大肠杆菌尿路感染的抗生素耐药模式与危险因素的关系

Ahmed G. Merdash, G. El-Sherbiny, A. Elgendy, M. Ahmad, H. El-Kabbany
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摘要

背景:尿路感染(uti)是最常见的细菌感染之一,每年影响全球超过1.5亿人。目的:探讨耐药大肠杆菌引起尿路感染的相关危险因素。方法从2021年1月至2022年1月底,从埃及Beni-Suef地区有尿路症状的门诊患者中收集了430份尿液样本,年龄从10岁到75岁不等,并采用标准微生物学方法进行处理。结果本研究共纳入430例患者,其中不合并尿路感染210例(48.82%),合并尿路感染220例(51.15%)。430例尿路感染患者中,女性287例(66.8%),其中合并77例(36.6%),不合并210例(100%),男性合并143例(65%)。病原菌分布情况显示,UTIs病原菌种类最多,大肠杆菌85高频菌株376株(87.42%),占19.9%,其次为克雷伯菌70(16.3)、铜绿假单胞菌58(13.5%)和肠球菌58(13.5%)。奇迹普罗透斯46(10.9%)。85株大肠杆菌中,46株来自复杂型尿路感染患者,39株来自非复杂型尿路感染患者,其中对哌拉西林/他唑巴坦35(41.2%)、磺胺甲新唑/甲氧苄啶35(41.2%)、阿莫西林-克拉维酸34(40%)和头孢吡肟34(40%)的耐药性最高,对粘菌素(3.5%)、亚胺培南(5%)、喹诺酮类药物(5%)和呋喃妥因(5%)的耐药性最低。结论呋喃妥因联合喹啉仍是治疗复杂和非复杂UTI的最佳选择。风险随着住院患者人数的增加而增加。
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The Relation between Antibiotic Resistance pattern and the Risk Factors Associated with Urinary Tract Infections Caused by E. coli.
Background: Urinary tract infections (UTIs) are one of the most common bacterial infections which affect more than 150 million individuals each year worldwide. Objective : this study was conducted to assess the risk factors associated with urinary tract infections (UTIs) caused by resistant Escherichia coli. Methodology Four hundred and thirty urine samples were collected from outpatients who had urinary tract symptoms, ages ranging from 10 to 75 years in Beni-Suef Egypt, during a period extended from January 2021 to the end January 2022 and processed by standard microbiological methods. Results A total of 430 patients were included in this study: 210 (48.82%) uncomplicated and 220 (51.15%) complicated UTIs. Of 430 UTIs patients 287(66.8%) were females (77(36.6%) were complicated and 210(100%) were uncomplicated), while 143 male UTIs patients were classified as complicated (65%). The prevalence of pathogenic microbes reveals bacterial species predominate in UTIs with 376 (87.42%) E. coli high-frequency bacterial strains 85 (19.9%), followed by Klebsiella sp. 70 (16.3), Pseudomonas aeruginosa 58 (13.5%) and Enterococcus sp. 58 (13.5%). Proteus mirabilis 46(10.9%). Among 85 E coli isolates 46 from complicated and 39 isolates from uncomplicated UTIs patients showed the highest resistance to piperacillin/tazobactam 35(41.2%), sulfamethoxazole /trimethoprim 35 (41.2%), amoxicillin-clavulanic acid 34 (40%) and cefepime 34 (40%) and the least resistant antibiotics in the present study were colistin (3.5%), imipenem (5%), quinolones (5%) and nitrofurantoin (5%). Conclusion , nitrofurantoin, and quinoline remain still the best choice for treating complicated and uncomplicated UTI. Risk increases with the number of patients hospitalizations.
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