埃塞俄比亚东南部教学转诊医院产前护理孕妇尿路感染分离菌药敏模式及相关因素分析

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引用次数: 1

摘要

背景:尿路感染(UTI)是由来自消化道的细菌爬上尿道开口并开始繁殖而引起感染。妊娠期尿路感染与母亲和婴儿的显著发病率相关。在包括埃塞俄比亚在内的大多数发展中国家,孕期尿路感染筛查不被视为产前保健的重要组成部分。本研究旨在评估埃塞俄比亚东南部麦达瓦拉布大学戈巴转诊医院孕妇的细菌谱和抗生素敏感性模式及相关危险因素。方法:于2020年6 - 8月进行基于机构的横断面研究。共有234名孕妇被纳入研究;数据由训练有素的采访者使用结构化问卷收集。收集所有孕妇的尿液样本,并在半胱氨酸赖氨酸电解质缺乏培养基上培养。数据采用SPSS 20.0进行分析。采用描述性统计方法用相关变量对研究对象进行解释。采用Logistic回归进行数据比较。p值<0.05为差异有统计学意义。结果:无症状组和有症状组尿路感染的总体患病率均为23.9%。经筛选的中游尿样中,无症状组和有症状组的细菌尿比例分别为16%和32.2%。尿路感染的发生率与导尿史和尿路感染相关(p<0.05)。大肠杆菌是最常见的分离菌(42.9%),其次是凝固酶阴性葡萄球菌(26.8%)和金黄色葡萄球菌(12.5%)。革兰氏阴性菌和革兰氏阳性菌分别占59%和41%。革兰氏阴性菌株对氨苄西林、萘啶酸和甲氧苄啶/磺胺甲恶唑耐药。此外,所有革兰氏阴性菌分离株对甲氧苄啶/磺胺甲恶唑均表现出高水平耐药性。结论:有症状和无症状孕妇均有明显的细菌尿。大多数分离株对常用抗生素耐药。这要求对所有孕妇进行尿路感染的早期筛查,那些被发现感染的孕妇需要用适当的药物治疗,以避免并发症。
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Drug Susceptibility Pattern and Associated Factors of Bacteria Isolated from Urinary Tract Infection among Pregnant Women Attending Antenatal Care in Teaching Referral Hospital, Southeast Ethiopia
Background: Urinary tract infection (UTI) is caused by bacteria from the digestive tract which climbs the opening of the urethra and begins to multiply to cause infection. UTI in pregnancy is associated with significant morbidity for both mother and baby. In most developing countries including Ethiopia, screening for UTI in pregnancy is not considered an essential part of Antenatal Care. This study aimed to assess the bacterial profile and antibiotic susceptibility pattern and associated risk factors among pregnant women in Madda Walabu University Goba Referral Hospital, Southeast Ethiopia. Methods: An institution-based cross-sectional study was conducted from June-August, 2020 . A total of 234 pregnant women were enrolled; data were collected using a structured questionnaire by a trained interviewer. Urine samples were collected from all pregnant women and culture on cysteine lysine electrolytes deficiency medium. Data were analyzed using SPSS 20.0. Descriptive statistics were used to explain the study participants with relevant variables. Logistic regression was used for data comparison. P-value <0.05 was accepted as statistically significant. Results: The overall prevalence of UTI was 23.9% among both asymptomatic and symptomatic groups. Of this screened midstream urine samples showed that 16% and 32.2%, had significant bacteriuria in the asymptomatic and symptomatic groups respectively. The prevalence of UTI was significantly associated with previous history of catheterization and urinary tract infection (p<0.05). E. coli was the most frequently isolated organism (42.9%) followed by coagulase-negative Staphylococcus (26.8%), and S. aureus (12.5%). Gram-negative and Gram-positive bacteria accounted for (59%) and (41%) respectively. Gram-negative isolates showed resistance to ampicillin, naldixic acid and trimethoprim/sulfamethoxazole. Also, all Gram-negative bacterial isolates revealed a high level of resistance against trimethoprim/sulfamethoxazole. Conclusion: Significant bacteriuria has been observed from both symptomatic and asymptomatic pregnant women. The majority of the isolates were resistant to commonly prescribed antibiotics. This calls for an early screening of all pregnant women for UTI and those found to be infected need treatment with an appropriate drug to avoid complications.
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