期刊论文详细信息
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Increasing ciprofloxacin resistance of isolates from infected urines of a cross-section of patients in Karachi
Marium Jamil1  Muhammad Yasin Bandukda1  Akhtar Amin Memon1  Farhan Essa Abdullah2 
[1] Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan;Department of Pathology, Sindh Medical College, Dow University of Health Sciences, Essa Lab, B-122, Block-H, Shahrah-e-Jahangir, Karachi, Pakistan
关键词: Karachi;    Ciprofloxacin;    Isolates;    Urine;   
Others  :  1165015
DOI  :  10.1186/1756-0500-5-696
 received in 2012-03-07, accepted in 2012-12-20,  发布年份 2012
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【 摘 要 】

Background

The objective of the research was to evaluate the current effectiveness of Ciprofloxacin on the uropathogens prevalent in infected urines of a cross-section of patients in Karachi, Pakistan.

Findings

An observational study conducted in a private diagnostic laboratory and its branches in key areas of Karachi City from February 2010 to July 2011. A total of 2963 consecutive urine samples were cultured on chocolate agar, CLED medium and selective EMB agar. Growth of possible uropathogens was noted, and compared retrospectively with earlier lab data of suggestive urine cultures (n = 1997) recorded during January 2009 and December 2009. The isolates were identified using routine procedures and the API 20 system and evaluated for their sensitivity to ciprofloxacin by Kirby-Bauer disk diffusion method. Data was subjected to statistical analysis on SPSS version 16. Out of the present-day culture-positive urines, 2409 (80.4%) yielded gram-negative rods, and 554 (18.5%) gram-positive cocci. E.coli (43.1%) was most frequent, followed by Klebsiella pneumoniae (22.4%) and Staphylococcus aureus (15.5%). 57.2% of the Gram-negative bacteria and 48.7% of the Gram-positive isolates were resistant to ciprofloxacin. In the earlier (2009) screening, 39% of Gram-negative rods and 48% of Gram-positive cocci were indifferent to the drug.

Conclusions

A decrease in bacterial susceptibility of uropathogens to ciprofloxacin, a commonly prescribed drug in our population, is underlined, occurring possibly due to overuse pressure. Empirical initial treatment with ciprofloxacin would be inadequate in more than half of UTI cases, thereby counseling increased C/S testing of urines to provide existing sensitivity data for apt drug prescription.

