Javascript yakadzimwa mubrowser yako parizvino.Zvimwe zviri pawebhusaiti ino hazvishande kana javascript yakadzimwa.
Bhalisa nemashoko ako chaiwo uye chaiwo mushonga wekufarira uye isu tichafananidza ruzivo rwaunopa nezvinyorwa mune yedu yakakura dhatabhesi uye email kopi yePDF kwauri nekukurumidza.
Adane Bitew, 1 Nuhamen Zena, 2 Abera Abdeta31 Dhipatimendi reMedical Laboratory Sciences, Faculty of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia;2 Microbiology, Millennium School of Medicine, St Paul's Hospital, Addis Ababa, Dhipatimendi reEthiopia;3 National Reference Laboratory yeClinical Bacteriology uye Mycology, Ethiopian Institute of Public Health, Addis Ababa, Ethiopia Munyori Anowirirana: Abera Abdeta, National Reference Laboratory yeClinical Bacteriology uye Mycology, Ethiopian Institute of Public Health, PO Box: 1242, Addis Ababa, Ethiopia. , +251911566420, email [email protected] Background: UTIs zvirwere zvinowanzoitika muvana.Kuziva kwezvikonzero zvinowanzokonzera zvirwere zvehutachiwana, maitiro avo ehutachiona hwehutachiona hwehutachiona, uye zvinokonzerwa nengozi mumamiriro ezvinhu chaiwo zvinogona kupa uchapupu hwekurapa kwakakodzera kwezviitiko.Zvinangwa : Chidzidzo ichi chakanangana nekuona iyo yakajairika etiology uye kuwanda kweanobatanidzwa uropathogens uye urinary tract infections, pamwe chete nemishonga inorwisa mabhakitiriya yehutachiona hwehutachiona, uye kuona njodzi dzinosangana nehutachiona hwehutachiwana muvarwere vevana.Zvishandiso uye nzira: Chidzidzo wakaitwa kubva muna Gumiguru 2019 kusvika Chikunguru 2020 paMillennium School of Medicine, St. maitiro.Antibiotic susceptibility test yehutachiona hwehutachiona uchishandisa nzira yeKirby Bauer disc diffusion.Nhamba dzinotsanangura uye kugadziriswa kwekugadzirisa kwakashandiswa kuenzanisa zviyero zvakasvibirira ne95% nguva dzekuvimba.P-kukosha kwemigumisiro: Kukura kwebhakitiriya / fungal kwakakosha kwakaonekwa mumasampuli e65 ane kuwanda kwe28.6%, iyo 75.4% (49/65) uye 24.6% (16/65) yaiva mabhakitiriya uye fungal pathogens, maererano.About 79.6% yehutachiona etiologies yaiva Escherichia coli uye Klebsiella pneumoniae (yakakwirira kupfuura astampicillin. 100%), cefazolin (92.1%) uye trimethoprim-sulfamethoxazole (84.1%), iyo inowanzoshandiswa empirically muEthiopia.Kureba kwekugara muchipatara (P = 0.01) uye catheterization (P = 0.04) yakabatanidzwa nehuwandu hwehutachiona hwehutachiwana. Mhedziso: Kudzidza kwedu kwakacherechedza kuwanda kwehuwandu hwehutachiona hwehutachiona.Enterobacteriaceae ndiyo inonyanya kukonzera zvirwere zvehutachiwana.Kureba kwekugara muchipatara uye catheterization yakabatanidzwa zvakanyanya nehutachiona hwehutachiwana.Both Gram-negative uye Gram-positive mabhakitiriya akanga akanyanya kusagadzikana. ampicillin uye trimethoprim-sulfamethoxazole.Mazwi akakosha: Antibiotic susceptibility maitiro, Pediatrics, Urinary tract infections, Ethiopia
Urinary tract infections (UTIs) inokonzerwa nebhakitiriya uye yeast ndechimwe chezvirwere zvinowanzoitika muvana.Munyika dzichiri kusimukira, chirwere chechitatu chinowanikwa muzera revana mushure mekufema uye zvirwere zvemudumbu.2 Zvirwere zvemudumbu muvana zvinosanganiswa nechirwere chenguva pfupi, kusanganisira fivha, dysuria, kukurumidza, uye kurwadziwa kwepashure.Inogonawo kutungamirira kukuvadzwa kwetsvo kwenguva refu, zvakadai sekuparara kwetsvo kusingaperi uye zvinetso zvenguva refu, kusanganisira kuwedzera kweropa uye kukanganisa kwetsvo. 