نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد، گروه میکروب‌شناسی، دانشکده پزشکی، دانشگاه علوم پزشکی شهید صدوقی، یزد، ایران

2 کارشناس ، گروه علوم آزمایشگاهی، دانشکده پیراپزشکی، دانشگاه علوم پزشکی شهید صدوقی، یزد، ایران

3 دانشیار، گروه پزشکی اجتماعی، دانشکده پزشکی و مرکز تحقیقات پایش سلامت، دانشگاه علوم پزشکی شهید صدوقی، یزد، ایران

4 دانشیار باکتری‌شناسی، گروه علوم آزمایشگاهی، دانشکده پیراپزشکی، دانشگاه علوم پزشکی شهید صدوقی، یزد، ایران دانشیار باکتری‌شناسی، کمیته تحقیقات و فناوری دانشجویی، دانشگاه علوم پزشکی و خدمات بهداشتی درمانی شهید صدوقی، یزد، ایران

10.30468/jsums.2024.7716.3021

چکیده

زمینه و هدف: عفونت­های مجاری ادراری (UTI[1]) از بیماری‌های عفونی شایع در سنین جوانی و میانسالی می‌باشد. تجویز آنتی‌بیوتیک‌های در طیف گسترده و افزایـش مقاومـت آنتـی‌بیوتیکی، تعیین الگوی مقاومـت باکتری‌ها را در پیشبرد درمـان ضـروری می‌سازد. هدف از این مطالعه، تعیین الگوی مقاومت دارویی در باکتری‌های مولد عفونت‌های ادراری در بیماران مراجعه‌کننده به دو مرکز درمانی و تشخیص طبی شهر یزد، ایران بود.
مواد و روش­ها: این مطالعه توصیفی- مقطعی در یک دوره یک ساله (1398) برروی 3563 نمونه عامل UTI بخش میکروب‌شناسی آزمایشگاه تشخیصی مرکزی و بیمارستان شهید صدوقی یزد انجام شد. باکتری‌های جداشده با روش‌های فنوتیپی شناسایی و مقاومت آنتی‌بیوتیکی جدایه‌ها به روش دیسک دیفیوژن انجام شد.
یافته­ها: از 3563 جدایه مثبت 4/80 درصد از بیماران سرپایی و 19/6 درصد از بیماران بستری جدا شد. شایع‌ترین باکتری‌های عامل  UTI در دو مرکز شامل: اشریشیا­کلی (57/8 درصد)، کلبسیلا پنومونیه (9/7 درصد)، استافیلوکوکوس اورئوس (9/1 درصد)، استرپتوکوکوس آگالاکتیه (7 درصد) و اسینتوباکتر (0/2 درصد) بود. بیشترین مقاومت آنتی‌بیوتیکی در جدایه­ های اشرشیاکلی بیماران سرپایی آموکسی سیلین-کلاوونات (62/9 درصد) و سپس نالیدیکسیک اسید (61/9 درصد) و در بیماران بستری آمپی سیلین (86 درصد) و کوتریموکسازول (72 درصد) بود. بیش از نیمی از این جدایه­ها ESBL مثبت بودند.
نتیجه‌گیری: از آن‌جا که توزیع مقاومت آنتی بیوتیکی جدایه­های عامل UTI در بیماران بستری و سرپایی متغیر می‌باشد از این‌رو تعیین مقاومت آنتی‌بیوتیکی عوامل عفونت در مراکز تشخیصی- درمانی در مناطق مختلف جغرافیایی اهمیت دارد.

تازه های تحقیق

https://scholar.google.com/citations?hl=en&user=y0WJyS4AAAAJ

https://www.ncbi.nlm.nih.gov/myncbi/kimia.saremi.1/bibliography/public/

https://scholar.google.com/citations?hl=en&user=oRqzUwQAAAAJ

https://www.ncbi.nlm.nih.gov/myncbi/zahra.dehghani.2/bibliography/public/

https://scholar.google.com/citations?user=y4S6LhEAAAAJ&hl=en

https://www.ncbi.nlm.nih.gov/myncbi/mahmood.vakili.1/bibliography/public/

https://scholar.google.com/citations?view_op=list_works&hl=en&user=fMi1vVQAAAAJ

https://www.ncbi.nlm.nih.gov/myncbi/maryam.sadeh.1/bibliography/public/

 

 

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Investigating Antibiotic Resistance Patterns in Bacteria Causing Urinary Tract Infections among Patients Referred to Two Medical Diagnosis and Treatment Centers in Yazd, Iran

نویسندگان [English]

  • Kimia Saremi 1
  • Zahra Dehghani 2
  • Mahmood Vakili 3
  • Maryam Sadeh 4

1 MSc Student, Department of Microbiology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 BSc, Department of Laboratory Sciences, School of Paramedicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

3 Associate Professor, Department of Community Medicine, School of Medicine AND Health Monitoring Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

4 Associate Professor, Department of Laboratory Sciences, School of Paramedicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Associate Professor, Student research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

چکیده [English]

Introduction: Urinary tract infections (UTIs) are prevalent infectious conditions affecting individuals in their youth and middle age. The increased use of broad-spectrum antibiotics and the growing resistance to these drugs emphasize the necessity of understanding bacterial resistance patterns in the context of treatment. This study aimed to identify the resistance patterns of bacteria causing UTIs in patients attending two medical diagnostic and treatment centers in Yazd, Iran.
Materials and Methods: Conducted for one year (2018), this descriptive-cross-sectional study involved analyzing 3563 samples of UTI agents collected from the microbiology department of the Central Diagnostic Laboratory and Shahid Sadoughi Hospital in Yazd. Identification of isolated bacteria utilized phenotypic methods, and antibiotic resistance assessments were performed using the disk diffusion method.
Results: Among 3563 positive isolates, 80.4% originated from outpatients, while 19.6% were from inpatients. The most prevalent bacteria causing UTIs in both centers were Escherichia coli (57.8%), Klebsiella pneumoniae (9.7%), Staphylococcus aureus (9.1%), Streptococcus agalactiae (7%), and Acinetobacter (0.2%). Escherichia coli isolates exhibited the highest antibiotic resistance, particularly against amoxicillin-clavulanate (62.9%) and nalidixic acid (61.9%). In hospitalized patients, resistance to ampicillin (86%) and cotrimoxazole (72%) was notable, with over half of these isolates displaying ESBL positivity.
Conclusion: Given the varying distribution of antibiotic resistance among UTI-causing isolates in both inpatient and outpatient settings, understanding antibiotic resistance patterns in diagnostic-treatment centers across diverse geographical areas is imperative.

کلیدواژه‌ها [English]

  • Antibiotic Resistance Pattern
  • Beta-lactamase Urinary Tract Infections
  • Urinary Tract Infection
  • Yazd
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