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Adane Bitew, 1 Nuhamen Zena, 2 Abera Abdeta31 Department of Medical Laboratory Sciences, Faculty of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia;2 Microbiology, Ụlọ Akwụkwọ Ọgwụ nke Millennium, Ụlọ Ọgwụ St Paul, Addis Ababa, Ngalaba Etiopia;3 National Reference Laboratory for Clinical Bacteriology and Mycology, Ethiopian Institute of Public Health, Addis Ababa, Ethiopia Onye edemede na-emekọrịta ihe: Abera Abdeta, National Reference Laboratory for Clinical Bacteriology and Mycology, Ethiopian Institute of Public Health, PO Box: 1242, Addis Ababa, Ethiopia , +251911566420, email [email protected] ndabere: UTI bụ ọrịa na-efe efe na-efe efe na ụmụaka. Ihe ọmụma nke ihe ndị na-akpatakarị ọrịa urinary tract, usoro ha nke ihe mgbochi nje, na ihe ize ndụ metụtara na ntọala ụfọdụ nwere ike inye ihe akaebe maka ọgwụgwọ kwesịrị ekwesị nke ikpe. : Ọmụmụ ihe a bụ iji chọpụta ihe ndị na-emekarị na ọdịdị nke uropathogens na ọrịa urinary tract, yana ihe ndị na-emepụta ihe na-eme ka nje bacteria dị iche iche, na ịchọta ihe ize ndụ ndị metụtara ọrịa urinary tract na ndị ọrịa ụmụaka. Ihe na ụzọ: Ọmụmụ ihe. E mere site na October 2019 ruo July 2020 na Millennium School of Medicine, St. Paul's Hospital. A na-anakọta mmamịrị ndị ọrịa nke ọma, tinye ya na mgbasa ozi, ma tinye ya na 37 ° C maka awa 18-48. Achọpụtara nje bacteria na yist dịka ọkọlọtọ. usoro.Nnwale nyocha nke nje nje bacteria na-eji usoro Kirby Bauer diski ike. A na-eji ọnụ ọgụgụ na-akọwapụta na mgbagha mgbagha na-eme ka ọnụ ọgụgụ nke raw na 95% oge ntụkwasị obi. Nsonaazụ P-uru: A na-ahụ nnukwu nje bacteria / fungal na 65 samples na a. njupụta nke 28.6%, nke 75.4% (49/65) na 24.6% (16/65) bụ nje bacteria na fungal pathogens, n'otu n'otu. 100%), cefazolin (92.1%) na trimethoprim-sulfamethoxazole (84.1%), bụ nke a na-ejikarị eme ihe na Etiopia. Ogologo oge ọnụnọ ụlọ ọgwụ (P=0.01) na catheterization (P=0.04) na-ejikọta ọnụ na ọrịa urinary tract. Mkpebi: Ọmụmụ ihe anyị chọpụtara na ọrịa urinary na-efe efe nke ukwuu.Enterobacteriaceae bụ isi ihe na-ebute ọrịa urinary tract. Ogologo oge ọnụnọ ụlọ ọgwụ na catheterization na-ejikọta ya na ọrịa urinary tract.Ma gram-negative na gram-positive bacteria bụ ndị na-eguzogide ọgwụ. ampicillin na trimethoprim-sulfamethoxazole.Keyokwu: Usoro nhụsianya ọgwụ nje, Ọgwụ ụmụaka, ọrịa urinary tract, Ethiopia