3 Wennerstrom et al15 vakatsanangura maronda erenal munenge 15% yevana mushure meUTI yekutanga, vachisimbisa kukosha kwekukurumidzira kuongororwa uye kurapwa kwekutanga kwehutachiona hwehutachiwana. 4 Zvidzidzo zvakawanda zvevana UTIs munyika dzakasiyana dzichiri kusimukira zvakaratidza kuti kuwanda kweUTIs kunosiyana kubva pa16% kusvika 34%.5-9 Mukuwedzera, kusvika ku8% yevana vane mwedzi 1 kusvika kumakore gumi nerimwe vachakura zvishoma UTI10. uye kusvika ku30% yevacheche nevana vanozivikanwa kuti vane zvirwere zvinowanzoitika mukati memwedzi mitanhatu-12 yekutanga mushure mekutanga UTI .11
Gram-negative uye Gram-positive mabhakitiriya, pamwe nemamwe marudzi eCandida, anogona kukonzera zvirwere zveweti.E.coli ndiyo inonyanya kukonzera zvirwere zveurinary tract infections, inoteverwa neKlebsiella pneumoniae.12 Zvidzidzo zvakaratidza kuti Candida marudzi, kunyanya Candida albicans, anoramba ari chikonzero chinowanzoitika cheCandida UTIs muvana.13 Zera, mamiriro ekudzingiswa, uye catheter yekugara kune ngozi. zvikonzero zveUTIs muvana.Vakomana vanonyanya kunetseka mugore rokutanga rehupenyu, mushure mezvo, nekuda kwekusiyana kwenhengo dzepabonde, chiitiko chacho chinonyanya kukwira kuvasikana, uye vacheche vechirume vasina kudzingiswa vari pangozi yakanyanya.1,33 Antibiotic susceptibility maitiro Uropathogens inosiyana nekufamba kwenguva, nzvimbo yemurwere, huwandu hwevanhu, uye maitiro ekiriniki.
Zvirwere zvinotapukira zvakadai seUTIs zvinofungidzirwa kuti ndizvo zvinokonzera 26% yevakafa pasi rose, 98% iyo inoitika munyika dzine mari shoma.14 Chidzidzo chevarwere vevana muNepal neIndia chakashuma kupararira kweUTIs ye57% 15 uye 48 %,16.Ongororo yechipatara yevana vekuSouth Africa yakaratidza kuti zvirwere zveweti zvinotora chikamu che11% chezvirwere zvehutano.17 Imwe ongororo yakaitwa muKenya yakaratidza kuti zvirwere zveurinary tract inosvika 11.9% yemutoro wechirwere chefebrile muvana vadiki.18
Zvishoma zvidzidzo zvakaratidza UTIs muvarwere vevana muEthiopia: zvidzidzo paHawassa Referral Hospital, Yekatit 12 Hospital, Felege-Hiwot Specialist Hospital uye Gondar University Hospital yakaratidza 27.5%, 19 15.9%, 20 16.7%, 21 uye 26.45% uye 22, zvichiteerana. .Munyika dzichiri kusimukira, kusanganisira Ethiopia, kushaikwa kwetsika dzeweti pamatanho akasiyana ehutsanana kunoramba kusingagoneki nekuti ivo vanonyanya kushandisa zviwanikwa.Nekudaro, pathogen spectrum yeUTI uye chimiro chayo chekubatwa nemishonga muEthiopia hazvizivikanwe.Kusvika izvi, izvi chidzidzo chine chinangwa chekuona kuwanda kwehutachiona hwehutachiwana, kuongorora mabhakitiriya uye fungal pathogens ane chekuita neUTIs, kuona maantimicrobial susceptibility profiles emabhakitiriya ari oga, uye kuona zvinhu zvikuru zvinokonzeresa zvine chekuita neUTIs.
Kubva muna Gumiguru 2019 kusvika Chikunguru 2020, ongororo yakaitwa muchipatara paDhipatimendi reVana reSt Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia.
Munguva yekudzidza, vese vana vanorwara nevarwere vekunze vakaonekwa muvana.
Munguva yekudzidza, vese vana varwere nevarwere vekunze vane UTI zviratidzo nezviratidzo vakapinda panzvimbo yekudzidza.
Saizi yemuenzaniso yakatemerwa kushandisa imwe-chikamu chekuenzanisa saizi yekuverenga formula ine 95% yekuvimba nguva, 5% muganho wekukanganisa, uye kuwanda kweUTIs mubasa rekutanga [15.9% kana P = 0.159)] Merga Duffa et al20 muAddis Ababa. , sezvinoratidzwa pasi apa.
