High multidrug resistance in urinary tract infections in a tertiary hospital, Kathmandu, Nepal.

Autor:	Shakya S; Central Department of Public Health, Tribhuvan University, Institute of Medicine, Kathmandu, Nepal., Edwards J; Department of Global Health, University of Washington, Seattle, WA, USA., Gupte HA; Narotam Sekhsaria Foundation, Mumbai, India., Shrestha S; World Health Emergencies Programme, WHO Country Office, Kathmandu, Nepal., Shakya BM; Department of Anaesthesiology, Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, Kathmandu, Nepal., Parajuli K; Department of Clinical Microbiology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal., Kattel HP; Department of Clinical Microbiology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal., Shrestha PS; Department of Anaesthesiology, Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, Kathmandu, Nepal., Ghimire R; Department of Clinical Pharmacology, Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, Kathmandu, Nepal., Thekkur P; Centre for Operational Research, International Union Against Tuberculosis and Lung Disease (The Union), Paris, France.; Centre for Operational Research, The Union South-East Asia Office, New Delhi, India.
Jazyk:	angličtina
Zdroj:	Public health action [Public Health Action] 2021 Nov 01; Vol. 11 (Suppl 1), pp. 24-31.
DOI:	10.5588/pha.21.0035
Abstrakt:	Setting: Tribhuvan University Teaching Tertiary Care Hospital, Kathmandu, Nepal, May-October 2019. Objective: 1) To describe the bacteriological profile, 2) to identify the antimicrobial resistance (AMR) pattern, and 3) to find the demographic characteristics associated with the presence of bacterial growth and multidrug resistance (MDR) in adult urine samples undergoing culture and drug susceptibility testing. Design: This was a hospital-based, cross-sectional study using routine laboratory records. Results: Among 11,776 urine samples, 16% (1,865/11,776) were culture-positive, predominantly caused by Escherichia coli (1,159/1,865; 62%). We found a high prevalence of resistance to at least one antibiotic (1,573/1,865; 84%) and MDR (1,000/1,865; 54%). Resistance to commonly used antibiotics for urinary tract infections (UTIs) such as ceftazidime, levofloxacin, cefepime and ampicillin was high. Patients aged ⩾60 years (adjusted prevalence ratio [aPR] 1.6, 95% CI 1.4-1.7) were more likely to have culture positivity. Patients with age ⩾45 years (45-59 years: aPR 1.5, 95% CI 1.3-1.7; ⩾60 years: aPR 1.4, 95% CI 1.2-1.6), male sex (aPR 1.3, 95% CI 1.2-1.5) and from inpatient settings (aPR 1.4, 95% CI 1.2-1.7) had significantly higher prevalence of MDR. Conclusion: Urine samples from a tertiary hospital showed high prevalence of E. coli and MDR to routinely used antibiotics, especially among inpatients. Regular surveillance and application of updated antibiograms are crucial to monitor the AMR situation in Nepal. (© 2021 The Union.)
Databáze:	MEDLINE
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