尼日利亚东南部埃努古某三级医院广谱β -内酰胺酶介导的尿路感染流行情况

Luke Jideofor Ugwu, Alphonsus Ogbonna Ogbuabor, Chris Okwudilichukwu Anyamene
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摘要

广谱β -内酰胺酶(ESBL)是一类质粒介导的多样化、复杂和快速进化的酶,可水解青霉素类、单结核菌类和广谱头孢菌素。在全球范围内,产esbl细菌的流行率越来越高,据报道,发展中国家的流行率更高。本研究旨在确定埃努古地区尿路感染(UTI)患者中产生ESBL的细菌分离株的患病率和抗菌药物敏感性模式。2019年4月至5月期间,在尼日利亚埃努古州埃努古州立科技大学教学医院,共收集了284名自我报告尿路感染的受试者的尿液样本。采用标准方法分析样品中尿路感染的存在和产esbl细菌的耐药模式。使用SPSS version 23 (IBM Corp Armok, NY)对数据进行描述性统计分析。共有145株金黄色葡萄球菌(n= 19)。从132例受试者中分离出大肠埃希菌(52例)、肺炎克雷伯菌(45例)、铜绿假单胞菌(12例)、粪肠球菌(9例)和神奇变形杆菌(8例),尿路感染患病率为34.6%。49株产esbl细菌与UTI有关,包括金黄色葡萄球菌(5株)、大肠杆菌(15株)、肺炎克雷伯菌(16株)、铜绿假单胞菌(13株)、粪肠球菌(8株)和神奇变形杆菌(7株),占产esbl细菌介导UTI的46.8%。产esbl细菌引起的尿路感染发病率很高。这预示着对细菌感染管理的巨大危险。
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Prevalence of Extended-spectrum Beta-lactamase Mediated Urinary Tract Infections in a Tertiary Hospital in Enugu, South East, Nigeria
Extended-Spectrum Beta-Lactamase (ESBL) are a class of plasmid-mediated diverse, complex and rapidly evolving enzymes which hydrolyzes penicillins, monobactams and broad-spectrum cephalosporins. There is increasing prevalence of ESBL-producing bacteria globally with higher prevalence reported in developing countries. The present study was designed to determine the prevalence and antimicrobial sensitivity pattern of ESBL producing bacteria isolates in patients with Urinary Tract Infection (UTI) in Enugu. Urine samples were collected from a total of 284 subjects with self-reported UTI In the Enugu State University of Science and Technology Teaching Hospital, Enugu State, Nigeria between the periods of April to May,2019.Samples were analyzed for the presence of UTI and antimicrobial resistance pattern of ESBL-producing bacteria using standard methods.  Data was analyzed by descriptive statistics using SPSS version 23 (IBM Corp Armok, NY). A total of 145 strains of Staphylococcus aureus (n= 19). Escherichia coli (n=52), Klebsiella pneumonia (n=45), Pseudomonas aeruginosa (n =12), Enterococcus faecalis (n=9) and Proteus mirabilis (n=8), were isolated from 132 subjects giving a UTI prevalence rate of 34.6%.  Forty-nine (49) ESBL-producing strains comprising Staphylococcus aureus (n=5), Escherichia coli (n=15), Klebsiella pneumonia (n=16), Pseudomonas aeruginosa (n=13), Enterococcus faecalis (n=8) and Proteus mirabilis (n=7) were implicated in UTI accounting for 46.8%ESBL-producing bacteria mediated UTI.  There is a high prevalence of ESBL-producing bacteria induced UTI. This portends a great danger to the management of bacterial infections.
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