Saddari Abderrazak, Benhamza Noussaiba, Dalli Mohammed, Ezrari Said, Benaissa Elmostapha, Ben Lahlou Yassine, Elouennass Mostafa, Maleb Adil
Laboratory of Microbiology, Faculty of Medicine and Pharmacy, University Mohammed the First, Oujda, Morocco.
Laboratory of Microbiology, Mohammed VI University Hospital, Oujda.
Ann Med Surg (Lond). 2023 Apr 7;85(5):1408-1412. doi: 10.1097/MS9.0000000000000581. eCollection 2023 May.
Due to its incidence, clinical polymorphism and severity, urinary tract infection is an important problem in elderly. The objectives of the authors' work were to establish the bacteriological profile of urinary tract infection and/or colonization in the elderly and then to study drug resistance of bacterial strains isolated.
This is a 36 months retrospective study from 22 March 2016 to 11 May 2019. The study included urinary specimens of persons aged 65 years or over, hospitalized or consulting at the authors' hospital. Urines were processed according to the recommendations of the medical microbiology reference system and European Committee on Antimicrobial Susceptibility Testing.
The authors collected 6552 requests for cytobacteriological examination of urine. Most of the specimens was collected in the middle stream (=5503; 84%). Cultures were sterile in 49.77% of cases. Positive in 50.22% of cases. Among positive samples we had 53.41% polymorphic cultures, 32.75% urinary tract infection, and 13.82% urinary tract colonization. Gender distribution showed a sex ratio at 0.62. Gram-negative bacilli, with the main species, dominated the isolated bacteria. Resistance rates of strains that we isolated were 70% for amoxicillin, 36.31% for amoxicillin-clavulanate and 25% for ciprofloxacin. A high resistance rate was seen for third generation cephalosporins. Least resistance recorded to nitrofurantoin.
ITU in the elderly is diverse and significantly different from that of younger patients, through its high contamination rate, difficulty in acquiring clinical information, high rate of asymptomatic bacteriuria, and high proportion of multidrug resistant bacteria.
由于其发病率、临床多态性和严重性,尿路感染是老年人中的一个重要问题。作者的研究目的是确定老年人尿路感染和/或定植的细菌学特征,然后研究分离出的细菌菌株的耐药性。
这是一项从2016年3月22日至2019年5月11日的36个月回顾性研究。该研究纳入了65岁及以上在作者所在医院住院或就诊的患者的尿液标本。尿液按照医学微生物学参考系统和欧洲抗菌药物敏感性测试委员会的建议进行处理。
作者收集了6552份尿液细胞细菌学检查申请。大多数标本是中段尿(=5503份;84%)。49.77%的病例培养无菌。50.22%的病例培养阳性。在阳性样本中,多态性培养占53.41%,尿路感染占32.75%,尿路定植占13.82%。性别分布显示性别比为0.62。革兰氏阴性杆菌,以主要菌种为主,在分离出的细菌中占主导。我们分离出的菌株对阿莫西林的耐药率为70%,对阿莫西林-克拉维酸的耐药率为36.31%,对环丙沙星的耐药率为25%。第三代头孢菌素的耐药率较高。呋喃妥因的耐药率最低。
老年人的尿路感染情况多样,与年轻患者有显著不同,表现为污染率高、获取临床信息困难、无症状菌尿率高以及多重耐药菌比例高。