Bacterial uropathogens and burden of antimicrobial resistance pattern in urine specimens referred to Ethiopian Public Health Institute.
Bacterial uropathogens and burden of antimicrobial resistance pattern in urine specimens referred to Ethiopian Public Health Institute.
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DOI：
10.1371/journal.pone.0259602
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Biazin H
中科院分区：
文献类型：
--
作者：
Addis T;Mekonnen Y;Ayenew Z;Fentaw S;Biazin H
尿路感染是普通人群发病的主要原因，是仅次于呼吸道感染的第二大常见传染病。适当的抗生素治疗对取得良好的治疗效果至关重要。因此，本研究的目的是调查尿路感染培养的病原体的概况，并确定它们对常用抗生素的耐药性。2017年1月至2018年12月，在埃塞俄比亚公共卫生研究所国家转诊实验室进行了一项横断面研究。所有阳性培养均以菌落形态、革兰氏染色和标准生化试验为特征。在Muller-Hinton琼脂上采用Kirby- Bauer纸片扩散试验对分离物进行了药敏试验。此外，根据制造商的说明，使用VITEK 2 Compact进行细菌鉴定、抗菌药敏试验和MDR表型检测。在1012份培养尿液标本中，325份（32.1%）显示明显的细菌尿。尿路感染的总患病率为325例（32.1%），其中21 ~ 30岁年龄组73例患病率最高（22.5%）。其中女性583例（57.6%），男性429例（42.4%）。179例（55%）女性的尿路感染相对高于146例（45%）男性。其中革兰氏阴性菌（GNB） 252株（51.7%）高于革兰氏阳性菌63株（19.4%）。GNB中以大肠杆菌168株（66.7%）、克雷伯菌32株（12.7%）、肠杆菌13株（5.2%）为主，而GPB中以凝固酶阴性葡萄球菌33株（52.4%）、肠球菌16株（25.4%）、金黄色葡萄球菌10株（15.9%）为主。大多数分离株对常用的抗菌素表现出高度的耐药性。亚胺培南、阿米卡星和呋喃妥因是革兰氏阴性菌株最敏感的抗生素，而呋喃妥因、克林霉素和庆大霉素对革兰氏阳性尿路病原体最有效。革兰氏阴性菌株中MDR、XDR和PDR分别为156/256（60.9%）、56/256（22.4%）、10/256(4%)，GPB中MDR、XDR和PDR分别为34/63（53.1%）、10/63（15.8%）和1/63（1.6%）。其中MDR 190/319株（59.5%），XDR 66/319株（20.7%），PDR 11/319株（3.45%）。尿路感染的患病率较高，革兰氏阴性菌是本研究中最常见的尿路感染原因。发现对常用抗生素的耐药性非常高。所有临床微生物学实验室必须开始对耐多药、广泛耐药甚至耐多药耐药菌株进行早期发现和密切监测，以减少目前已成为全球问题的抗微生物药物耐药性的威胁。
Urinary tract infections (UTIs) are the leading causes of morbidity in the general population, and is the second most common infectious disease after respiratory infections. Appropriate antibiotic therapy is essential to achieving good therapeutic results. Therefore, the purpose of this study was to investigate the profile of pathogens cultured from urinary tract infections and to determine their resistance profiles to commonly prescribed antibiotics. A cross-sectional study was carried out at the National Referral Laboratory of the Ethiopian Institute of Public Health from January 2017 to December 2018. All positive cultures were characterized by colony morphology, Gram stain, and standard biochemical tests. The antimicrobial susceptibility test of the isolate was performed using the Kirby- Bauer disk diffusion test on Muller-Hinton agar. In addition, bacterial identification, antimicrobial susceptibility testing and phenotypic detection of MDR were performed with VITEK 2 Compact according to the manufacturer’s instructions. Out of 1012 cultured urine specimens, 325 (32.1%) was showed significant bacteriuria. The overall prevalence of UTIs was 325(32.1%) and the highest prevalence rate was obtained from 21–30 years age group 73(22.5%). Among UTIs patients, 583(57.6%) were females and 429(42.4%) were males. The UTIs of 179 (55%) women is relatively higher than that of men 146 (45%). Among 325 isolates, Gram-negative bacteria (GNB) appeared more frequently 252 (51.7%) than Gram-positive bacteria 63 (19.4%). In GNB, E. coli 168(66.7%), Klebsiella species 32(12.7%), and Enterobacter species 13 (5.2%) were dominated isolates whereas in GPB accounted for coagulase-negative staphylococcus (CoNS) 33(52.4%), Enterococcus species 16(25.4%), and Staphylococcus aureus 10(15.9%). Major of the isolates showed high levels of antibiotic resistance to commonly prescribed antimicrobials. Imipenem, Amikacin, and Nitrofurantoin were the most sensitive antibiotics for Gram-negative isolates while Nitrofurantoin, clindamycin, and Gentamycin were effective against gram-positive uropathogens. Overall, 156/256(60.9%), 56/256(22.4%), 10/256(4%) of gram-negative isolates were MDR, XDR, and PDR respectively while among the GPB isolates, 34/63(53.1%), 10/63(15.8%), and 1/63(1.6%) were MDR, XDR, and PDR isolates respectively. Among the tested bacterial strains, 190/319 (59.5%) were MDR, 66/319 (20.7%) strains were XDR, and 11/319 (3.45%) were PDR isolated. The prevalence of urinary tract infection was high, and Gram-negative organisms were the most common causes of UTIs in this study. It was found that the resistance to commonly used antibiotics is very high. Early detection and close monitoring of MDR, XDR, or even PDR bacterial strains must be started by all clinical microbiology laboratories to reduce the menace of antimicrobial resistance that is now a global problem.
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影响因子：
3.7
作者：
Algammal, Abdelazeem M.;El-Sayed, Mahmoud E.;Ghobashy, Madeha O., I
通讯作者：
Ghobashy, Madeha O., I
影响因子：
3.9
作者：
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通讯作者：
Mabrok MA
影响因子：
3.7
作者：
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通讯作者：
Belachew, Teshome
影响因子：
3.7
作者：
Algammal, Abdelazeem M.;Mohamed, Mohamed Fathi;Mabrok, Mahmoud
通讯作者：
Mabrok, Mahmoud
影响因子：
5.5
作者：
Gessese, Yonas Alem;Damessa, Dereje Leta;Gebremedhin, Endrias Zewdu
通讯作者：
Gebremedhin, Endrias Zewdu