Ọrịa urinary tract (UTIs) nke nje bacteria na yist na-ebute bụ otu n'ime ọrịa urinary a na-ahụkarị na ụmụaka.Na mba ndị ka na-emepe emepe, ọ bụ ọrịa nke atọ a na-ahụkarị na ọgbọ ụmụaka mgbe ọrịa iku ume na eriri afọ.2 Ọrịa eriri afọ na ụmụaka. na-ejikọta ya na ọrịa na-adịghị adịte aka, gụnyere ahụ ọkụ, dysuria, ngwa ngwa, na mgbu azụ dị ala.Ọ pụkwara ịkpata mmebi akụrụ na-adịte aka, dị ka ọkpụkpụ akụrụ na-adịgide adịgide na nsogbu dị ogologo oge, gụnyere ọbara mgbali elu na ọdịda akụrụ. 3 Wennerstrom et al15 kọwara nhụsianya gbasara akụrụ n'ihe dịka 15% nke ụmụaka mgbe mbụ UTI gasịrị, na-emesi mkpa ọ dị nrịanrịa ngwa ngwa na ọgwụgwọ mbụ nke ọrịa urinary tract. Tụkwasị na nke ahụ, mmefu na njikwa urinary tract metụtara nlekọta ahụike dị oke elu.3, 4 Ọtụtụ nchọpụta nke UTI ụmụaka na mba dị iche iche na-emepe emepe egosiwo na ọnụ ọgụgụ nke UTI dị iche site na 16% ruo 34% .5-9 Tụkwasị na nke ahụ, ruo 8% nke ụmụaka dị afọ 1 ọnwa ruo afọ 11 ga-etolite ma ọ dịkarịa ala otu UTI10, na ihe ruru 30% nke ụmụ ọhụrụ na ụmụaka ka amara na ha na-ebute ọrịa ugboro ugboro n'ime ọnwa 6-12 mbụ mgbe mbụ UTI .11
Gram-negative na gram-positive bacteria, yana ụfọdụ ụdị Candida, nwere ike ịkpata ọrịa urinary tract.E.coli bụ ihe na-akpatakarị ọrịa urinary tract, sochiri Klebsiella pneumoniae.12 Nnyocha egosiwo na ụdị Candida, karịsịa Candida albicans, na-anọgide na-akpatakarị Candida UTI na ụmụaka. ihe na-akpata UTI na ụmụaka.Ụmụ nwoke na-esiwanye ike n'afọ mbụ nke ndụ, mgbe nke ahụ gasịrị, n'ihi ọdịiche dị na akụkụ ahụ mmekọahụ, ihe omume ahụ na-akawanye elu na ụmụ agbọghọ, na ụmụ ọhụrụ a na-ebighị úgwù nọ n'ihe ize ndụ dị elu.1,33 Ụdị ihe mgbochi nje. Uropathogens dịgasị iche n'oge, ọnọdụ mpaghara onye ọrịa, ọnụọgụ mmadụ, na njirimara ụlọ ọgwụ.
A na-eche na ọrịa ndị na-efe efe dị ka UTI na-akpata 26% nke ọnwụ zuru ụwa ọnụ, 98% n'ime ha na-eme na mba ndị na-akpata obere ego.14 Nnyocha e mere ndị ọrịa ụmụaka na Nepal na India kọrọ na ọnụ ọgụgụ zuru ezu nke UTI nke 57%15 na 48. %,16. Nnyocha ụlọ ọgwụ nke ụmụaka South Africa gosiri na ọrịa urinary na-ebute 11% nke ọrịa ahụike.17 Nnyocha ọzọ na Kenya chọpụtara na ọrịa urinary na-ebute ihe dịka 11.9% nke ibu nke ọrịa febrile na ụmụaka.18
Ọmụmụ ihe ole na ole achọpụtala UTI na ndị ọrịa ụmụaka na Etiopia: ọmụmụ na Ụlọ Ọgwụ Hawassa Referral, Yekatit 12 Hospital, Felege-Hiwot Specialist Hospital na Ụlọ Ọgwụ Mahadum Gondar gosipụtara 27.5%, 19 15.9%, 20 16.7%, 21 na 26.45% na 22, n'otu n'otu. .Na mba ndị ka na-emepe emepe, gụnyere Etiopia, enweghi omenala mmamịrị na ọkwa dị iche iche nke ịdị ọcha ka na-anọgide na-abaghị uru n'ihi na ha na-ebuwanye ibu. Ọmụmụ ihe ezubere iji chọpụta mgbasa nke ọrịa urinary tract, nyochaa nje bacteria na fungal pathogens jikọtara ya na UTIs, chọpụta profaịlụ mgbochi nje nke njepụ nje bacteria, na ịchọpụta isi ihe ndị nwere ike ime na UTIs.
Site na Ọktọba 2019 ruo Julaị 2020, emere ọmụmụ ihe gbasara ngalaba ụlọ ọgwụ na Ngalaba Paediatrics nke St Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia.