Z α/2 = 95% nguva yekuvimba yakakosha kukosha kwekugovera kwakajairika, yakaenzana ne1.96 (Z kukosha pa α = 0.05);
D = margin of error, yakaenzana ne5%, α = ndiyo nhanho yekukanganisa vanhu vanoda kushivirira;batanidza izvi mufomula, n= (1.96)2 0.159 (1–0.159)/(0.05)2=206 uye tora 10% isina kupindurwa apo n = 206+206/10 = 227.
Nzira yesampling yakanakira yakashandiswa muchidzidzo ichi. Unganidza data kusvika saizi yaunoda yawanikwa.
Mashoko akaunganidzwa mushure mekuwana mvumo yakanyorwa kubva kuvabereki.Mamiriro emagariro evanhu (zera, murume kana mukadzi, uye nzvimbo yekugara) uye zvinhu zvine ngozi zvinosanganiswa (catheter, yapfuura UTI, hutachiwana hwehutachiwana hweHIV, kudzingiswa, uye urefu hwekugara muchipatara) yevatori vechikamu chidzidzo vakaunganidzwa nevanamukoti vane hunyanzvi vachishandisa data rakagara rataurwa.Bhuku remibvunzo rakarongeka rekuedzwa.Zviratidzo uye zviratidzo zvemurwere uye chirwere chepamusoro zvakanyorwa nechiremba wevana.
Pamberi pekuongorora: sociodemographic maitiro (zera, murume kana mukadzi, nezvimwewo) uye ruzivo rwekiriniki uye kurapwa kwevatori vechikamu chekudzidza rwakaunganidzwa kubva mumibvunzo.
Kuongorora: Kuitwa kwe autoclave, incubator, reagents, microscope, uye microbiological quality yepakati (sterility yepakati uye kukura kwekuita kwepakati yega yega) yakaongororwa maererano nemaitiro akaenzana asati ashandiswa.Kuunganidza uye kutakura kwekliniki samples inoitwa. mushure measeptic maitiro.Inoculation yemakiriniki samples yakaitwa pasi pechipiri chekuchengetedza kabhineti.
Post-Analysis: Zvose zvakabviswa ruzivo (zvakadai semigumisiro ye laboratory) inotaridzirwa kuti inokodzera, yakakwana uye inopindirana uye yakanyorwa isati yapinda maturusi ezvinyorwa.Data inochengetwawo munzvimbo yakachengeteka.Bacterial uye mbiriso yakagadzika yakachengetwa maererano neStandard Operating Procedure. SOP) yeSt. Paul's Hospital Millennium Medical College (SPHMMC).
Yese data yeongororo yakaitwa nekodhi, yakapinda kaviri, uye yakaongororwa pachishandiswa Statistical Package yeSocial Sayenzi (SPSS) software version 23.Shandisa nhamba dzinotsanangura nekugadzirisa zvinhu kuti ufungidzire hutsinye hwereshiyo ne95% nguva dzekuvimba kune zvakasiyana.P values <0.05 yaionekwa seyakakosha.
Urine samples dzakaunganidzwa kubva kumurwere wega wega weti aishandisa midziyo isina utachiona.Vabereki kana vatarisiri vevatori vechikamu chidzidzo vakapihwa mirairidzo yakakodzera yekuti ungaunganidza sei wakachena-captured midstream weti samples.Catheter uye suprapubic urine samples dzakaunganidzwa nevanamukoti vakadzidziswa uye vanachiremba.Pakarepo mushure mekuunganidza. Zvikamu zvemasamples zvakaiswa paMacConkey agar plates (Oxoid, Basingstoke neHampshire, England) uye blood agar (Oxoid, Basingstoke neHampshire, England) 1 μL calibration loop.Masamples akasara akaiswa pabrain heart infusion agar yakawedzerwa nechloramphenicol (100 µgml-1) uye gentamicin (50 µgml-1) (Oxoid, Basingstoke, uye Hampshire, England).
All incubated plates were incubated aerobically at 37°C for 18-48 hours and checked for bacterial and/kana yeast growth.Colony counts of bacteria or yeast produce ≥105 cfu/mL weti yaionekwa sekukura kukuru.Weti samples inobereka zvitatu kana kupfuura. hazvina kutariswa kuti zviongororwe zvakare.
