R Baral, L B Shrestha, N Ortuño-Gutiérrez, P Pyakure, B Rai, S P Rimal, S Singh, S K Sharma, B Khanal, K Selvaraj, A M V Kumar
{"title":"尼泊尔一家三级医院尿路感染的低产量但高水平的多药耐药性。","authors":"R Baral, L B Shrestha, N Ortuño-Gutiérrez, P Pyakure, B Rai, S P Rimal, S Singh, S K Sharma, B Khanal, K Selvaraj, A M V Kumar","doi":"10.5588/pha.21.0044","DOIUrl":null,"url":null,"abstract":"<p><strong>Setting: </strong>There are concerns about the occurrence of multidrug resistance (MDR) in patients with urine tract infections (UTI) in Nepal.</p><p><strong>Objective: </strong>To determine culture positivity, trends in MDR among <i>Escherichia coli and Klebsiella pneumoniae</i> infections and seasonal changes in culture-positive UTI specimens isolated from 2014 to 2018 at the B P Koirala Institute of Health Sciences, Dharan, Eastern Nepal.</p><p><strong>Design: </strong>This was a cross-sectional study using secondary laboratory data.</p><p><strong>Results: </strong>Among 116,417 urine samples tested, 19,671 (16.9%) were culture-positive, with an increasing trend in the number of samples tested and culture positivity. <i>E. coli</i> was the most common bacteria (54.3%), followed by <i>K. pneumoniae</i> (8.8%). Among <i>E. coli</i> and <i>K. pneumoniae</i> isolates, MDR was found in respectively 42.5% and 36.0%. MDR was higher in males and people aged >55 years, but showed a decreasing trend over the years. The numbers of isolates increased over the years, with a peak always observed from July to August.</p><p><strong>Conclusion: </strong>Low culture positivity is worrying and requires further work into improving diagnostic protocols. Decreasing trends in MDR are a welcome sign. Information on seasonal changes that peak in July-August can help laboratories better prepare for this time with adequate buffer stocks to ensure culture and antibiotic susceptibility testing.</p>","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"11 Suppl 1","pages":"70-76"},"PeriodicalIF":1.3000,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8575377/pdf/i2220-8372-11-s1-70.pdf","citationCount":"2","resultStr":"{\"title\":\"Low yield but high levels of multidrug resistance in urinary tract infections in a tertiary hospital, Nepal.\",\"authors\":\"R Baral, L B Shrestha, N Ortuño-Gutiérrez, P Pyakure, B Rai, S P Rimal, S Singh, S K Sharma, B Khanal, K Selvaraj, A M V Kumar\",\"doi\":\"10.5588/pha.21.0044\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Setting: </strong>There are concerns about the occurrence of multidrug resistance (MDR) in patients with urine tract infections (UTI) in Nepal.</p><p><strong>Objective: </strong>To determine culture positivity, trends in MDR among <i>Escherichia coli and Klebsiella pneumoniae</i> infections and seasonal changes in culture-positive UTI specimens isolated from 2014 to 2018 at the B P Koirala Institute of Health Sciences, Dharan, Eastern Nepal.</p><p><strong>Design: </strong>This was a cross-sectional study using secondary laboratory data.</p><p><strong>Results: </strong>Among 116,417 urine samples tested, 19,671 (16.9%) were culture-positive, with an increasing trend in the number of samples tested and culture positivity. <i>E. coli</i> was the most common bacteria (54.3%), followed by <i>K. pneumoniae</i> (8.8%). Among <i>E. coli</i> and <i>K. pneumoniae</i> isolates, MDR was found in respectively 42.5% and 36.0%. MDR was higher in males and people aged >55 years, but showed a decreasing trend over the years. The numbers of isolates increased over the years, with a peak always observed from July to August.</p><p><strong>Conclusion: </strong>Low culture positivity is worrying and requires further work into improving diagnostic protocols. Decreasing trends in MDR are a welcome sign. Information on seasonal changes that peak in July-August can help laboratories better prepare for this time with adequate buffer stocks to ensure culture and antibiotic susceptibility testing.</p>\",\"PeriodicalId\":46239,\"journal\":{\"name\":\"Public Health Action\",\"volume\":\"11 Suppl 1\",\"pages\":\"70-76\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2021-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8575377/pdf/i2220-8372-11-s1-70.pdf\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Public Health Action\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5588/pha.21.0044\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Public Health Action","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5588/pha.21.0044","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
Low yield but high levels of multidrug resistance in urinary tract infections in a tertiary hospital, Nepal.
Setting: There are concerns about the occurrence of multidrug resistance (MDR) in patients with urine tract infections (UTI) in Nepal.
Objective: To determine culture positivity, trends in MDR among Escherichia coli and Klebsiella pneumoniae infections and seasonal changes in culture-positive UTI specimens isolated from 2014 to 2018 at the B P Koirala Institute of Health Sciences, Dharan, Eastern Nepal.
Design: This was a cross-sectional study using secondary laboratory data.
Results: Among 116,417 urine samples tested, 19,671 (16.9%) were culture-positive, with an increasing trend in the number of samples tested and culture positivity. E. coli was the most common bacteria (54.3%), followed by K. pneumoniae (8.8%). Among E. coli and K. pneumoniae isolates, MDR was found in respectively 42.5% and 36.0%. MDR was higher in males and people aged >55 years, but showed a decreasing trend over the years. The numbers of isolates increased over the years, with a peak always observed from July to August.
Conclusion: Low culture positivity is worrying and requires further work into improving diagnostic protocols. Decreasing trends in MDR are a welcome sign. Information on seasonal changes that peak in July-August can help laboratories better prepare for this time with adequate buffer stocks to ensure culture and antibiotic susceptibility testing.
期刊介绍：
Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.
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