N'ime oge ọmụmụ ihe, a na-ahụ ndị niile na-arịa ọrịa ụmụaka na ndị na-arịa ọrịa na-ahụ maka ụmụaka.
N'ime oge ọmụmụ ihe, ndị niile na-arịa ọrịa ụmụaka na ndị ọrịa na-ahụ maka akara UTI na ihe mgbaàmà gara ebe ọmụmụ ihe.
Ekpebiri nha nlere anya site na iji usoro ngụkọ nha nha nha nke otu nwere oge ntụkwasị obi 95%, oke njehie 5%, yana ọtụtụ UTI na ọrụ mbụ [15.9% ma ọ bụ P=0.159)] Merga Duffa et al20 na Addis Ababa , dị ka egosiri n'okpuru.
Z α / 2 = 95% ntụkwasị obi etiti oge dị oke mkpa maka nkesa nkịtị, hà 1.96 (uru Z na α = 0.05);
D = oke njehie, nhata 5%, α = bụ ọkwa nke njehie ndị mmadụ dị njikere ịnabata;Tinye ihe ndị a na usoro, n = (1.96) 2 0.159 (1-0.159)/(0.05)2=206 wee were 10% azaghị ebe n = 206+206/10 = 227.
Eji usoro nlere anya dabara adaba n'ime ọmụmụ ihe a. Chịkọta data ruo mgbe a ga-enweta nha nlele achọrọ.
A nakọtara data mgbe ha nwetasịrị nkwenye ederede sitere n'aka ndị nne na nna. Njirimara sociodemographic (afọ, okike, na ebe obibi) na ihe ize ndụ metụtara ya (catheter, UTI gara aga, ọnọdụ nje immunodeficiency mmadụ (HIV), ibi úgwù, na ogologo oge ịnọ n'ụlọ ọgwụ). Ndị nọọsụ ruru eru chịkọtara ndị sonyere ọmụmụ ihe site na iji data akọwapụtara nke ọma.Ihe ndekọ ahaziri ahazi maka ule ahụ. Ihe ịrịba ama na mgbaàmà nke onye ọrịa na ọrịa dị n'okpuru bụ onye dọkịta na-ahụ maka ụmụaka na-aga.
Tupu nyocha: njirimara sociodemographic (afọ, okike, wdg) na ozi gbasara ahụike na ọgwụgwọ nke ndị na-amụ ihe na-anakọta site na ajụjụ ọnụ.
Analysis: A na-enyocha arụmọrụ nke autoclave, incubator, reagents, microscope, na microbiological àgwà nke ọkara (sterility nke ọkara na ọrụ uto nke onye ọ bụla) dị ka usoro ọkọlọtọ si dị tupu ejiri ya. Mgbe usoro aseptic gasịrị. A na-eme ọgwụ mgbochi nke ụlọ ọgwụ n'okpuru ụlọ nchekwa nchekwa nke abụọ.
Nyochaa Post-Analysis: A na-enyocha ozi niile ewepụtara (dị ka nsonaazụ ụlọ nyocha) maka ntozu, izu oke na ịdị n'otu wee dekọọ tupu abanye na ngwaọrụ ndekọ. SOP) nke St. Paul's Hospital Millennium Medical College (SPHMMC).
Edebere data niile maka nyocha ahụ, tinye ya ugboro abụọ, wee nyochaa ya site na iji ụdị sọftụwia Statistical Package for the Social Sciences (SPSS) 23. Jiri ọnụ ọgụgụ nkọwa na mgbagha mgbagha iji tụọ ọnụ ọgụgụ siri ike na oge ntụkwasị obi 95% maka mgbanwe dị iche iche. P ụkpụrụ. <0.05 ka a tụlere dị ka ihe dị mkpa.
Enyere ndị nne na nna ma ọ bụ ndị nlekọta nke ndị na-amụ ihe ntụziaka kwesịrị ekwesị maka otu esi achịkọta mmamịrị urine dị ọcha nke dị n'etiti. , a na-ewere ihe nlele na ụlọ nyocha microbiology nke SPHMMC maka nhazi ọzọ. A na-etinye akụkụ nke ihe nlele ahụ na efere MacConkey agar (Oxoid, Basingstoke na Hampshire, England) na ọbara agar (Oxoid, Basingstoke na Hampshire, England) na ụlọ nchekwa nchekwa na-eji a 1 μL calibration loop. A na-etinye ihe nlele ndị fọdụrụ na ụbụrụ obi infusion agar agbakwunyere na chloramphenicol (100 μgml-1) na gentamicin (50 μgml-1) (Oxoid, Basingstoke, na Hampshire, England).