Pure isolates ehutachiona hwehutachiona hwakatanga kuonekwa nekoloni morphology, Gram staining.Gram-positive mabhakitiriya akave akawedzera kushandiswa kushandisa catalase, bile aescin, pyrrolidinopeptidase (PRY) uye rabbit plasma.Gram-negative mabhakitiriya kuburikidza nemiedzo yebiochemical yakadai se (urease test, indole bvunzo, citrate kushandiswa bvunzo, trisaccharide iron bvunzo, hydrogen sulfide (H2S) yekugadzira bvunzo, lysine iron agar bvunzo, motility bvunzo uye oxidase bvunzo bvunzo) kune iyo mhando yemhando).
Mbiriso yakaonekwa pachishandiswa nzira dzechijairira dzekuongorora dzakadai seGram staining, embryo tube assays, carbohydrate fermentation uye assimilation assays uchishandisa chromogenic medium (CHROMagar Candida medium, bioM'erieux, France) maererano nemirairo yemugadziri.
Antimicrobial susceptibility test yakaitwa naKirby Bauer disc diffusion paMueller Hinton agar (Oxoid, Basingstoke, England) maererano neClinical Laboratory Standards Institute (CLSI) mirayiridzo24.Kumiswa kwebhakitiriya kwega yega kwakagadzirirwa mu 0.5 mL yemukaka wekudya uye yakagadziridzwa kuti iite turbidity. enzanisa chiyero che 0.5 McFarland kuti uwane zvingangoita 1 × 106 colony-forming units (CFUs) per mL yebiomass. Dhinda swab isina utachiona mukati mekumiswa uye bvisa zvinhu zvakawandisa nekuidzvanya padivi pechubhu. pakati peMueller Hinton agar plate uye yakagovaniswa zvakaenzana pamusoro pepakati.MaAntibiotic disks akaiswa paMueller Hinton agar seeded yega yega mukati memaminitsi gumi nemashanu ekuisa jekiseni uye akaiswa pa35-37 °C kwemaawa 24. Shandisa caliper kuyera dhayamita yenzvimbo yekudzivirira.Diameter-area inhibition yakadudzirwa seyakaoma (S), yepakati (I), kana inopikisa (R) maererano neClinical and Laboratory Standards Institute (CLSI) mirayiridzo24.Staphylococcus aureus (ATCC 25923), Escherichia coli (ATCC 25922) uye Pseudomonas aeruginosa (ATCC 27853) yakashandiswa semhando yekudzora mhando yekutarisa kushanda kwemishonga inorwisa mabhakitiriya.
Kune mabhakitiriya eGram-negative, tinoshandisa mahwendefa emishonga inorwisa mabhakitiriya: amoxicillin / clavulanate (30 μg);ciprofloxacin (5 μg);nitrofurantoin (300 μg);ampicillin (10 μg);amikacin (30 μg);Meropenem (10 μg);Piperacillin-tazobactam (100/10 μg);Cefazolin (30 μg);Trimethoprim-sulfamethoxazole (1.25 / 23.75 μg).
Antibacterial discs yeGram-positive isolates yaiva: penicillin (10 units);cefoxitin (30 μg);nitrofurantoin (300 μg);vancomycin (30 μg);trimethoprim-sulfamethoxazole (1.25 / g) 23.75 μg);Ciprofloxacin (5 μg);Doxycycline (30 μg) All antimicrobial discs akashandiswa muchidzidzo chedu aiva zvigadzirwa zveOxide, Basingstoke uye Hampshire, England.
Sezvinoratidzwa muTebhenekeri 1, chidzidzo ichi chakanyoresa 227 (227) varwere vevana vakaratidza kana kuti vainyanya kufungidzirwa kuti vane UTI uye vakasangana nemasarudzo ekusarudza.Vadzidzi vevarume vezvidzidzo (138; 60.8%) vakapfuura vakadzi vechidzidzo chevakadzi (89; 39.2%), ine chiyero chevakadzi kuvarume che1.6: 1. Nhamba yezvidzidzo zvekudzidza yakanga yakasiyana-siyana mumapoka ezera, neboka rezera re ˂ 3-makore ane varwere vakawanda (119; 52.4%), inoteverwa ne13-15- ane makore (37; 16.3%) uye mapoka ezera remakore 3-6 (31; 13.7%), zvakateerana.Zvinhu zvekutsvakurudza zvinonyanya maguta, ane chiyero chemaguta-mumaruwa che2.4: 1 (Table 1).
