Rahimi Bilal A, Afghan Jalat K, Sirat Rahmatullah, Kakar Khalil A, Lali Wais M, Rahimy Najeebullah, Farooqi Khushhal
Department of Pediatrics, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan.
Head of Research Unit, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan.
Indian J Community Med. 2023 Nov-Dec;48(6):867-872. doi: 10.4103/ijcm.ijcm_705_22. Epub 2023 Dec 1.
Antimicrobial resistance is a global public health threat. Highest burden of resistance is reported from low- and middle-income countries.
To investigate and report the current scenario of increased antibiotic resistance of uropathogens among symptomatic urinary tract infection patients in Kandahar, Afghanistan.
From January 2018 to December 2021, this retrospective study was carried out at two main hospitals in Kandahar City, Afghanistan. Here, culture and sensitivity profiles of uropathogens were studied among symptomatic Bacteriuria in the presence of genitourinary symptoms (i.e., dysuria, suprapubic pain or tenderness, frequency, or urgency) (UTI) patients.
Among urine samples of 1589 patients, 1047 (65.9%) were culture positive and included in this study. Most of these patients (626/1047 [59.8%]) were females, with majority (818 [78.1%]) having age between 19 and 39 years. Gram-negative bacteria were the most prevalent (840/1047 [80.2%]), with (653/1047 [62.4%]) as the most common isolated uropathogen. Overall gram-negative bacteria had higher resistance against commonly used antibiotics of cotrimoxazole (62.8%), ciprofloxacin (56.0%), levofloxacin (47.5%), cefixime (44.5%), fosfomycin (41.5%), and even ceftriaxone (48.3%).
Kandahar province has higher resistance rates against commonly used empirical antibiotics like norfloxacin, ciprofloxacin, levofloxacin, and cefixime. Nitrofurantoin should be used as the first-line antibiotic in treating UTI patients. Public health authorities should make strict regulations and policies to reduce irrational use, inappropriate prescription, and over-the-counter availability of antibiotics in Kandahar.
抗菌药物耐药性是全球公共卫生威胁。低收入和中等收入国家报告的耐药负担最高。
调查并报告阿富汗坎大哈有症状尿路感染患者中尿路病原体抗生素耐药性增加的现状。
2018年1月至2021年12月，在阿富汗坎大哈市的两家主要医院开展了这项回顾性研究。在此，对存在泌尿生殖系统症状（即排尿困难、耻骨上疼痛或压痛、尿频或尿急）的有症状菌尿症（尿路感染）患者的尿路病原体培养和药敏情况进行了研究。
在1589例患者的尿液样本中，1047例（65.9%）培养呈阳性并纳入本研究。这些患者大多数（626/1047 [59.8%]）为女性，大多数（818 [78.1%]）年龄在19至39岁之间。革兰氏阴性菌最为常见（840/1047 [80.2%]），其中大肠杆菌（653/1047 [62.4%]）是最常见的分离出的尿路病原体。总体而言，革兰氏阴性菌对常用抗生素复方新诺明（62.8%）、环丙沙星（56.0%）、左氧氟沙星（47.5%）、头孢克肟（44.5%）、磷霉素（41.5%）甚至头孢曲松（48.3%）的耐药性更高。
坎大哈省对诺氟沙星、环丙沙星、左氧氟沙星和头孢克肟等常用经验性抗生素的耐药率较高。呋喃妥因应用作治疗尿路感染患者的一线抗生素。公共卫生当局应制定严格的法规和政策，以减少坎大哈抗生素的不合理使用、不当处方和非处方可得性。
