ʻO nā hiʻohiʻona bacteria a me nā fungal o nā maʻi urinary tract i nā maʻi pediatric

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Adane Bitew, 1 Nuhamen Zena, 2 Abera Abdeta31 Keʻena ʻOihana Lapaʻau Lapaʻau, Faculty of Health Science, Addis Ababa University, Addis Ababa, Ethiopia;2 Microbiology, Kula Millennium o Medicine, St Paul's Hospital, Addis Ababa, Keʻena ʻAitiopa;3 National Reference Laboratory for Clinical Bacteriology and Mycology, Ethiopian Institute of Public Health, Addis Ababa, Ethiopia Corresponding Author: Abera Abdeta, National Reference Laboratory for Clinical Bacteriology and Mycology, Ethiopian Institute of Public Health, PO Box: 1242, Addis Ababa, Ethiopia , +251911566420, leka uila [email protected] Background: He mau maʻi maʻamau ka UTI i nā keiki. : Ua hoʻoholo kēia haʻawina e hoʻoholo i ka etiology maʻamau a me ka prevalence o nā uropathogens pili a me nā maʻi urinary tract, a me nā ʻaoʻao o ka antibiotic susceptibility profiles o nā bacterial isolates, a e ʻike i nā mea pilikia e pili ana i nā maʻi urinary tract i nā maʻi pediatric. Ua mālama ʻia mai ʻOkakopa 2019 a Iulai 2020 ma ke Kula ʻo Millennium o Medicine, St. Paul's Hospital. kaʻina. prevalence o 28.6%, o ka 75.4% (49/65) a me 24.6% (16/65) he bacterial a me fungal pathogens. Ma kahi o 79.6% o na etiologies bacteria o Escherichia coli a me Klebsiella pneumoniae. 100%), cefazolin (92.1%) a me trimethoprim-sulfamethoxazole (84.1%), i hoʻohana mau ʻia ma ʻAitiopa. Nā hopena: Ua ʻike ʻia kā mākou noiʻi ʻana i ka nui o nā maʻi urinary tract. ʻO Enterobacteriaceae ke kumu nui o nā maʻi maʻi urinary. ampicillin and trimethoprim-sulfamethoxazole.Keywords: Antibiotic susceptibility patterns, Pediatrics, Urinary tract infections, Ethiopia
ʻO nā maʻi maʻi urinary tract (UTI) i hana ʻia e ka bacteria a me ka hū kekahi o nā maʻi maʻamau maʻamau i nā keiki. pili pū me ka maʻi maʻi pōkole, e like me ke kuni, dysuria, wikiwiki, a me ka ʻeha hope haʻahaʻa. Ua wehewehe ʻo 3 Wennerstrom et al15 i ka ʻili ʻana o ka renal ma kahi o 15% o nā keiki ma hope o ka UTI mua, e hōʻike ana i ke koʻikoʻi o ka ʻike wikiwiki a me ka mālama mua ʻana i nā maʻi maʻi urinary. 4 Ua hōʻike ʻia ka nui o nā noiʻi ʻana i nā UTI pediatric ma nā ʻāina ulu like ʻole ka nui o ka UTI mai 16% a 34%.5-9 Eia kekahi, a hiki i ka 8% o nā keiki mai 1 mahina a 11 mau makahiki e hoʻomohala ma kahi o hoʻokahi UTI10. a hiki i ka 30% o nā pēpē a me nā keiki i ʻike ʻia e loaʻa i nā maʻi hou i loko o nā mahina 6-12 mua ma hope o ka UTI mua .11
ʻO nā hua bacteria Gram-negative a me Gram-positive, a me kekahi mau ʻano Candida, hiki ke hoʻoulu i nā maʻi maʻi urinary tract.E.coli ke kumu maʻamau o nā maʻi ʻeha o ka mimi, a ukali ʻia e Klebsiella pneumoniae.12 Ua hōʻike ʻia nā haʻawina ʻo nā ʻano Candida, ʻo ia hoʻi ʻo Candida albicans, ke kumu maʻamau o ka maʻi Candida UTI i nā keiki. ʻOi aku ka maʻalahi o nā keikikāne i ka makahiki mua o ke ola, ma muli o nā ʻokoʻa o nā ʻano wahine, ʻoi aku ka nui o ka maʻi i nā kaikamahine, a ʻoi aku ka nui o nā pēpē kāne ʻoki poepoe ʻole ʻia.1,33 Antibiotic susceptibility patterns ʻokoʻa ka nui o nā uropathogens i ka manawa, ka wahi o ka maʻi, ka demographics, a me nā ʻano lapaʻau.​​​1
Ua manaʻo ʻia ʻo nā maʻi maʻi e like me ka UTI ke kuleana no ka 26% o ka make honua, 98% o ia mau mea ma nā ʻāina haʻahaʻa loaʻa. %.