Tafura 1 Socio-demographic maitiro ezvidzidzo zvekudzidza uye kuwanda kwemaitiro akanaka masampuli (N= 227)
Kukura kwakakosha kwebhakitiriya/mbiriso kwakaonekwa mumakumi matanhatu neshanu emakumi maviri nenomwe (227) weti samples yehuwandu hwehuwandu hwe28.6% (65/227), iyo 21.6% (49/227) yaive hutachiona hwehutachiona, nepo 7% (16/227) vaiva fungal pathogens.Kupararira kweUTI kwaive kwakanyanya muboka remakore 13-15 pa 17/37 (46.0%) uye muboka remakore 10-12 kwaive kwakadzikira pa2/21 (9.5%).Tafura 2) .Vakadzi vaive nehuwandu hweUTIs, 30/89 (33.7%), zvichienzaniswa ne35/138 (25.4%) varume.
Pamakumi mana nemapfumbamwe mabhakitiriya akaparadzana, 79.6% (39/49) aive Enterobacteriaceae, iyo Escherichia coli ndiyo yaive yakajairika bhakitiriya inoverengera 42.9% (21/49) yehuwandu hwemabhakitiriya isolate, ichiteverwa neKlebsiella pneumoniae mabhakitiriya, achiverengera 34.6% ( 17/49) yemabhakitiriya isolates.Mana (8.2%) akaparadzana akamiririrwa neAcinetobacter, isina kuvirisa Gram-negative bacillus.Gram-positive bacteria inosvika 10.2% (5/49) chete yemabhakitiriya isolates, iyo 3 ( 60.0%) yaiva Enterococcus.Pa16 yeast isolates, 6 (37.5%) yakamiririrwa naC. -acquired uropathogens, 15/20 yaiva hutachiona hwehutachiona.Pa19 ICU-yakawana uropathogens, 10 / 19 yaiva mbiriso.Pamakumi matanhatu neshanu-positive weti samples, 39 (60.0%) yaiva muchipatara uye 26 (40.0%) yaiva nharaunda-inotorwa (Tafura 3).
Tafura 3 Logistic regression analysis yezvipingamupinyi zvine chokuita nehutachiona hwehutachiwana muvarwere vevana vane SPHMMC (n = 227)
Pakati pevarwere vevana 227, 129 vakaiswa muchipatara kwemazuva asingasviki 3, avo 25 (19.4%) vaiva netsika-yakanaka, 120 vakapinzwa kukiriniki yekunze, avo 25 (20.8%) vakanga vane tsika dzakanaka, uye 63 vaiva nhoroondo yehutachiona hwehutachiona.Pakati pavo, makumi maviri nenhatu (37.70%) aive akanaka kune tsika, makumi matatu nemasere aive ekugara catheter, makumi maviri (52.6%) aive akanaka kune tsika, uye makumi manomwe neshanu aive akanaka kune tembiricha yemuviri> 37.5 ° C, ayo 21 (29.6%) zvaive zvakanaka kune tsika (Table 3).
Vafemberi veUTI vakaongororwa bivariately, uye vaive neiyo logistic regression values yekugara kwemwedzi 3-6 (COR 2.122; 95% CI: 3.31-3.43; P=0.002) uye catheterization (COR= 3.56; 95) %CI : 1.73–7.1;P = 0.001) .Kuongororwa kwakawanda kwakaitwa pane bivariately inokosha inofanotaura nezveUTI ine zvinotevera logistic regression values: kureba kwekugara 3-6 mwedzi (AOR = 6.06, 95% CI: 1.99-18.4; P = 0.01) uye catheterization ( AOR = 0.28; 95% CI: 0.13-0.57, P = 0.04) .Kureba kwekugara muchipatara kwemwedzi 3-6 kwakabatanidzwa zvakanyanya neUTI (P = 0.01) . P = 0.04) .Zvisinei, kugara, zvepabonde, makore, nzvimbo yekubvumirwa, nhoroondo yekare yeUTI, chimiro cheHIV, kupisa kwemuviri, uye chirwere chisingaperi hachina kuwanikwa chichibatanidzwa zvakanyanya neUTI (Table 3).
