Bacteriological Profile of Urinary Tract Infections among Postmenopausal Women Visiting Alka Hospital, Lalitpur, Nepal

S. Yadav, P. R. Dahal, Shivjee Sah, V. Sharma
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Abstract

Urinary tract infection (UTI) is one of the most common diseases encountered worldwide and is a major public health problem in terms of morbidity and financial costs. A cross-sectional study was conducted in Alka Hospital, Lalitpur, Nepal from February to July, 2014. A total of 353 midstream urine samples were collected from postmenopausal women visiting Alka Hospital, Lalitpur, Nepal. The samples were examined by microscopically and culture methods. The isolated organisms were identified by conventional microbiological methods. Antibiotic susceptibility test was performed by modified Kirby-Bauer disc diffusion method according to CLSI (2011) guidelines. Among 353 urine samples processed, 32 % (113) showed significant bacteriuria. Out of 113 bacterial isolates, the prevalence of gram negative bacteria was 97.3% (110) while that of gram positive was 2.7% (3). The most predominating organisms causing UTI were Escherichia coli (84.9%) followed by Klebsiella pneumoniae (5.3%), Enterococcus faecalis (1.7%), Providencia spp. (1.7%), Klebsiella oxytoca (1.7%), Proteus mirabilis (1.7%), Proteus vulgaris (0.9%), Citrobacter freundii (0.9%) and Staphylococcus aureus (0.9%). Antibiotic susceptibility tests of the isolates showed that, most of the gram negative bacterial isolates were sensitive to Piperacillin+Tazobactam followed by Amikacin, Imipenem and Nitrofurantoin, while they were resistant to Amoxicillin. All gram positive isolates were sensitive to Amoxicillin and resistant to Gentamycin. This study showed that higher aged postmenopausal women (>80 years) were at higher risk for UTI than those of lower aged ones (<80 years).
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尼泊尔拉利特普尔Alka医院绝经后妇女尿路感染的细菌学分析
尿路感染(UTI)是世界范围内最常见的疾病之一,在发病率和经济成本方面是一个主要的公共卫生问题。横断面研究于2014年2月至7月在尼泊尔拉利特普尔的Alka医院进行。在尼泊尔拉利特普尔Alka医院就诊的绝经后妇女共收集了353份中游尿液样本。用显微镜和培养法对样品进行了检测。采用常规微生物学方法对分离得到的微生物进行鉴定。药敏试验采用改良Kirby-Bauer盘片扩散法,按照CLSI(2011)指南进行。在处理的353份尿液样本中,32%(113份)显示明显的细菌尿。113株细菌中,革兰氏阴性菌的检出率为97.3%(110株),革兰氏阳性菌的检出率为2.7%(3株)。引起尿路感染的主要病原菌为大肠杆菌(84.9%),其次为肺炎克雷伯菌(5.3%)、粪肠球菌(1.7%)、普罗维登氏菌(1.7%)、氧化克雷伯菌(1.7%)、奇异变形杆菌(1.7%)、寻常变形杆菌(0.9%)、弗氏柠檬酸杆菌(0.9%)和金黄色葡萄球菌(0.9%)。药敏试验结果显示,革兰氏阴性菌对哌拉西林+他唑巴坦最敏感,其次为阿米卡星、亚胺培南和呋喃妥因,对阿莫西林耐药。所有革兰氏阳性分离株对阿莫西林敏感,对庆大霉素耐药。本研究显示高龄绝经后妇女(>80岁)发生UTI的风险高于高龄绝经后妇女(<80岁)。
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