He kakaikahi mau haʻawina i hōʻike i ka UTI i nā maʻi pediatric ma ʻAitiopa: nā haʻawina ma Hawassa Referral Hospital, Yekatit 12 Hospital, Felege-Hiwot Specialist Hospital a me Gondar University Hospital i hōʻike ʻia 27.5%, 19 15.9%, 20 16.7%, 21 a me 26.45% a me 22. .Ma nā ʻāina e ulu ana, me ʻAitiopia, ʻaʻole i kūpono ka nele o nā moʻomeheu mimi ma nā pae like ʻole o ka hoʻomaʻemaʻe ʻana no ka mea he kumu waiwai lākou. ʻO ka noiʻi ʻana e hoʻoholo i ka nui o nā maʻi maʻi urinary tract, ka nānā ʻana i nā pathogens bacterial a fungal e pili ana me UTI, e hoʻoholo i nā ʻaoʻao antimicrobial susceptibility o nā maʻi maʻi bacterial, a e ʻike i nā mea nui e pili ana i nā UTI.
Mai ʻOkakopa 2019 a Iulai 2020, ua mālama ʻia kahi noiʻi cross-sectional e pili ana i ka haukapila ma ka Paediatrics Department of St Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia.
I ka wā o ke aʻo ʻana, ʻike ʻia nā maʻi maʻi pediatric āpau a me nā maʻi ma waho i nā pediatrics.
I loko o ka wā aʻo, ua hele nā ​​maʻi pediatric a pau me nā hōʻailona a me nā hōʻailona UTI i ke kahua noiʻi.
Ua hoʻoholo ʻia ka nui o ka laʻana me ka hoʻohana ʻana i kahi ʻano helu helu hoʻohālike hoʻokahi me kahi manawa hilinaʻi 95%, 5% margin of error, a me ka prevalence o UTI i ka hana mua [15.9% a i ʻole P=0.159)] Merga Duffa et al20 ma Addis Ababa , e like me ka mea i hoikeia malalo iho nei.
Z α/2 = 95% hilinaʻi koʻikoʻi koʻikoʻi no ka puʻunaue maʻamau, e like me 1.96 (Z waiwai ma α = 0.05);
D = ka palena o ka hewa, e like me 5%, α = ka pae o ka hewa i makemake nā kānaka e ʻae;e hoʻopili i kēia mau mea i loko o ke kumu hoʻohālike, n= (1.96)2 0.159 (1–0.159)/(0.05)2=206 a manaʻo he 10% pane ʻole ʻia kahi n = 206+206/10 = 227.
Ua hoʻohana ʻia kahi ʻano laʻana maʻalahi ma kēia haʻawina. E hōʻiliʻili i ka ʻikepili a hiki i ka loaʻa ʻana o ka nui o ka laʻana i makemake ʻia.
