Abstract：
Management of urinary tract infections is challenged by increasing antimicrobial resistance (AMR) worldwide. In this study, we describe the trends in antimicrobial resistance of uropathogens isolated from the largest private sector laboratory in Ghana over a five-year period. We reviewed positive urine cultures at the MDS Lancet Laboratories from 2017 to 2021. The proportions of uropathogens with antimicrobial resistance to oral and parenteral antimicrobials recommended by the Ghana standard treatment guidelines were determined. The proportion of multi-drug resistant isolates, ESBL and carbapenemase-producing phenotypes were determined. Of 94,134 urine specimens submitted for culture, 20,010 (22.1%) were culture positive. Enterobacterales was the most common group of organisms, E. coli (70.6%) being the most common isolate and Enterococcus spp. the most common gram-positive (1.3%) organisms. Among oral antimicrobials, the highest resistance was observed to ciprofloxacin (62.3%) and cefuroxime (60.2%) and the least resistance to fosfomycin (1.9%). The least resistance among parenteral antimicrobials was to meropenem (0.3%). The highest multi-drug resistance levels were observed among Klebsiella spp. (68.6%) and E. coli (64.0%). Extended-spectrum beta-lactamase (ESBL) positivity was highest in Klebsiella spp. (58.6%) and E. coli (50.0%). There may be a need to review the Ghana standard treatment guidelines to reflect increased resistance among uropathogens to recommended antimicrobials.
摘要：
尿路感染的管理受到全球抗菌素耐药性（AMR）增加的挑战。在这项研究中,我们描述了在过去5年中从加纳最大的私营部门实验室分离出的尿路病原体的耐药性趋势.我们回顾了2017年至2021年MDS柳叶刀实验室的尿液培养阳性。确定了加纳标准治疗指南推荐的对口服和肠胃外抗菌药物具有耐药性的尿路病原体的比例。多重耐药菌株的比例，确定了产ESBL和碳青霉烯酶的表型。在接受培养的94,134份尿液样本中，20,010（22.1%）为培养阳性。肠杆菌是最常见的一组生物，大肠杆菌(70.6%)是最常见的分离株和肠球菌属。最常见的革兰氏阳性（1.3％）生物。在口服抗菌药物中，对环丙沙星(62.3%)和头孢呋辛(60.2%)的耐药率最高,对磷霉素的耐药率最低(1.9%).肠胃外抗菌药物中耐药性最小的是美罗培南（0.3％）。在克雷伯菌属中观察到最高的多药耐药水平。(68.6%)和大肠杆菌(64.0%)。克雷伯菌属的超广谱β-内酰胺酶（ESBL）阳性率最高。(58.6%)和大肠杆菌(50.0%)。可能需要审查加纳标准治疗指南，以反映尿路病原体对推荐的抗菌药物的耐药性增加。