Matafura 4 uye 5 anotsanangura maitiro ehutachiona hwehutachiona hweGram-negative uye Gram-positive mabhakitiriya kune mapfumbamwe maantibioti akaongororwa. zvakatevedzana.Pakati pemishonga yose yakaedzwa, mabhakitiriya eGram-negative ndiwo akanyanya kupikisa ampicillin, cefazolin, uye trimethoprim-sulfamethoxazole, ane simba rekudzivirira re100%, 92.1%, uye 84.1%, maererano.E.coli, rudzi rwakanyanya kudzorerwa, rwakanga rwakanyanya kupikisa ampicillin (100%), cefazolin (90.5%), uye trimethoprim-sulfamethoxazole (80.0%).Klebsiella pneumoniae ndiro bhakitiriya rechipiri rinowanzogara riri roga, riine simba rekudzivirira re94.1%. ku cefazolin uye 88.2% kusvika ku trimethoprim/sulfamethoxazole Tafura 4.Iyo yepamusoro-soro yepamusoro-soro yekudzivirira (100%) yeGram-positive bacteria yakaonekwa mu trimethoprim / sulfamethoxazole, asi zvose zvakaparadzana zveGram-positive bacteria (100%) zvakakonzerwa ne oxacillin ( tafura 5).
Urinary tract infections (UTIs) inoramba iri chimwe chezvikonzero zvinowanzokonzera kurwara mukuita kwevana.Kukurumidza kuongororwa kweUTI muvana kwakakosha nokuti inogona kuva chiratidzo chekusagadzikana kwetsvo zvakadai semavanga, hypertension, uye kuguma kwechirwere chetsvo. chidzidzo chedu, kuwanda kwehutachiona hwehutachiwana hwakanga huri 28.6%, iyo 21.6% yakakonzerwa nehutachiona hwehutachiona uye 7% nehutachiona hwefungal. muEthiopia naMerga Duffa et al.Saizvozvowo, 27.5% et al 19 Chiitiko cheUTIs nekuda kwembiriso muEthiopiya, kunyanya vana, hazvizivikanwi nokuda kwekutaura kwedu.Izvi ndezvokuti zvirwere zvefungal zvinowanzoonekwa sezvisina kukosha kudarika zvirwere zvebhakitiriya nehutachiona muEthiopia.Naizvozvo, chiitiko chembiriso. -induced urinary tract infection muvarwere vevana vakarondedzerwa muchidzidzo ichi chaiva 7%, yekutanga munyika.Kuwanda kweUTIs inokonzerwa nembiriso yakataurwa muchidzidzo chedu inopindirana nehuwandu hwe5.2% yakashumwa mune chidzidzo chevana Seifi et. al.25 Zvisinei, Zarei yakashuma kupararira kwe16.5% uye 19.0% - Mahmoudabad et al 26 uye Alkilani et al 27 muIran neEgypt, maererano.Kuwanda kwepamusoro mune zvidzidzo zviviri izvi hazvishamisi sezvo zvidzidzo zvakabatanidzwa zvaive varwere veICU. pasina zera rekuda.Kusiyana kwehuwandu hweUTIs pakati pezvidzidzo zvinogona kubva mukusiyana kwekugadzira zvidzidzo, maitiro emagariro evanhu ezvidzidzo zvekudzidza, uye comorbidities.
Muchidzidzo chezvino, 60% yeUTIs yakawanikwa muchipatara (intensive care unit uye wadhi-yakawanikwa) .Migumisiro yakafanana (78.5%) yakaonekwa naAubron et al.28, kunyange zvazvo kupararira kweUTI munyika dzichiri kusimukira kwakasiyana nekudzidza uye nenharaunda, pasina kusiyana kwenharaunda muhutachiona uye fungal pathogens inokonzera UTIs.Mabhakitiriya akajairika akadzorerwa kubva kumagariro emuweti aiva Gram-negative bacilli, kunyanya Escherichia coli, inoteverwa neKlebsiella. pneumoniae.6,29,30 Zvichienderana nezvidzidzo zvekare zvakafanana, 29,30 chidzidzo chedu chakaratidzawo kuti Escherichia coli ndiyo yainyanya kuwanda mabhakitiriya.Mabhakitiriya akajairika akaita 42.9% yehuwandu hwehutachiona hwehutachiona, hunoteverwa neKlebsiella pneumoniae, iyo yakaita 34.6% of bacterial isolates.Escherichia coli ndiyo yainyanyozivikanwa nebhakitiriya pathogen munharaunda- nechipatara-yakawanikwa UTIs (57.1% uye 42.9%, zvichiteerana).Ongororo dzakawanda dzakaratidza kuti Candida ndicho chinokonzera kanenge 10-15% yechipatara-yakawanikwa. Urinary tract infections muzvipatara, uye candida inonyanya kuwanda mumakamuri ekuchengetedza zvakanyanya.31-33 Muchidzidzo chedu, Candida yakaverengera 7% yeUTIs, 94% iyo yaiva nosocomial-yakawanikwa, iyo 62.5% yakaonekwa muvarwere veICU. .Candida albicans ndiyo yainyanya kukonzera candidiasis, uye 81.1% yeCandida yakaparadzaniswa kubva kune wadhi-yakawanikwa weti tsika-yakanaka uye ICU-yakawanikwa yakanaka weti tsika samples. immunocompromised varwere senge ICU varwere.