Ua hōʻiliʻili ʻia ka ʻikepili ma hope o ka loaʻa ʻana o ka ʻae ʻike i kākau ʻia mai nā mākua. ʻO nā hiʻohiʻona sociodemographic (makahiki, ke kāne, a me kahi o ka noho ʻana) a me nā mea pilikia e pili ana (catheter, UTI mua, ke kūlana kanaka immunodeficiency virus (HIV), ʻoki poepoe, a me ka lōʻihi o ka noho maʻi). Ua hōʻiliʻili ʻia nā poʻe i komo i ke aʻo ʻana e nā kahu hānai kūpono me ka hoʻohana ʻana i ka ʻikepili i hōʻike mua ʻia.ʻO kahi nīnau nīnau i kūkulu ʻia no ka hoʻāʻo. Ua hoʻopaʻa ʻia nā hōʻailona a me nā hōʻailona o ka mea maʻi a me ka maʻi lalo e ka pediatrician hele.
Ma mua o ka hoʻopaʻa ʻana: ua hōʻiliʻili ʻia nā hiʻohiʻona sociodemographic (makahiki, kāne, etc.) a me ka ʻike lapaʻau a me ka mālama ʻana o nā poʻe komo haʻawina mai nā nīnau nīnau.
Nānā: Ua loiloi ka hana o ka autoclave, incubator, reagents, microscope, a me ka microbiological quality of medium (sterility of the medium and growth performance of every medium) e like me nā kaʻina hana maʻamau ma mua o ka hoʻohana ʻana. ma hope o nā kaʻina hana aseptic.Ua hana ʻia ka inoculation o nā hōʻailona lapaʻau ma lalo o kahi keʻena palekana lua.
Post-Analysis: Hoʻopaʻa ʻia nā ʻike āpau i unuhi ʻia (e like me nā hopena laboratory) no ka pono, piha a me ke kūlike a hoʻopaʻa ʻia ma mua o ke komo ʻana i nā mea hana helu. SOP) o ka Halemai o St. Paul's Millennium Medical College (SPHMMC).
Hoʻopili ʻia nā ʻikepili a pau no nā noiʻi, hoʻokomo pālua ʻia, a hoʻopaʻa ʻia me ka polokalamu Statistical Package for the Social Science (SPSS) version 23. E hoʻohana i nā helu wehewehe a me ka hoʻihoʻi logistic e koho i nā lakio koʻikoʻi me 95% mau manawa hilinaʻi no nā ʻokoʻa like ʻole. <0.05 i manaʻo nui ʻia.
Ua hōʻiliʻili ʻia nā laʻana mimi mai kēlā me kēia maʻi pediatric me ka hoʻohana ʻana i nā ipu mimi sterile. Ua hāʻawi ʻia nā mākua a i ʻole kahu o nā mea komo i ke aʻo ʻana i nā ʻōlelo aʻoaʻo kūpono e pili ana i ke ʻano o ka hōʻiliʻili ʻana i nā laʻana mimi maʻemaʻe i hopu ʻia. , lawe ʻia nā laʻana i ke keʻena microbiology o SPHMMC no ka hana hou ʻana. 1 μL calibration loop. Ua hoʻopaʻa ʻia nā mea i koe ma ka lolo infusion agar i hoʻohui ʻia me ka chloramphenicol (100 µgml-1) a me ka gentamicin (50 µgml-1) (Oxoid, Basingstoke, a me Hampshire, ʻEnelani).
Hoʻokomo ʻia nā papa a pau i hoʻoheheʻe ʻia i ka aerobically ma 37 ° C no nā hola 18-48 a nānā ʻia no ka ulu ʻana o ka hua bacteria a/a i ʻole ka hū. ʻaʻole i noʻonoʻo ʻia no ka hoʻokolokolo hou ʻana.
ʻO nā mea hoʻokaʻawale maʻemaʻe o nā pathogen bacteria i hōʻike mua ʻia e ka colony morphology, Gram staining. Gram-positive bacteria i hōʻike hou ʻia me ka catalase, bile aescin, pyrrolidinopeptidase (PRY) a me ka plasma rabbit. ho'āʻo indole, ho'āʻo hoʻohana citrate, ho'āʻo hao trisaccharide, ho'āʻo hana hydrogen sulfide (H2S), ho'āʻo lysine iron agar, ho'āʻo motility a me ka ho'āʻo oxidase) i ka pae ʻano.
