尼日利亚一家教学医院成人人类免疫缺陷病毒尿路感染的细菌学和抗菌特征

S. Ebede, I. Nwafia, M. Ohanu, U. Ozumba, C. Chukwuka, C. Onyedum
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摘要

导读:在人类免疫缺陷病毒感染(HIV)患者中,尿路感染(UTI)治疗失败的发生率不断上升。本研究旨在确定尼日利亚大学埃努古教学医院HIV感染患者尿路感染的细菌学。方法:采用横断面研究方法,300例年龄、性别匹配的成年HIV阳性患者,以表面健康的HIV阴性者为对照。两组中游尿液样本分别在MacConkey、blood琼脂平板上培养,37℃有氧培养。采用琼脂扩散法进行药敏试验,并按照CSLI指南进行解释。双盘协同试验证实了广谱β -内酰胺酶的产生。结果:患者平均年龄22.0±3岁。雌虫优势度为76.0%。(P = 0.493)。研究组的尿路感染患病率为5.7%,对照组为2.7%。研究组分离到的细菌以大肠杆菌最多(55.0%),腐生葡萄球菌最少(5.0%)。对照组仅检出大肠杆菌(62.5%)和肺炎克雷伯菌(37.5%)(r=0.973, P=0.005)。大多数分离出的微生物对常用抗生素具有耐药性。20%(20.0%)分离的肺炎克雷伯菌和14.0%分离的大肠埃希菌产生ESBL。
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Bacteriology and Antimicrobial Profile of Urinary Tract Infection in Adult Patients with Human Immunodeficiency Virus in a Nigerian Teaching Hospital
Introduction: There has been a rising incidence of treatment failures of Urinary Tract Infection (UTI) in patients with human Immunodeficiency Virus Infection (HIV). This study was carried out to determine the bacteriology of urinary tract infections in patients with HIV infections in University of Nigeria Teaching Hospital, Enugu. Methods: The study was a cross sectional study, involving 300 adult HIV positive patients, matched for age and sex with apparently healthy HIV negative subjects as control. Mid-stream urine samples from both groups were cultured on MacConkey, blood agar plates and incubated aerobically at 37°C. Antimicrobial susceptibility testing was done with agar diffusion method and interpreted according to CSLI guidelines. Extended spectrum beta-lactamases production was confirmed phenotypically using double disc synergy test. Results: The mean age of the subjects was 22.0 ± 3 years. There was a preponderance of females 76.0%. (P=0.493). The prevalence of UTI in the study group was 5.7% as against 2.7% in the control group. The most predominant bacteria isolated from study group were Escherichia coli (55.0%) with the least being Staphyloccocus saprophyticus (5.0%). In the control group only Escherichia coli (62.5%) and Klebsiella pneumoniae (37.5%) were isolated (r=0.973, P=0.005). Most of the organisms isolated were resistant to the commonly used antibiotics. Twenty percent (20.0%) of the Klebsiella pneumoniae and 14.0% of Escherichia coli isolated were ESBL producing.
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