Muchidzidzo ichi, vakadzi vainyanya kubatwa nehutachiona hwehutachiona kupfuura varume, uye varwere vezera re 12-15 vainyanya kunetseka.Zvisinei, musiyano pakati pemamiriro maviri aya wakanga usingaoneki.Kushaikwa kwekubatana pakati peUTI uye zvepabonde uye zera rinogona kutsanangurwa neboka rezera rekutanga umo varwere vaipinzwa basa.Tichifunga nezve epidemiological mapatani eUTIs, chiitiko chevarume nevakadzi chinowanzoita sechakaenzana muhucheche, nehukuru hwechirume munguva yekuzvarwa uye hukuru hwevakadzi muhuduku. uye panguva yekudzidzira chimbuzi.Pakati pezvimwe zvinongororwa zvakaongororwa nengozi, kugara muchipatara kwemazuva 3-30 kwakabatanidzwa neUTI (P = 0.01) .Kuwirirana pakati pehurefu hwekugara muchipatara uye UTI yakaonekwa mune zvimwe zvidzidzo.34,35 UTI mu. chidzidzo chedu chakabatanidzwawo zvakanyanya ne catheterization (P = 0.04) . Maererano naGokula et al.35 uye Mutsvene nevamwe.36, catheterization yakawedzera kutyisidzira kweUTIs ne3 kusvika ku10%, zvichienderana nehurefu hwe catheterization.Sterlity kudzivirira nyaya panguva yekuisa catheter, infrequent catheter replacement, uye kusava nehanya kwe catheter kunogona kukonzera kuwedzera kwehutachiwana hwehutachiwana hwehutachiwana.
Munguva yekudzidza, varwere vakawanda vevana vari pasi pemakore matatu vakabvumirwa kuchipatara vane zviratidzo zvehutachiwana hwehutachiwana kupfuura mamwe mapoka ezera.Izvi zvinogona kuva nokuti zera iri ndiro nguva yekudzidzira potty, iyo inopindirana nezvimwe zvidzidzo.37- 39
Muchidzidzo ichi, mabhakitiriya eGram-negative ndiwo akanyanya kurwisa ampicillin uye trimethoprim-sulfamethoxazole, aine huwandu hwekusagadzikana kwe100% ne84.1%, zvichiteerana. Escherichia coli neKlebsiella pneumoniae aiwanzopora airamba ampicillin (100%) uye trimethoprim-sulfamethoxazole (81.0%).Saizvozvowo, chiyero chepamusoro-soro chekudzivirira (100%) muhutachiona hweGram-positive chakaonekwa mu trimethoprim/sulfamethoxazole.Ampicillin uye trimethoprim-sulfamethoxazole zvakashandiswa zvakanyanya sekutanga-empiric kurapwa kwezvirwere zveurinary tract. munzvimbo dzose dzehutano muEthiopia, sezvakakurudzirwa neMinistry of Health's Standard Treatment Guidelines (STG) .40-42 Resistance rates ye gram-negative uye gram-positive bacteria kune ampicillin uye trimethoprim-sulfamethoxazole muchidzidzo ichi.Kuramba kushandiswa kwemishonga mu mharaunda inowedzera mukana wekusarudza nekuchengetedza kwezvipingamupinyi zvinopikisa mumamiriro ezvinhu akadaro.43-45 Kune rumwe rutivi, chidzidzo chedu chakaratidza kuti amikacin uye meropenem ndiyo yaiva mishonga yakanyatsoshanda kurwisa mabhakitiriya eGram-negative uye oxacillin ndiyo yainyanya kushanda kurwisa Gram. -mabhakitiriya akanaka.Data iri munyaya ino inotorwa kubva papepa risina kudhindwa naNuhamen Zena, iro rakaiswa kuAddis Ababa University Institutional Repository.46
Nekuda kwekushomeka kwezviwanikwa, hatina kukwanisa kuita antifungal susceptibility bvunzo pane fungal pathogens dzakaonekwa muchidzidzo ichi.