Ua ʻike ʻia nā hū me ka hoʻohana ʻana i nā ʻano diagnostic maʻamau e like me ka Gram staining, embryo tube assays, carbohydrate fermentation and assimilation assays me ka hoʻohana ʻana i ke ʻano chromogenic (CHROMagar Candida medium, bioMʻerieux, Farani) e like me nā ʻōlelo a ka mea hana.
Ua hana ʻia ka hoʻāʻo ʻana i ka antimicrobial susceptibility e Kirby Bauer disc diffusion ma Mueller Hinton agar (Oxoid, Basingstoke, ʻEnelani) e like me nā alakaʻi Clinical Laboratory Standards Institute (CLSI) 24. Ua hoʻomākaukau ʻia nā hoʻokuʻu ʻana o kēlā me kēia kaʻawale i 0.5 mL o ka hupa nutrient a hoʻoponopono ʻia no ka turbidity e hoʻohālikelike i ka maʻamau 0.5 McFarland no ka loaʻa ʻana o 1 × 106 colony-forming units (CFUs) no ka mL o ka biomass. E kaomi i kahi swab sterile i loko o ka hoʻokuʻu ʻana a wehe i nā mea keu ma ke kaomi ʻana i ka ʻaoʻao o ka paipu. ke kikowaena o kahi pā Mueller Hinton agar a māhele like ʻia ma luna o ka waena. Ua kau ʻia nā disks antibiotic ma luna o Mueller Hinton agar i hoʻolaʻa ʻia me kēlā me kēia kaʻawale i loko o 15 mau minuke o ka inoculation a incubated ma 35-37 °C no nā hola 24. E hoʻohana i kahi caliper e ana i ka anawaena o ka wahi o ka inhibition.Diameter-area inhibition ua unuhi 'ia ma ke 'ano he sensitive (S), intermediate (I), a i 'ole resistant (R) e like me ka Clinical and Laboratory Standards Institute (CLSI) guidelines24.Staphylococcus aureus (ATCC 25923), Escherichia coli (ATCC 25922) a me Pseudomonas aeruginosa (ATCC 27853) i hoʻohana ʻia ma ke ʻano he ʻano hoʻomalu maikaʻi e nānā i ka pono o nā lāʻau antibiotic.
No nā hua bacteria Gram-negative, hoʻohana mākou i nā papa antibiotic: 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).
ʻO nā disks antibacterial no nā mea hoʻokaʻawale Gram-positive: penicillin (10 mau ʻāpana);cefoxitin (30 μg);nitrofurantoin (300 μg);vancomycin (30 μg);trimethoprim-sulfamethoxazole (1.25 / g) 23.75 μg);Ciprofloxacin (5 μg);ʻO Doxycycline (30 μg) .ʻO nā disiki antimicrobial a pau i hoʻohanaʻia i kā mākou aʻoʻana he huahana ia o Oxide, Basingstoke a me Hampshire,ʻEnelani.
E like me ka mea i hōʻike ʻia ma ka Papa 1, ua hoʻopaʻa inoa kēia haʻawina i nā maʻi pediatric 227 (227) i hōʻike a i manaʻo nui ʻia he UTI a hoʻokō i nā pae koho. me ka ratio o ka wahine a me ke kane o 1.6: 1. Ua loli ka heluna o na mea a'o ma na hui makahiki, me ka ˂ 3 makahiki ka nui o na ma'i (119; 52.4%), a ukaliia e ka 13-15- makahiki-makahiki (37; 16.3%) a me 3-6-makahiki-kahiko hui (31; 13.7%), i kēlā me kēia. ʻO nā mea noiʻi he mau kūlanakauhale nui, me ka lakene kūlanakauhale-kūlanakau o 2.4: 1 (Table 1).
