Abstract:
A cross-sectional study of microorganisms isolated from mid-stream urine samples obtained from 139 patients with suspected urinary tract infection (UTI) who presented leukocyturia was conducted from April to June 2019 at Saint Joseph Kitgum Hospital (Uganda). All microorganisms were identified by MALDI-TOF mass spectrometry in a laboratory in Spain. Antimicrobial susceptibility was determined on site using the disc diffusion method (Kirby-Bauer test) and these results were subsequently compared with those obtained in Spain using the Becton Dickinson Phoenix M50 device. The overall prevalence of UTI with bacterial growth was 64.0% (n = 89) (95% CI, 56.1-72.0), and 11 presented mixed infection. As a result, 100 microorganisms were isolated. The most common uropathogens were Enterococcus spp. (57%) and Escherichia coli (28%). Nitrofurantoin was the most effective drug (81.7% in Gram-positive and 87.3% in Gram-negative bacteria), followed by imipenem (94.2% and 74.5%, respectively). The highest resistance rates were observed for amoxicillin and ciprofloxacin (66.2% and 44.6%, respectively). Given the increasing trend toward antibiotic resistance, there is a need for bacteriological cultures and continuous surveillance of uropathogen antibiotic susceptibility. Use of amoxicillin and ciprofloxacin as empirical treatments for UTIs should be discontinued in Uganda. The findings of this study may be useful for clinicians, as they may improve empirical treatment.
摘要:
2019年4月至6月,在圣约瑟夫基特古姆医院(乌干达)进行了一项从139例疑似尿路感染(UTI)患者中获得的中流尿液样本中分离出的微生物的横断面研究。在西班牙的实验室中通过MALDI-TOF质谱鉴定了所有微生物。使用圆盘扩散方法(Kirby-Bauer试验)在现场确定了抗微生物敏感性,随后将这些结果与使用BectonDickinsonPhoenixM50装置在西班牙获得的结果进行了比较。UTI伴细菌生长的总体患病率为64.0%(n=89)(95%CI,56.1-72.0),11例出现混合感染。因此,分离出100种微生物。最常见的尿路病原菌是肠球菌属。(57%)和大肠杆菌(28%)。呋喃妥因是最有效的药物(革兰氏阳性细菌为81.7%,革兰氏阴性细菌为87.3%),其次是亚胺培南(94.2%和74.5%,分别)。阿莫西林和环丙沙星的耐药率最高(分别为66.2%和44.6%,分别)。鉴于抗生素耐药性的增加趋势,需要进行细菌学培养和对尿路病原体抗生素敏感性的连续监测。乌干达应停止使用阿莫西林和环丙沙星作为尿路感染的经验性治疗。这项研究的结果可能对临床医生有用,因为它们可能会改善经验治疗。