Huwandu hwehutachiwana hweUTI hwaive 28.6%, 75.4% (49/65) hwaive hunoenderana nemabhakitiriya uye 24.6% (19/65) maUTI akakonzerwa nembiriso. albicans uye vasiri albicans C. albicans vave vachibatanidzwa neUTI-induced UTIs, kunyanya kune varwere veICU.Kureba kwekugara muchipatara uye catheterization yemwedzi 3 kusvika ku6 yakabatanidzwa zvikuru neUTI.Both gram-negative uye gram-positive mabhakitiriya anonyanya kukosha. kusagadzikana kune ampicillin uye trimethoprim-sulfamethoxazole inokurudzirwa neBazi rezvehutano kuti iwane empiric kurapwa kweUTIs.Rimwe basa rinofanira kuitwa paUTIs muvana, uye ampicillin uye trimethoprim-sulfamethoxazole inofanira kuonekwa zvakare semishonga inosarudzwa ye empiric treatment yeUTIs.
Chidzidzo chacho chakaitwa maererano neDeclaration of Helsinki.Zvose zvehutsika uye zvisungo zvakagadziriswa zvakanaka uye tsvakurudzo yakaitwa nekodzero yehutano uye SPHMMC mvumo kubva kuInternal Review Board yeDhipatimendi reMedical Laboratory Sciences, Faculty of Health Sciences, Addis. Ababa University.Sezvo chidzidzo chedu chaisanganisira vana (vari pasi pemakore gumi nematanhatu), havana kukwanisa kupa mvumo yakanyorwa yechokwadi.Naizvozvo, fomu remvumo rinofanira kuzadzwa nemubereki/muchengeti.Muchidimbu, chinangwa chebasa uye zvaro. mabhenefiti anotsanangurwa zvakajeka kumubereki/muchengeti wega wega.Vabereki/vachengeti vanorairwa kuti ruzivo rwemwana wega-wega ruchengetwe zvakavanzika.Mubereki/muchengeti anoziviswa kuti mwana wake haasungirwe kupinda muchidzidzo kana akadaro. kusabvuma kutora chikamu muchidzidzo.Kana vabvuma kupinda muchidzidzo uye vasingade kuenderera mberi, vakasununguka kubuda muchidzidzo chero nguva panguva yechidzidzo.
Tinoda kutenda chiremba wevana varipo panzvimbo yekudzidza kuti vaongorore zvakasimba varwere kubva pane maonero ekuratidzwa kwekliniki.Tinotendawo zvikuru kune varwere vakapinda muchidzidzo.Tinodawo kutenda Nuhamen Zena nokutibvumira bvisa data rakakosha kubva kutsvagurudzo yake isina kudhindwa, iyo yakaiswa kuAddis Ababa University repository.
1. Shaikh N, Morone NE, Bost JE, Farrell MH.Kuwanda kwehutachiona hwehutachiwana muvana: meta-analysis.Pediatr Infect Dis J. 2008;27:302.doi:10.1097/INF.0b013e31815e4122
2. Srivastava RN, Bagga A. Urinary tract infections.In: Srivastava RN, Bagga A, eds.Pediatric Nephrology.4th edition.New Delhi: Jaypee;2005:235-264.
3. Wennerstrom M, Hansson S, Jodal U, Stokland E. Primary uye akawana mavanga erenal kuvakomana nevasikana vane zvirwere zveurinary tract infections.J Pediatrics.2000;136:30-34.doi: 10.1016/S0022-3476(00)90045 -3
4. Millner R, Becknell B. Urinary tract infections.Pediatric Clinical North AM.2019;66:1-13.doi:10.1016/j.pcl.2018.08.002
5. Rabasa AI, Shatima D. Urinary tract infection muvana vanoshaya zvokudya zvakakwana paMaiduguri University Teaching Hospital.J Trop Pediatrics.2002;48:359–361.doi:10.1093/tropej/48.6.359
6. Peji AL, de Rekeneire N, Sayadi S, et al.Kutapukirwa muvana vakapinzwa muchipatara vane kushaya zvokudya zvinovaka muviri kwakaoma muNiger.PLoS One.2013;8:e68699.doi: 10.1371/journal.pone.0068699
7. Uwaezuoke SN, Ndu IK, Eze IC.Kuwanda uye ngozi yehutachiona hwehutachiwana muvana vasina zvokudya zvinovaka muviri: kuongorora kwakarongeka uye meta-analysis.BMC Pediatrics.2019;19:261.doi: 10.1186/s12887-08-y-162
Nguva yekutumira: Kubvumbi-14-2022