Papa 1 Nā hiʻohiʻona Socio-demographic o nā kumuhana aʻo a me ka pinepine o nā laʻana moʻomeheu maikaʻi (N= 227)
Ua ʻike ʻia ka ulu nui ʻana o ka maʻi bacterial/yeast ma 65 o 227 (227) mau hōʻailona mimi no ka laha nui o 28.6% (65/227), ʻo 21.6% (49/227) nā pathogens bacteria, aʻo 7 % (16/227) ʻO ka maʻi maʻi fungal. ʻO ka prevalence o UTI ka mea kiʻekiʻe loa ma ka hui 13-15 makahiki ma 17/37 (46.0%) a ma ka pūʻulu makahiki 10-12 he haʻahaʻa loa ia ma 2/21 (9.5%). Papa 2) .He kiʻekiʻe ka nui o nā UTI i nā wahine, 30/89 (33.7%), i hoʻohālikelike ʻia me 35/138 (25.4%) kāne.
ʻO 49 mau mea hoʻokaʻawale bacteria, 79.6% (39/49) ʻo Enterobacteriaceae, a ʻo Escherichia coli ka maʻi bacteria maʻamau i helu ʻia no 42.9% (21/49) o nā mea maʻi bacterial a pau, a ukali ʻia e Klebsiella pneumoniae bacteria, helu no 34.6% ( 17/49) o na mea ma'i bacteria. Eha (8.2%) kaawale i hoikeia e Acinetobacter, he bacillus Gram-negative ole. ʻO 60.0%) ʻo Enterococcus. ʻO nā mea hū he 16, ʻo 6 (37.5%) i pani ʻia e C. albicans. No nā uropathogens i loaʻa i ke kaiāulu, 76.9% (20/26) ʻo Escherichia coli a me Klebsiella pneumoniae. No ka 20 ward -ua loaʻa nā uropathogens, 15/20 he bacterial pathogens.O ka 19 ICU-loaʻa uropathogens, 10/19 he hū.O ka 65 moʻomeheu-maikaʻi mimi samples, 39 (60.0%) i loaʻa i ka haukapila a me 26 (40.0%) i i loaʻa i ke kaiāulu (Table 3).
Papa 3 Logistic regression analysis o nā mea pilikia e pili ana i ka maʻi urinary tract i nā maʻi pediatric me SPHMMC (n = 227)
Ma waena o nā maʻi maʻi pediatric 227, ua hoʻopaʻa ʻia ʻo 129 i ka hale maʻi no ka liʻiliʻi ma mua o 3 mau lā, ʻo 25 (19.4%) ka moʻomeheu-maikaʻi, 120 i hoʻokomo ʻia i ka hale maʻi outpatient, nona ka 25 (20.8%) he moʻomeheu-maikaʻi, a ʻo 63 i loaʻa. he moʻolelo o ka maʻi mimi.Ma waena o lākou, he 23 (37.70%) maikaʻi no ka moʻomeheu, 38 no ka catheter indwelling, 20 (52.6%) maikaʻi no ka moʻomeheu, a he 71 maikaʻi no ka wela o ke kino> 37.5 ° C, ʻo 21 (29.6%). ua maikaʻi no ka moʻomeheu (Table 3).
Ua kālailai ʻia nā wānana o UTI, a ua loaʻa iā lākou nā waiwai regression logistic no ka lōʻihi o ka noho ʻana 3-6 mahina (COR 2.122; 95% CI: 3.31-3.43; P=0.002) a me ka catheterization (COR= 3.56; 95)% CI : 1.73–7.1;P = 0.001) . Ua hanaʻia ka hoʻoponopono houʻana ma luna o nā mea wānana koʻikoʻi nui o ka UTI me nā koina hoʻololi logistic: lōʻihi o ka nohoʻana 3-6 mahina (AOR = 6.06, 95% CI: 1.99-18.4; P = 0.01) a me ka catheterization ( AOR = 0.28; 95% CI: 0.13-0.57, P = 0.04). ʻO ka lōʻihi o ka noho maʻi o 3-6 mahina i pili nui i ka UTI (P = 0.01). P = 0.04). Akā naʻe,ʻaʻole iʻike nuiʻia ka pilina o ka noho, ke kāne, ka makahiki, ke kumu o ke komoʻana, ka moʻolelo mua o ka UTI, ke kūlana HIV, ka mahana o ke kino, a me ka maʻi maʻi mau loa me UTI (Table 3).
