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首页> 外文期刊>Annals of Clinical and Laboratory Science: Official Journal of the Association of Clinical Scientists >Clinical and Laboratory Profile of Urinary Tract Infections Associated with Extended Spectrum beta-Lactamase Producing Escherichia coli and Klebsiella pneumoniae
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Clinical and Laboratory Profile of Urinary Tract Infections Associated with Extended Spectrum beta-Lactamase Producing Escherichia coli and Klebsiella pneumoniae

机译：与产超广谱β-内酰胺酶的大肠杆菌和肺炎克雷伯菌相关的尿路感染的临床和实验室概况

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Background. Urinary tract infection (UTI) is mainly due to invasion of the urethra, bladder or kidneys by pathogens. The emergence of extended spectrum beta-lactamases (ESBL) is responsible for frequently observed empirical therapy failures. Objectives. To study the clinical and laboratory characteristics of UTIs caused by ESBL producing Escherichia coli (E. coli) and Klebsiella pneumonia (K. pneumonia). Methods. A cross-sectional clinical and laboratory study was performed at King Khalid Hospital, Hafr Al Batin, Saudi Arabia between March 2014 to October 2015. A total of 908 urine samples from suspected UTI patients was collected. Samples were isolated on Cysteine Electrolyte-Deficient (CLED) agar. Positive cultures were identified and tested for antimicrobial susceptibility by MicroScan (R) WalkAway-96 SI System, and then ESBL was confirmed by double disc synergy test (DDST) and phenotypic confirmatory disc diffusion test (PCDDT). Results. A total of 680 samples (288 males and 392 females) were culture positive. 520 samples (76.5%) of E. Coli were found and 160 samples of K. pneumonia were identified (23.5%). ESBL testing showed 296 (218 E. coli and 78 K. pneumonia) samples of positive isolates. Non-ESBL isolates showed highest resistance to ampicillin followed by Mezocillin and Trimethoprim-Sulphamethoxazole- which are usually recommended as the initial treatment of UTI-while ESBL isolates showed resistance to third generation cephalosporin along with Ampicillin and Trimethoprim-Sulphamethoxazole. In this study, four significant risk factors for ESBL infection such as diabetes, recurrent UTI, previous use of antibiotics and previous hospitalization were found. Conclusion. Identifying the risk factors and antibiotic susceptibility patterns associated with ESBL producing E. coli and K. pneumonia is a useful guide for treatment strategy and control of ESBL UTI.
机译：背景。尿路感染（UTI）主要是由于病原体侵入尿道，膀胱或肾脏。广谱β-内酰胺酶（ESBL）的出现是导致经常观察到的经验疗法失败的原因。目标。研究由产ESBL的大肠杆菌（E. coli）和肺炎克雷伯菌（K. pneumonia）引起的UTI的临床和实验室特征。方法。 2014年3月至2015年10月间，在沙特阿拉伯Hafr Al Batin的King Khalid医院进行了横断面临床和实验室研究。从可疑的UTI患者中收集了908份尿液样本。在半胱氨酸缺乏电解质（CLED）琼脂上分离样品。鉴定阳性培养物并通过MicroScan（R）WalkAway-96 SI系统测试其抗菌敏感性，然后通过双盘协同试验（DDST）和表型确认性盘扩散试验（PCDDT）确认ESBL。结果。总共680个样本（男性288例，女性392例）培养阳性。共发现520个大肠杆菌样品（76.5％），鉴定出160个肺炎克雷伯菌样品（23.5％）。 ESBL测试显示296份阳性分离物（218株大肠杆菌和78株肺炎性肺炎）。非ESBL分离株对氨苄青霉素的耐药性最高，其次是美佐西林和甲氧苄氨嘧啶-磺胺甲恶唑，通常建议将其作为UTI的初始治疗，而ESBL分离株与氨苄青霉素和甲氧苄氨嘧啶-磺胺甲恶唑对第三代头孢菌素耐药。在这项研究中，发现了ESBL感染的四个重要危险因素，例如糖尿病，复发性UTI，先前使用抗生素和先前住院。结论。确定与产生ESBL的大肠杆菌和肺炎克雷伯菌相关的危险因素和抗生素敏感性模式，对于ESBL UTI的治疗策略和控制具有指导意义。

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