A na-etinye efere niile etinyere na ikuku ikuku na 37 ° C maka awa 18-48 wee lelee maka nje bacteria na / ma ọ bụ yist na-eto eto. Ọnụ ọgụgụ nke nje bacteria ma ọ bụ yist na-emepụta ≥105 cfu/mL mmamịrị ka a na-ewere dị ka ọganihu dị ukwuu. Ihe nlele urine na-enye ụdị atọ ma ọ bụ karịa echeghị maka nyocha ọzọ.
Ekewapụrụ iche iche nke nje nje na mbụ site na morphology colony, Gram staining.Gram-positive bacteria e jikwa catalase, bile aescin, pyrrolidinopeptidase (PRY) na oke bekee. Indole test, citrate utilization test, trisaccharide iron test, hydrogen sulfide (H2S) ule mmepụta, lysine iron agar test, motility test and oxidase test test) ruo n'ụdị ụdị).
Achọpụtara yists site na iji usoro nyocha oge niile dị ka ntụpọ Gram, nyocha tube embrayo, ịgba ụka carbohydrate na nyocha assimilation site na iji chromogenic medium (CHROMagar Candida medium, bioM'erieux, France) dịka ntuziaka onye nrụpụta si dị.
Ejiri Kirby Bauer disc mgbasa na Mueller Hinton agar (Oxoid, Basingstoke, England) dị ka Clinical Laboratory Standards Institute (CLSI) si kwuo, 24. A na-akwado nkwụsị nke nje nke ọ bụla dịpụrụ adịpụ na 0.5 mL nke efere na-edozi ahụ ma gbanwee maka turbidity. dakọtara ọkọlọtọ 0.5 McFarland iji nweta ihe dịka 1 × 106 colony-forming units (CFUs) kwa mL nke biomass. Tinye swab na-adịghị mma n'ime nkwusioru ma wepụ ihe karịrị ihe site na ịpị ya n'akụkụ akụkụ nke tube ahụ. etiti nke Mueller Hinton agar efere ma kesaa ya n'ụzọ ziri ezi. A na-etinye diski ọgwụ nje na Mueller Hinton agar seeded na onye ọ bụla dịpụrụ adịpụ n'ime nkeji iri na ise nke inoculation na incubated na 35-37 Celsius C maka awa 24. Jiri caliper tụọ ya. Dayameta nke mpaghara inhibition. A tụgharịrị mgbochi nke dayameta dị ka mmetụta (S), etiti (I), ma ọ bụ na-eguzogide (R) dị ka ụkpụrụ Clinical and Laboratory Standards Institute (CLSI) si kwuo24.Staphylococcus aureus (ATCC 25923), Escherichia coli (ATCC 25922) na Pseudomonas aeruginosa (ATCC 27853) ejiri mee ihe dị ka ụdị njikwa mma iji lelee ịdị irè nke ọgwụ nje.
Maka nje bacteria na-adịghị mma, anyị na-eji efere ọgwụ nje: 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).
Disiki na-egbochi nje maka gram-nke dịpụrụ adịpụ bụ: penicillin (nkeji 10);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 eji na ọmụmụ anyị bụ ngwaahịa nke Oxide, Basingstoke na Hampshire, England.
Dị ka e gosiri na Tebụl 1, ọmụmụ ihe a debanyere 227 (227) ndị ọrịa ụmụaka bụ ndị gosipụtara ma ọ bụ ndị a na-enyo enyo na ha nwere UTI ma zute akara nhọrọ. ya na nwanyi na nwoke ruru 1.6: 1. Ọnụ ọgụgụ nke ọmụmụ ihe na-agbanwe n'ofe dị iche iche, na ˂ 3 afọ otu nwere ọtụtụ ndị ọrịa (119; 52.4%), sochiri 13-15- afọ (37; 16.3%) na 3-6-afọ otu (31; 13.7%), n'otu n'otu. Ihe nyocha bụ tumadi obodo, na obodo-ime obodo ruru nke 2.4: 1 (Table 1).
