Odongo Charles O, Niyibizi Jean Baptiste, Bizimana Ezechiel, Nshimiyimana Irènèe, Ruhangaza Deogratias
Division of Basic Medical Sciences, School of Medicine, University of Global Health Equity, P.O.Box 6955, Kigali-Butaro, Rwanda.
Pathology Department, Butaro District Hospital, Burera District, Northern Province, Rwanda.
Afr Health Sci. 2024 Sep;24(3):21-29. doi: 10.4314/ahs.v24i3.4.
Urinary tract infections are a common cause for antibiotic consumption. Empirical treatment is common for community-acquired infections owing to predictability of pathogens.
Describe sensitivity profiles of uropathogens at a regional hospital in Rwanda.
Hospital-based cross-sectional study in which clean-catch urine samples were analyzed. A two-stage process involving dipstick urinalysis and urine culture was used to identify true infections. The Kirby-Bauer disc diffusion method was used for antibiotic sensitivity analysis as per EUCAST guidelines.
Of 198 samples studied, 107 met criterion for UTI with 94 yielding significant growth. Klebsiella pneumoniae (35%), and Escherichia coli (32%) were the most common organisms isolated. Others included Staphylococcal species, Proteus spp, Enterobacter spp and Salmonella. Very high resistance frequencies (above 70%) were observed against amoxycillin, cotrimoxazole, trimethoprim, aztreonam and fosfomycin. Resistance to fluoroquinolones, aminoglycosides and cephalosporins varied between 40-60%. High levels of cross resistance were observed for drugs of the same class. Resistance to the potentiated penicillins, meropenem, cefoxitin and nitrofurantoin were less than 30%. Piperacillintazo bactum performed best with 91% sensitivity against all organisms tested.
High levels of resistance were observed for most antibiotics studied. For empirical treatment of community-acquired UTI in our setting, nitrofurantoin remains effective while ciprofloxacin is not.
尿路感染是抗生素使用的常见原因。由于病原体具有可预测性，经验性治疗在社区获得性感染中很常见。
描述卢旺达一家地区医院尿路病原体的敏感性概况。
基于医院的横断面研究，对清洁中段尿样本进行分析。采用包括试纸条尿液分析和尿培养的两阶段过程来确定真正的感染。根据欧洲抗菌药物敏感性试验委员会（EUCAST）指南，采用 Kirby-Bauer 纸片扩散法进行抗生素敏感性分析。
在研究的198个样本中，107个符合尿路感染标准，94个有显著生长。分离出的最常见病原体为肺炎克雷伯菌（35%）和大肠埃希菌（32%）。其他包括葡萄球菌属、变形杆菌属、肠杆菌属和沙门氏菌。观察到对阿莫西林、复方新诺明、甲氧苄啶、氨曲南和磷霉素的耐药率非常高（超过70%）。对氟喹诺酮类、氨基糖苷类和头孢菌素类的耐药率在40%-60%之间。同一类药物观察到高水平的交叉耐药。对加酶青霉素、美罗培南、头孢西丁和呋喃妥因 的耐药率低于30%。哌拉西林-他唑巴坦表现最佳，对所有测试病原体的敏感性为91%。
在所研究的大多数抗生素中观察到高水平耐药。在我们的环境中，对于社区获得性尿路感染的经验性治疗，呋喃妥因仍然有效，而环丙沙星则无效。
