重症监护病房尿路感染患者分离细菌的抗生素耐药性模式

Fatemeh Forouzani, Asghar Sharifi, Najmeh Mojarad, Zahra Mohammadi, Reza Shahriarirad
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摘要

背景:尿路感染(UTI)是最重要的卫生保健问题之一,在医院内感染中扮演着重要角色。尿路感染引起的抗生素耐药率上升不仅会导致发病率和死亡率,还会给医疗基础设施带来巨大的经济负担。本研究旨在评估重症监护病房(ICU)中尿毒症的发病率,并确定导致感染的常见微生物及其抗生素耐药性概况。研究方法在这项透视横断面研究中,收集了伊朗西南部亚苏季两家主要转诊医院重症监护室 2015- 2016 年收治的患者数据。患者以随后的方式被选中,并被要求提供中段尿液样本。随后将阳性培养物置于差异培养基中进行致病病原体诊断,同时使用穆勒-辛顿琼脂培养物通过盘式扩散法进行抗生素谱分析,以评估病原体对测试抗生素的敏感性和耐药性。结果根据细菌培养结果,在 112 份尿液样本中,100 份(89.2%)呈阴性,12 份(10.8%)呈阳性,其中大多数为革兰氏阴性菌(6.25%),最常见的病原体是大肠埃希菌(5.3%)。本研究人群中的所有尿毒症病例均对头孢氨苄、氨苄西林和阿莫西林完全耐药。此外,所有革兰氏阴性培养物都对阿米卡星敏感。抗生素图谱结果与年龄、性别和革兰氏结果之间也没有明显关联。结论:我们报告了伊朗一家公立医院尿路病原体耐药性模式的实际数据。大肠埃希菌在所有UTI中的发病率较高,但对抗生素的耐药率较低。对萘啶酸和三甲氧苄啶-磺胺甲噁唑的耐药性明显低于其他口服抗生素,因此这两种抗生素是经验性治疗的合适且廉价的替代药物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Antibiotic Resistance Pattern Among Isolated Bacteria from Urinary Tract Infection Patients in the Intensive Care Unit
Background: Urinary tract infection (UTI) is one of the most important health care issues with a major role in occurrence of nosocomial infections. Rise in antibiotic resistance rate by UTIs not only lead to morbidity and mortality, but also impose a remarkable financial burden on health care infrastructure. This study was undertaken to evaluate the prevalence of UTIs and identify common microorganisms responsible for infection and their antibiotic resistance profile in our Intensive Care Unit (ICU). Methods: In this perspective cross-sectional study, data from patients admitted to the ICU of two main referral hospitals in Yasouj, Southern-west Iran from 2015- 2016 was collected. Patients were selected in a subsequent manner and were asked to provide a midstream urine sample. Positive cultures were subsequently placed in differential culture medium for the diagnosis of the causative pathogen, while also evaluating with Muller Hinton Agar culture for antibiogram through disc diffusion method, to evaluate the pathogens sensitivity and resistance towards the tested antibiotics. Results: Based on bacterial culture results among a total of 112 obtained urine samples, 100 (89.2%) were negative while 12 (10.8%) were positive, in which the majority were gram-negative (6.25%) and the most frequent pathogen was Escherichia coli (5.3%). All cases of UTI in our population were fully resistant to cephalexin, ampicillin, and amoxicillin. Also, all gram-negative cultures were sensitive to amikacin. There was also no significant association between the antibiogram results with age, gender, and gram results. Conclusion: we report actual data on the resistance patterns of uro-pathogens in a public hospital in Iran. Escherichia coli showed a high prevalence among all UTIs with lower resistance rates to the antibiotics. Resistance to nalidixic acid and trimethoprim-sulfamethoxazole were significantly lower than other oral antibiotics, making both a suitable and cheap alternative for the empirical treatment.
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