Tebụl 1 Njirimara mmekọrịta ọha na eze nke isiokwu ọmụmụ yana ugboro ole ihe atụ dị mma na omenala (N= 227)
A hụrụ uto nke nje bacteria / yist dị mkpa na 65 nke 227 (227) nlele mmamịrị maka mkpokọta 28.6% (65/227), nke 21.6% (49/227) bụ nje nje, ebe 7 % (16/227) bụ ọrịa nje fungal. Ọnụ ọgụgụ nke UTI kachasị elu na 13-15 afọ otu na 17/37 (46.0%) na na 10-12 afọ otu ọ kasị ala na 2/21 (9.5%).Table 2. Ụmụ nwanyị nwere ọnụ ọgụgụ dị elu nke UTIs, 30/89 (33.7%), ma e jiri ya tụnyere 35/138 (25.4%) ụmụ nwoke.
N'ime nje bacteria 49 dịpụrụ adịpụ, 79.6% (39/49) bụ Enterobacteriaceae, nke Escherichia coli bụ nje bacteria na-ahụkarị maka 42.9% (21/49) nke mkpokọta nje bacteria, sochiri Klebsiella pneumoniae bacteria, na-aza 34.6% ( 17/49) nke nje bacteria. Acinetobacter nọchitere anya anọ (8.2%), nke na-abụghị gram-negative bacillus . 60.0%) bụ Enterococcus. N'ime 16 yist dịpụrụ adịpụ, 6 (37.5%) nọchitere anya C. albicans. N'ime 26 obodo nwetara uropathogens, 76.9% (20/26) bụ Escherichia coli na Klebsiella pneumoniae.Of the -enwetara uropathogens, 15/20 bụ nje nje bacteria. N'ime 19 ICU-enweta uropathogens, 10/19 bụ yists. N'ime 65 omenala mmamịrị mmamịrị, 39 (60.0%) nwetara ụlọ ọgwụ na 26 (40.0%). obodo enwetara (Table 3).
Tebụl 3 Nyochaa nlọghachi azụ nke ihe ize ndụ metụtara ọrịa urinary tract na ndị ọrịa ụmụaka nwere SPHMMC (n = 227)
N'ime ndị ọrịa ụmụaka 227, 129 nọ n'ụlọ ọgwụ maka ihe na-erughị ụbọchị 3, nke 25 (19.4%) bụ omenala, 120 nabatara n'ụlọ ọgwụ na-apụ apụ, nke 25 (20.8%) bụ omenala omenala, na 63 nwere. akụkọ ihe mere eme nke ọrịa urinary tract.N'ime ha, 23 (37.70%) dị mma maka ọdịbendị, 38 bụ maka catheter obibi, 20 (52.6%) dị mma maka ọdịbendị, yana 71 dị mma maka okpomọkụ ahụ> 37.5 Celsius C, nke 21 (29.6%). dị mma maka omenala (Table 3).
A na-enyocha ndị amụma UTI n'ụzọ dị iche iche, ha nwekwara ụkpụrụ nlọghachi azụ nke logistic maka ogologo oge ịnọ 3-6 ọnwa (COR 2.122; 95% CI: 3.31-3.43; P = 0.002) na catheterization (COR= 3.56; 95)% CI : 1.73–7.1;P = 0.001) . A na-eme nyocha nyocha ọtụtụ ugboro na ndị na-ebu amụma dị iche iche nke UTI na ụkpụrụ nlọghachi azụ ndị a: ogologo oge ịnọ 3-6 ọnwa (AOR = 6.06, 95% CI: 1.99-18.4; P = 0.01) na catheterization ( AOR = 0.28; 95% CI: 0.13-0.57, P = 0.04) . Ogologo oge ọnụnọ ụlọ ọgwụ nke ọnwa 3-6 na-ejikọta ọnụ ọgụgụ dị ukwuu na UTI (P = 0.01) .Nkwekọrịta nke UTI na catheterization bụkwa ihe ndekọ ọnụ ọgụgụ (P = 0.01). P=0.04) .Otú ọ dị, ebe obibi, mmekọahụ, afọ, isi iyi nke nnabata, akụkọ ihe mere eme nke UTI gara aga, ọnọdụ HIV, okpomọkụ ahụ, na ọrịa na-adịghị ala ala achọpụtaghị na ọ bụ ihe jikọrọ ya na UTI (Table 3).
