Urinary pathogenic bacterial profile, antibiogram of isolates and associated risk factors among pregnant women in Ambo town, Central Ethiopia: a cross-sectional study
Urinary pathogenic bacterial profile, antibiogram of isolates and associated risk factors among pregnant women in Ambo town, Central Ethiopia: a cross-sectional study
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DOI：
10.1186/s13756-017-0289-6
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发表时间：
2017-12-29
影响因子：
5.5
通讯作者：
Gebremedhin, Endrias Zewdu
中科院分区：
文献类型：
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作者：
Gessese, Yonas Alem;Damessa, Dereje Leta;Gebremedhin, Endrias Zewdu
背景：尿路感染（UTI）是一种常见的细菌感染，对孕妇造成严重的健康问题。在孕妇中进行了一项研究，目的是估计UTI的患病率，确定细菌分离株的菌落图，并评估与UTI.Methods相关的潜在危险因素：采用横断面研究设计，收集了2016年3月至2016年12月期间300例孕妇的中段尿样本。将样品接种到半胱氨酸乳糖电解质缺乏培养基（CLED）中。将来自CLED的菌落在麦康凯和血琼脂平板上传代培养。采用标准琼脂纸片扩散法测定药物敏感性。采用卡方（X-2）检验和Logistic回归分析显示UTI与解释变量之间的关联，并分别确定UTI的预测因子。结果：本研究中孕妇的年龄范围为16 ~ 46岁（平均值+/-标准差= 25 +/- 4.7岁）。孕妇中UTI的总体患病率为18.7%（95%置信区间[CI]：14.4-23.54%）。有症状和无症状UTI的患病率分别为20.4%（95%CI：13.09-29.46%）和17.8%（95%CI：12.70-23.83%）。鉴定出的优势菌为E.大肠埃希菌（46.4%）、S.金黄色葡萄球菌（14.3%）、凝固酶阴性葡萄球菌[CoNS]（14.3%）和变形杆菌属（10.6%）。大多数革兰阴性菌对氨苄西林、头孢曲松、庆大霉素和呋喃妥因耐药率分别为70%、66%、68%和64%，而革兰阳性菌对氨苄西林耐药率为75-100%。所有菌株均存在多重耐药。多变量logistic回归分析显示，月收入≥ 500埃塞俄比亚比尔（21.18美元）的孕妇患UTI的几率是月收入> 2001埃塞俄比亚比尔[84.79美元]的孕妇的4.78倍（P = 0.046）。同样，吃生肉的人患尿路感染的风险更高（OR = 2.04，95% CI：1.09，3.83，P = 0.026），既往有UTI病史与吃熟肉且无尿路感染史的人相比（OR = 2.29，95%CI = 1.15-4.56，P = 0.019）。结论：泌尿系病原菌的感染率和耐药性较高。健康教育、持续监测UTI及其耐药性模式对减少孕妇有症状和无症状菌尿和多重耐药菌的后果至关重要。
Background: Urinary tract infection (UTI) is a well-known bacterial infection posing serious health problem in pregnant women. A study was conducted in pregnant women with the objectives of estimating prevalence of UTI, determining antibiogram of the bacterial isolates and assessment of the potential risk factors associated with UTI.Methods: A cross-sectional study design was used to collect 300 mid-stream urine samples from pregnant women from March 2016 to December, 2016. Samples were inoculated into Cysteine Lactose Electrolyte Deficient medium (CLED). Colonies from CLED were subcultured onto MacConkey and Blood agar plates. A standard agar disc diffusion method was used to determine antimicrobial susceptibility. Chi-square (X-2) test & logistic regression were used to show associations between UTI and explanatory variables & identify the predictors of UTI, respectively.Results: The age of pregnant women enrolled in this study ranges from 16 to 46 years (mean +/- standard deviation = 25 +/- 4.7 years). The overall prevalence of UTI in pregnant women was 18.7% (95% confidence interval [CI]: 14.4-23.54%). The prevalence of symptomatic and asymptomatic UTI was 20.4% (95% CI: 13.09-29.46%) and 17.8% (95% CI: 12.70-23.83%) respectively. The predominant bacteria identified were E. coli (46.4%), S. aureus (14.3%), coagulase negative Staphylococci [CoNS] (14.3%) and Proteus species (10.6%). Majority of Gram-negative bacteria isolates were resistant to ampicillin (70%), ceftriaxon (66%), gentamicin (68%) and nitrofurantoin (64%) while 75-100% of the Gram positive isolates were resistance to ampicillin. Multiple drug resistance was observed in all of the isolates. Multivariable logistic regression revealed that the odds of acquiring UTI was 4.78 times higher in pregnant women earning monthly income of = 500 Ethiopian Birr (21.18 USD) as compared to those earning monthly income > 2001 Ethiopian Birr [84.79 USD] (P = 0.046). Similarly, the risk of UTI was higher in those who eat raw meat (OR = 2.04, 95% CI: 1.09, 3.83, P = 0.026) and had previous UTI history (OR = 2.29, 95% CI = 1.15-4.56, P = 0.019) as compared to those who eat cooked meat and had no previous history of UTI.Conclusions: The prevalence & antimicrobial resistance of uropathogens was high. Health education, continuous surveillance of UTI and their antimicrobial resistance pattern are essential to reduce the consequence of symptomatic and asymptomatic bacteriuria and multi-drug resistant bacteria in pregnant women.