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慢性肾脏病患者中引起尿路感染的细菌的患病率及抗菌谱

Prevalence and antibiogram of bacteria causing urinary tract infection among patients with chronic kidney disease.

作者信息

Thapa Tika Bahadur, Pokhrel Sushant, Lamichhane Anit, Singh Vinay Kumar, Shrestha Ojaswee, Sapkota Manisha, Khanal Puspa Raj

机构信息

Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Soalteemode, Kathmandu, Nepal.

Department of Pathology, Sumeru Hospital Pvt Ltd, Dhapakhel, Lalitpur, Nepal.

出版信息

Open Med (Wars). 2023 Oct 19;18(1):20230824. doi: 10.1515/med-2023-0824. eCollection 2023.

Abstract

Identifying and appropriately managing urinary tract infections (UTIs) among chronic kidney disease (CKD) patients are essential to reduce further disease complications and economic burden. Hence, this study aims to determine the prevalence of UTIs among CKD patients and study the antibiogram of the bacterial isolates. Four hundred eighty-two clean catch midstream urine samples were collected from CKD patients during the study period. The samples were cultured, and bacteria were isolated using standard microbiological techniques. Antibiotic susceptibility testing was performed by the Kirby-Bauer disc diffusion method following the Clinical and Laboratory Standards Institute guidelines. Of the 482 CKD patients, 15.8% were culture positive, and the majority was elderly aged group population. Most bacterial isolates were 50%, followed by 15.80%, species 15.80%, and 11.84%. The majority of bacteria were found to be resistant to beta-lactam antibiotics, ampicillin (94.67%), ceftriaxone (89.04%), cefotaxime (87.5%), and ceftazidime (84.0%), while polymyxin, colistin, vancomycin, meropenem, and imipenem were the most sensitive antibiotics. In our study, higher levels of antibiotic resistance were observed among urinary isolates. Therefore, our findings suggest clinicians to choose better antibiotic options to treat UTIs among CKD patients.

摘要

识别并妥善管理慢性肾脏病(CKD)患者的尿路感染(UTIs)对于减少进一步的疾病并发症和经济负担至关重要。因此,本研究旨在确定CKD患者中UTIs的患病率,并研究细菌分离株的抗菌谱。在研究期间,从CKD患者中收集了482份清洁中段尿样本。对样本进行培养,并使用标准微生物技术分离细菌。按照临床和实验室标准协会的指南,采用 Kirby-Bauer 纸片扩散法进行抗生素敏感性测试。在482例CKD患者中,15.8%培养呈阳性,且大多数为老年人群体。大多数细菌分离株为[此处信息缺失]占50%,其次是[此处信息缺失]占15.80%,[此处信息缺失]种占15.80%,[此处信息缺失]占11.84%。发现大多数细菌对β-内酰胺类抗生素耐药,氨苄西林(94.67%)、头孢曲松(89.04%)、头孢噻肟(87.5%)和头孢他啶(84.0%),而多粘菌素、黏菌素、万古霉素、美罗培南和亚胺培南是最敏感的抗生素。在我们的研究中,尿液分离株中观察到较高水平的抗生素耐药性。因此,我们的研究结果建议临床医生为CKD患者治疗UTIs时选择更好的抗生素选项。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e513/10590610/da03dda25db3/j_med-2023-0824-fig001.jpg

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