Tebụl 4 na 5 na-akọwa usoro nhụsianya nke nje nje gram-negative na gram-positive bacteria na ọgwụ nje itoolu a tụlere. N'ime ọgwụ niile a nwalere, nje bacteria gram-adịghị mma bụ ndị kasị eguzogide ampicillin, cefazolin, na trimethoprim-sulfamethoxazole, na ọnụego nguzogide nke 100%, 92.1%, na 84.1%, n'otu n'otu.E.coli, ụdị ndị a na-enwetakarị, nwere nnukwu nguzogide ampicillin (100%), cefazolin (90.5%), na trimethoprim-sulfamethoxazole (80.0%). ka cefazolin na 88.2% ka trimethoprim/sulfamethoxazole Tebụl 4. A na-ahụta ọnụ ọgụgụ nguzogide kachasị elu (100%) nke nje bacteria gram-positive na trimethoprim/sulfamethoxazole, ma ihe niile dịpụrụ adịpụ nke nje bacteria Gram-positive (100%) nwere ike ịnweta oxacillin (100%). okpokoro 5).
Ọrịa mamịrị (UTIs) na-anọgide na-abụ otu n'ime ihe ndị na-ebute ọrịa na-efe efe na ụmụaka. Nchọpụta mbụ nke UTI na ụmụaka dị mkpa n'ihi na ọ nwere ike ịbụ ihe na-egosi adịghị mma nke akụrụ dị ka ọnyà, ọbara mgbali elu, na ọrịa akụrụ na njedebe nke njedebe. Ọmụmụ ihe anyị, ọnụ ọgụgụ nke ọrịa urinary tract bụ 28.6%, nke 21.6% kpatara ya site na nje bacteria na 7% site na fungal pathogens. na Etiopia site Merga Duffa et al.N'otu aka ahụ, 27.5% et al 19 Ihe omume UTI n'ihi yist na Etiopia, karịsịa ụmụaka, amaghị maka ntụaka anyị. Nke a bụ n'ihi na a na-ewerekarị ọrịa fungal dị ka ihe na-adịghị mkpa karịa ọrịa nje na nje virus na Etiopia. -ọrịa urinary tract induced na ndị ọrịa ụmụaka na-akọ na nchọpụta a bụ 7%, nke mbụ na mba ahụ. Ọnụ ọgụgụ nke UTI kpatara site na yist a na-akọ na ọmụmụ anyị na-adabere na ọnụ ọgụgụ 5.2% nke a na-akọ na ọmụmụ ihe na ụmụaka site na Seifi et al.25 Otú ọ dị, Zarei kọrọ akụkọ ihe mere eme nke 16.5% na 19.0% - Mahmoudabad et al 26 na Alkilani et al 27 na Iran na Egypt n'otu n'otu. Ọnụ ọgụgụ dị elu na ọmụmụ ihe abụọ a abụghị ihe ijuanya ebe ọ bụ na isiokwu ọmụmụ gụnyere ndị ọrịa ICU. na-enweghị mmasị afọ. Ọdịiche dị n'ọtụtụ UTI n'etiti ọmụmụ ihe nwere ike ịmalite site na ọdịiche dị na nhazi ọmụmụ, njirimara sociodemographic nke isiokwu ọmụmụ, na comorbidities.
