背景:社区获得性尿路感染(UTI)是当今最常见的感染性疾病之一。令人震惊的抗微生物药物耐药性水平正在全球发展,这限制了治疗选择,并可能导致危及生命的问题。
目的:我们的研究旨在收集非住院埃及UTI病例的监测数据,并制定针对多药耐药病原体(MDR)的策略。据我们所知,这是第一项在短时间内(三个月)筛查这种高数量(15,252个尿液样本)的研究,提供有关非住院埃及UTI患者耐药谱的有价值数据。
方法:收集不同患者的15,252例尿液样本。使用半定量方法鉴定阳性培养物。采用Kirby-Bauer圆盘扩散法进行抗生素药敏试验,双盘扩散法用于产超广谱β-内酰胺酶菌株,统计数据处理采用卡方检验。
结果:结果显示61%的阳性培养物,女性占67.5%。婴儿和老年患者表现出最高的阳性文化(74.4%和69.2%,分别)。尽管大肠杆菌是最常见的尿路病原体(47.19%),克雷伯菌属(24.42%)是最多的MDR和产超广谱β-内酰胺酶(ESBL)的生物。大肠杆菌和克雷伯菌属。对头孢菌素的耐药性增加(75%和81%,分别)。相比之下,两种生物都对碳青霉烯类抗生素表现出很高的敏感性。不像克雷伯菌属。,大肠杆菌对UTI的一线处理(呋喃妥因)高度敏感(92%)。此外,与其他国家相比,甲氧苄啶/磺胺甲恶唑的敏感性更高。
结论:尽管大肠杆菌是我们分离的克雷伯菌属中最常见的细菌。对大多数测试抗生素表现出更高的耐药性。幸运的是,甲氧苄啶/磺胺甲恶唑显著增加敏感性,尤其是对大肠杆菌。然而,这两个物种都表现出很高的头孢菌素耐药率。此外,重要的是与世界卫生组织合作,推动埃及的抗菌素耐药性国家行动计划,尤其是在社区中,以最大程度地减少埃及社区细菌耐药性的机会。
BACKGROUND: Community-acquired urinary tract infection (UTI) is one of the most common infectious diseases nowadays. Alarming increased levels of antimicrobial resistance are developing globally which limit treatment options and may lead to life-threatening problems.
OBJECTIVE: Our study aimed to collect surveillance data on non-hospitalized Egyptian UTI cases and to develop strategies against multidrug-resistant pathogens (MDR). According to our knowledge, this is the first study to screen this high number (15,252 urine samples) in a short period (three months), providing valuable data on resistance profiles in non-hospitalized Egyptian UTI patients.
METHODS: A total of 15,252 urine samples were collected from different patients. Positive cultures were identified using a semi-quantitative method. Kirby-Bauer\'s disc diffusion method was used for antibiotic susceptibility testing, the double disc diffusion method was used for extended-spectrum beta-lactamases-producing strains, and the Chi-square test was used for statistical data processing.
RESULTS: The results showed 61% positive cultures, females accounted for 67.5%. Infants and elderly patients showed the highest positive cultures (74.4% and 69.2%, respectively). Despite Escherichia coli being the most common uropathogen (47.19%), Klebsiella species(24.42%) were the most MDR and extended-spectrum β-lactamase (ESBL)-producing organisms. E. coli and Klebsiella spp. displayed increased resistance to cephalosporins (75% and 81%, respectively). In contrast, both organisms displayed high sensitivity to carbapenems. Unlike Klebsiella spp., E. coli was highly sensitive (92%) to first-line treatment (nitrofurantoin) for UTI. Moreover, trimethoprim/sulfamethoxazole showed higher sensitivity rates compared to other nations.
CONCLUSIONS: Despite Escherichia coli being the most often identified bacteria in our isolates Klebsiella spp. displayed higher resistance to the majority of tested antibiotics. Fortunately, trimethoprim/sulfamethoxazole significantly increased sensitivity, especially against E. coli. However, both species showed high rates of cephalosporin resistance. Moreover, It is important to promote Egypt\'s national action plan for antimicrobial resistance in collaboration with the World Health Organization, especially in the community to minimize the chance of bacterial resistance in the Egyptian community.