data ratio was 1:1.1. was the dominant isolate (50%) followed by species (12%), species (12%), and species (8%). Overall resistance rates to Cotrimoxazole, Ampicillin, Augmentin, and Ceftriaxone were 90.4%, 88.8%, 82.5%, and 79.3%, respectively. The sensitivity rates for Chloramphenicol, Amikacin, Vancomycin, Meropenem, Cefoxitin, and Nitrofurantoin ranged from 72% to 100%. The antibiogram of isolates showed that 43 (86%) isolates were resistant to two or more antimicrobials, and 49 (98%) were resistant to at least one antibiotic.
Urinary tract infections are mostly caused by Gram-negative bacteria predominantly in females and Escherichia coli are the most common isolates. Resistance rates to Cotrimoxazole, Ampicillin, Augmentin, and Ceftriaxone were high. Chloramphenicol, Amikacin, Vancomycin, Meropenem, Cefoxitin, and Nitrofurantoin are considered appropriate antimicrobials for the empirical treatment of complicated urinary tract infections in the emergency department. Yet, using antibiotics indiscriminately for patients with complicated UTIs may increase the resistance rate and also lead to treatment failure, hence the prescriptions should be revised following the culture and sensitivity results.
对感染进行经验性治疗仍然是导致对抗生素产生耐药性的病原体出现的一个主要因素。本研究旨在评估埃塞俄比亚提库尔·安贝萨医院急诊科尿路病原体的流行情况及抗菌药敏模式。
回顾性分析2015年1月至2016年1月在提库尔·安贝萨医院实验室收集的两年期间的尿液样本数据，以检测细菌病原体及其抗菌药敏情况。按照 Kirby-Bauer 方法的标准，采用纸片扩散法进行抗菌药敏试验。
在总共收集的220份样本中，50份（22.7%）培养呈阳性。男女数据比例为1:1.1。大肠埃希菌是主要分离菌株（50%），其次是肺炎克雷伯菌属（12%）、金黄色葡萄球菌属（12%）和粪肠球菌属（8%）。对复方新诺明、氨苄西林、阿莫西林/克拉维酸和头孢曲松的总体耐药率分别为90.4%、88.8%、82.5%和79.3%。氯霉素、阿米卡星、万古霉素、美罗培南、头孢西丁和呋喃妥因的敏感率在72%至100%之间。分离菌株的抗菌谱显示，43份（86%）分离菌株对两种或更多种抗菌药物耐药，49份（98%）对至少一种抗生素耐药。
尿路感染主要由革兰氏阴性菌引起，女性居多，大肠埃希菌是最常见的分离菌株。对复方新诺明、氨苄西林、阿莫西林/克拉维酸和头孢曲松的耐药率较高。氯霉素、阿米卡星、万古霉素、美罗培南、头孢西丁和呋喃妥因被认为是急诊科对复杂性尿路感染进行经验性治疗的合适抗菌药物。然而，对复杂性尿路感染患者不加区别地使用抗生素可能会增加耐药率，也会导致治疗失败，因此应根据培养和药敏结果调整处方。