N'ime ọmụmụ ihe ugbu a, 60% nke UTI nwetara ụlọ ọgwụ (ngalaba nlekọta ahụike na ụlọ ọrụ ward) .Aubron et al. Achọpụtara nsonaazụ ndị yiri ya (78.5%).28, ọ bụ ezie na mgbasa nke UTI na mba ndị ka na-emepe emepe dịgasị iche site n'ọmụmụ ihe na mpaghara, na-enweghị ọdịiche mpaghara na nje bacteria na fungal pathogens na-akpata UTI. Ọtụtụ nje bacteria na-enweta site na omenala mmamịrị bụ Gram-negative bacilli, tumadi Escherichia coli, sochiri Klebsiella. pneumoniae.6,29,30 N'ikwekọ na ọmụmụ ihe mbụ yiri nke ahụ, 29,30 ọmụmụ anyị gosikwara na Escherichia coli bụ nje bacteria na-emekarị. Bacteria a na-ahụkarị bụ 42.9% nke mkpokọta nje bacteria, sochiri Klebsiella pneumoniae, nke ruru 34.6% nke nje bacteria. ọrịa urinary tract na ntọala ụlọ ọgwụ, na candida na-ahụkarị na ngalaba nlekọta ahụike .31-33 N'ọmụmụ ihe anyị, Candida nwetara 7% nke UTI, 94% bụ ndị nosocomial-nwetara, nke 62.5% na-ahụ na ndị ọrịa ICU. .Candida albicans bụ isi ihe na-akpata candidiasis, na 81.1% nke Candida bụ ndị dịpụrụ adịpụ site na ward-enweta mmamịrị omenala-nke ọma na ICU-enwetara mma mmamịrị omenala samples.Our results bụghị ihe ijuanya ebe Candida bụ opportunistic pathogen nke nwere ike ịkpata ọrịa na. Ndị ọrịa na-egbochi ọnụ dị ka ndị ọrịa ICU.
N'ime ọmụmụ ihe a, ụmụ nwanyị na-enwekarị nsogbu karịa ndị nwoke na-ebute ọrịa urinary tract, na ndị ọrịa nọ na 12-15 dị afọ . Otú ọ dị, ọdịiche dị n'etiti ọnọdụ abụọ ahụ abụghị ihe ndekọ ọnụ ọgụgụ. Enweghị njikọ dị n'etiti UTI na okike na Enwere ike ịkọwa afọ site n'afọ ndị bụ isi bụ ndị a na-ewebata ndị ọrịa. N'iburu n'uche usoro ọrịa na-efe efe nke UTI, ihe omume nwoke na nwanyị n'ozuzu na-egosi na ha nhata n'oge ọ bụ nwata, na oke nwoke n'oge amụrụ ọhụrụ na oke nwanyị na nwata na nwata. na n'oge ọzụzụ ụlọ mposi. N'ime ihe ize ndụ ndị ọzọ a na-enyocha ọnụ ọgụgụ, ọnụnọ ụlọ ọgwụ nke 3-30 ụbọchị na-ejikọta ya na UTI (P = 0.01) . A na-ahụ njikọ n'etiti ogologo oge ụlọ ọgwụ na UTI na ọmụmụ ndị ọzọ.34,35 UTI na Ọmụmụ ihe anyị nwekwara njikọ dị ukwuu na catheterization (P=0.04) .Dịka Gokula et al.35 na Saint et al.36, catheterization mụbara ihe iyi egwu nke UTI site na 3 ruo 10%, dabere na ogologo oge nke catheterization. Ihe mgbochi mgbochi mgbochi n'oge ntinye catheter, ngbanwe nke catheter na-adịghị adịkarị, na nlekọta catheter na-adịghị mma nwere ike ime ka mmụba nke ọrịa urinary na-emetụta catheter.
N'ime oge ọmụmụ ihe, ọtụtụ ndị ọrịa ụmụaka na-erubeghị afọ atọ nabatara n'ụlọ ọgwụ nwere mgbaàmà nke ọrịa urinary tract karịa afọ ndị ọzọ. 39
N'ime ọmụmụ ihe a, nje bacteria na-adịghị mma bụ ndị kasị eguzogide ampicillin na trimethoprim-sulfamethoxazole, na ọnụ ọgụgụ nkwụsị nke 100% na 84.1%, n'otu n'otu. trimethoprim-sulfamethoxazole (81.0%). N'otu aka ahụ, ọnụ ọgụgụ kasị elu n'ozuzu nguzogide (100%) na nje bacteria gram-positive ka a hụrụ na trimethoprim/sulfamethoxazole. Ampicillin na trimethoprim-sulfamethoxazole ejiriwo ya mee ihe dị ka usoro ọgwụgwọ mbụ nke ọrịa urinary tract. na ụlọ ọrụ ahụike niile dị na Etiopia, dị ka ndị Ministry of Health's Standard Treatment Guidelines (STG) kwadoro .40-42 Ọnụ ọgụgụ nkwụsị nke gram-negative na gram-positive bacteria na ampicillin na trimethoprim-sulfamethoxazole na ọmụmụ ihe a. obodo na-abawanye ohere nke nhọrọ na mmezi nke nsogbu ndị na-eguzogide ọgwụ na ọnọdụ ahụ.43-45 N'aka nke ọzọ, nchọpụta anyị gosiri na amikacin na meropenem bụ ọgwụ kachasị mma megide nje bacteria gram-negative na oxacillin bụ ọgwụ kachasị mma megide Gram. -Bacteria dị mma.A na-ewepụta data dị n'isiokwu a site na akwụkwọ a na-ebipụtaghị nke Nuhamen Zena, bụ nke ebugoro na Ụlọ Ọrụ Ụlọ Akwụkwọ University Addis Ababa.46
N'ihi mmachi akụrụngwa, anyị enweghị ike ịme nnwale antifungal na nje fungal ndị achọpụtara na ọmụmụ a.