【 授权许可】

   
2012 Abdullah et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Foxman B, Brown P: Epidemiology of Urinary tract infections transmission and risk factors, incidence and costs. Infect Dis Clin North Am 2003, 17:227-241.
  • [2]Scottish Intercollegiate Guidelines Network (SIGN): Management of suspected bacterial urinary tract infection in Adults. Edinburgh (Scotland): A national clinical guideline; 2006. Publication no. 88
  • [3]LeBel M: Ciprofloxacin: chemistry, mechanism of action, resistance, antimicrobial spectrum, pharmacokinetics, clinical trials, and adverse reactions. Pharmacotherapy 1988, 8:3-33.
  • [4]Bleidorn J, Gagyor I, Kochen MM, Wegscheider K, Hummers-Pradier E: Symptomatic treatment (ibuprofen) or antibiotics (ciprofloxacin) for uncomplicated urinary tract infection? - results of a randomized controlled pilot trial. BMC Med 2010, 26(8):30.
  • [5]Nizami SQ, Khan IA, Farooqui B: Treatment of UTI in children in Karachi, Pakistan: which antibiotic to use? Infect Dis J Pak 1997, Jul-Sep:25-26.
  • [6]Farooqui BJ, Khurshid M, Alam M: Urinary tract infections. J Pak Med Assoc 1989, 39:129-131.
  • [7]Farajnia S, Alikhani MY, Ghotaslou R, Naghili B, Nakhlband A: Causative agents and antimicrobial susceptibilities of urinary tract infections in the northwest of Iran. Int J Infect Dis 2009, 13(2):140-144.
  • [8]Abmed A, Zafar A, Rizvi S, et al.: Quinolone resistance among common urinary tract pathogens E.coli and Kiebsiella Infect. Dis J Pak 2000, 7:1211.
  • [9]Gupta V, Yadav A, Joshi RM: Antibiotic resistance pattern in uropathogens. Indian J Med Microbiol 2002, 20(2):96-98.
  • [10]Antibiotic pattern of pathology Laboratory: Antibiotic susceptibility repoil Jan-June 1997. Aga khan university hospital J Pak. Med Assoc 1998, 48:24.
  • [11]Khan FA, Siddiqui SH, Bailey E: Urinary tract infection: a survey of the prevalent strains and their sensitivity. J Pak Med Assoc 1981, 31:259-262.
  • [12]Ronald A: The etiology of urinary tract infection: traditional and emerging pathogens. Am J Med 2002, 113(Suppl. 1):14S-19S.
  • [13]Anbumani N, Mallika M: Antibiotic resistance pattern in uropathogens in a tertiary care hospital. Indian J Pract Doctor 2007, 4(1):204-207.
  • [14]Mughal MSN, Asghar MT, Zia MA, Ismail T: Comparison of the antibacterial activities of different brands of Ciprofloxacin. Revista UDO Agrícola 2009, 9(3):700-704.
  • [15]Nicolle LE: The prevention of hospital-acquired urinary tract infection. Clin Infect Dis 2008, 46(2):251-253.
  • [16]Acar JF, Goldstein FW: Consequences of increasing resistance to antimicrobial agents. Clin Infect Dis 1998, 27(1):125-130.
  • [17]Clec’h C, Schwebel C, Francais A, Toledano D, Fosse JP, Garrouste-Orgeas M, et al.: Does catheter associated urinary tract infection increase mortality in critically Ill patients? Infect Contr Hosp Epidemiol 2007, 28(12):1367-1373.
  • [18]Ramzan M, Bakhsh S, Salam A, Khan GM, Junaid M: Comparative study of various growth media in isolation of urinary tract pathogens. Gomal J Med Sc 2004, 2(1):16-19.
  • [19]Le TP, Miller GL: Empirical therapy for uncomplicated urinary tract infections in an Era of increasing antimicrobial resistance: a decision and cost analysis. Clin Infect Dis 2001, 33(5):615-621.
  • [20]Boerema J, Boll B, Muytjens H, Branolte J: Efficacy and safety of ciprofloxacin (Bay 0 9867) in the treatment of patients with complicated urinary tract infections. J Antimicrob Chemother 1985, 16(2):211-217.
  • [21]Talan DA, Krishnadasan A, Abrahamian FM, Stamm WE, Moran GJ, Emergency ID net study group: Prevalence and risk factor analysis of trimethoprim-sulfamethoxazole— and fluoroquinolone-resistant Escherichia coli infection among emergency department patients with pyelonephritis. Clin Infect Dis 2008, 47(9):1150-1158.
  • [22]Karlowsky JA, Kelly LJ, Thornberry C, Jones ME, Sahm DF: Trends in antimicrobial resistance among urinary tract infection isolates of Escherichia coli from female outpatients in the united states. Antimicrob Agents Chemother 2002, 46(8):2540-2545.
  • [23]Astal ZE: Increasing ciprofloxacin resistance among prevalent urinary tract bacterial isolates in Gaza strip. Palestine J Biomed Biotec 2005, 3:238-241.
  • [24]Orenstein R, Wong ES: Urinary tract infections in adults. Am Fam Physician 1999, 59(5):1225-1234.
  • [25]Mouton CP, Pierce B, Espino DV: Common infections in older adults. Am Fam Physician 2001, 63(2):257-269. 15
  • [26]Spence J, Ross J: Urinary tract infections in children. CJEM 2001, 2(3):197-200.
  • [27]Ackermann RJ, Monroe PW: Bacteremic urinary tract infection in older people. J Am Geriatr Soc 1996, 44(8):927-933.
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