Alawainati Mahmood, Ayoob Zahra, Almajed Eman, Alkhawaja Safaa, Abdulaal Noof, Alkhnaizi Rehab, Shaheen Hanin, Hubail Fatema, Saeed Nermin Kamal
Department of Family Medicine, Primary Healthcare Centers, Manama, Bahrain.
Department of Family Medicine, Royal College of Surgeons in Ireland-Medical University of Bahrain, Manama, Bahrain.
Sultan Qaboos Univ Med J. 2025 May 2;25(1):395-402. doi: 10.18295/2075-0528.2849.
This study aimed to determine the clinical and microbiological profiles of patients with urinary tract infections (UTIs) in primary healthcare centres in Bahrain.
This retrospective cross-sectional study was conducted at 27 primary care centres in Bahrain between January and December 2022. All patients with positive urine cultures, defined as the presence of ≥100,000 colony-forming units/mL were included. Participants' sociodemographic characteristics, comorbidities, risk factors for resistant uropathogens, uropathogen types and antibiotic sensitivity outcomes were assessed. Descriptive and inferential statistics were analysed.
A total of 1,985 patients were included, with an average age of 40.57 ± 20.18 years. Most participants were female (n = 1,802, 90.8%) and Bahraini (n = 1,699, 85.6%). Diabetes mellitus (20.1%) and hypertension (17.9%) were the most prevalent comorbidities among the participants. (n = 1,220, 61.5%) and (n = 342, 17.2%) were the most common uropathogens identified. Nearly 1 in 5 patients had resistant uropathogens (n = 412, 20.8%), with extended-spectrum β-lactamase (ESBL) uropathogens being the most prevalent (n = 401, 20.2%). Patients with diabetes ( <0.001), hypertension ( <0.001), a history of previous ESBL infections ( <0.001), previous carbapenem-resistant ( = 0.019), a history of antibiotic use ( <0.001) and recent hospitalisation ( <0.001) exhibited a higher prevalence of resistant uropathogens. Logistic regression analysis indicated that older patients ( = 0.002) and participants who had used antibiotics (odds ratio [OR] = 1.470; = 0.002) or had been hospitalised (OR = 1.762; = 0.017) had higher rates of resistant UTIs. A personal history of ESBL infections increased the risk of having resistant uropathogens by 3-fold (OR = 3.347; <0.001).
Resistant uropathogens are common among patients with culture-positive UTIs in primary care settings in Bahrain, especially among older patients, those with recent antibiotic use and hospitalisation and those who had ESBL UTIs. Rational antibiotic use based on sensitivity patterns and ongoing surveillance is important to mitigate the risks of resistant UTIs.
本研究旨在确定巴林基层医疗中心尿路感染（UTIs）患者的临床和微生物学特征。
本回顾性横断面研究于2022年1月至12月在巴林的27个基层医疗中心进行。纳入所有尿培养阳性的患者，定义为菌落形成单位≥100,000个/mL。评估参与者的社会人口学特征、合并症、耐药尿路病原体的危险因素、尿路病原体类型和抗生素敏感性结果。进行描述性和推断性统计分析。
共纳入1985例患者，平均年龄40.57±20.18岁。大多数参与者为女性（n = 1802，90.8%）和巴林人（n = 1699，85.6%）。糖尿病（20.1%）和高血压（17.9%）是参与者中最常见的合并症。大肠埃希菌（n = 1220，61.5%）和金黄色葡萄球菌（n = 342，17.2%）是最常见的尿路病原体。近五分之一的患者有耐药尿路病原体（n = 412，20.8%），其中产超广谱β-内酰胺酶（ESBL）的尿路病原体最为常见（n = 401，20.2%）。糖尿病患者（P<0.001）、高血压患者（P<0.001）、既往有ESBL感染史的患者（P<0.001）、既往有耐碳青霉烯类肠杆菌科细菌感染史的患者（P = 0.019）、有抗生素使用史的患者（P<0.001）和近期住院的患者（P<0.001）中耐药尿路病原体的患病率较高。逻辑回归分析表明，老年患者（P = 0.002）以及使用过抗生素的参与者（比值比[OR]=1.470；P = 0.002）或住院的参与者（OR = 1.762；P = 0.017）发生耐药UTIs的几率更高。ESBL感染个人史使耐药尿路病原体的风险增加3倍（OR = 3.347；P<0.001）。
在巴林基层医疗环境中，培养阳性UTIs患者中耐药尿路病原体很常见，尤其是老年患者、近期使用过抗生素和住院的患者以及有ESBL UTIs的患者。根据敏感性模式合理使用抗生素并持续监测对于降低耐药UTIs的风险很重要。