Ọnụ ọgụgụ zuru oke nke UTI bụ 28.6%, nke 75.4% (49/65) bụ UTI metụtara nje na 24.6% (19/65) bụ ihe yist kpatara UTI.Enterobacteriaceae bụ isi ihe na-ebute ọrịa urinary tract. Abụọ C. A na-ejikọta albicans na ndị na-abụghị albicans C. albicans na-ejikọta ya na UTIs na-akpata yist, karịsịa na ndị ọrịa ICU. Ogologo oge ọnụnọ ụlọ ọgwụ na catheterization nke 3 ruo 6 ọnwa na-ejikọta ya na UTI. Abụọ gram-negative na gram-positive bacteria bụ nke ukwuu. na-eguzogide ọgwụ ampicillin na trimethoprim-sulfamethoxazole nke Ministry of Health na-atụ aro maka ọgwụgwọ empiric nke UTIs. A ghaghị ịrụ ọrụ ọzọ na UTIs na ụmụaka, na ampicillin na trimethoprim-sulfamethoxazole kwesịrị ịtụgharị uche dị ka ọgwụ ndị a na-ahọrọ maka ọgwụgwọ ahụike nke UTIs.
Emere ọmụmụ ihe ahụ dị ka nkwupụta Helsinki si kwuo. A na-eleba anya n'echiche na ọrụ niile nke ọma na a na-eme nchọpụta ahụ site n'ikike ụkpụrụ omume na ikike SPHMMC sitere na Board Review Internal Review of Department of Medical Laboratory Sciences, Faculty of Health Sciences, Addis Mahadum Ababa.Ebe ọ bụ na ọmụmụ ihe anyị metụtara ụmụaka (ndị na-erubeghị afọ 16), ha enweghị ike ịnye ezi nkwenye ederede. Ya mere, nne na nna / onye nlekọta ga-emejupụta akwụkwọ nkwenye ahụ. Na nkenke, nzube nke ọrụ na ya. A na-akọwara ndị nne na nna / onye nlekọta ọ bụla uru nke ọma. A na-adụ ọdụ ka ndị nne na nna / ndị nlekọta na-edebe ihe ọmụma nke nwa ọ bụla na nzuzo. ekwetaghị isonye na ọmụmụ ihe ahụ. Ozugbo ha kwetara isonye na ọmụmụ ihe ma enweghị mmasị ịga n'ihu, ha nweere onwe ha ịhapụ ọmụmụ ihe n'oge ọ bụla n'oge ọmụmụ ihe.
Ọ ga-amasị anyị ikele onye dọkịta na-ahụ maka ụmụaka na-aga na saịtị ọmụmụ maka nyochaa siri ike nke ndị ọrịa site n'echiche ngosi ụlọ ọgwụ. Anyị na-enwekwa ekele dị ukwuu maka ndị ọrịa na-ekere òkè na ọmụmụ ihe ahụ. Anyị ga-achọkwa ikele Nuhamen Zena maka ikwe ka anyị nwee ike. wepụta data dị mkpa na nyocha ya na-ebipụtabeghị, bụ nke ebugoro na ebe nchekwa mahadum Addis Ababa.
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Oge nzipu: Eprel-14-2022