Hōʻike nā papa 4 a me 5 i nā ʻano maʻamau antimicrobial āpau o Gram-negative a me Gram-positive bacteria i nā lāʻau ʻeiwa i loiloi ʻia. ʻO Amikacin a me meropenem nā lāʻau lapaʻau maikaʻi loa i hoʻāʻo ʻia e kūʻē i ka bacteria Gram-negative, me nā helu kū'ē o 4.6% a me 9.1%, Ma waena o nā lāʻau lapaʻau a pau i ho'āʻoʻia,ʻo Gram-negative bacteria ka mea kū'ē loa i ka ampicillin, cefazolin, a me ka trimethoprim-sulfamethoxazole, me nā helu kū'ē o 100%, 92.1%, a me 84.1%.coli, ka mea maʻamau i hoʻōla hou ʻia, ʻoi aku ka nui o ke kūʻē ʻana i ka ampicillin (100%), cefazolin (90.5%), a me trimethoprim-sulfamethoxazole (80.0%). ʻO Klebsiella pneumoniae ka lua o ka maʻi bacteria i hoʻokaʻawale pinepine ʻia, me ka helu kūʻē o 94.1% i ka cefazolin a me ka 88.2% i ka trimethoprim/sulfamethoxazole Papa 4. ʻO ke kiʻekiʻe kiʻekiʻe kiʻekiʻe kiʻekiʻe holoʻokoʻa pākēneka (100%) o Gram-maikaʻi bacteria ua nānā 'ia ma trimethoprim / sulfamethoxazole, akā naʻe a pau isolates o Gram-positive bacteria (100%) hiki i ka oxacillin ( papa 5).
ʻO nā maʻi maʻi urinary tract (UTI) kekahi o nā kumu maʻamau o ka maʻi maʻi i ka hana pediatric. ʻO kā mākou noiʻi, ʻo ka prevalence o nā maʻi urinary tract he 28.6%, nona ka 21.6% i kumu ʻia e nā maʻi bacterial a me 7% e nā pathogens fungal. ma ʻAitiopa e Merga Duffa et al.Pēlā nō, ʻo 27.5% et al 19 ʻAʻole ʻike ʻia ka nui o nā UTI ma muli o ka hū ma ʻAitiopa, ʻoi aku ka nui o nā keiki, no kā mākou ʻike. -induced urinary tract maʻi i loko o nā maʻi pediatric i hōʻikeʻia ma kēia haʻawina he 7%, ka mea mua ma ka'āina.ʻO ka nui o nā UTI i hanaʻia e ka mea hū i hōʻikeʻia i loko o kā mākou aʻoʻana ua kūlike me ka nui o 5.2% i hōʻikeʻia i loko o kahi haʻawina i nā keiki e Seifi et al.25 Eia naʻe, ua hōʻike ʻo Zarei i kahi prevalence o 16.5% a me 19.0% - Mahmoudabad et al 26 a me Alkilani et al 27 ma Iran a me ʻAigupita, ʻo ia hoʻi. me ka makemake ole o na makahiki. Hiki i ka like ole o ka laha o ka UTI ma waena o na ha'awina mai ka like'ole o ka ho'olālā a'o, nā hi'ohi'ona sociodemographic o nā kumuhana a'o, a me nā comorbidities.
Ma ka haʻawina o kēia manawa, 60% o nā UTI i loaʻa i ka haukapila (ʻoihana mālama kino a loaʻa i ka hale mālama). Ua ʻike ʻia nā hopena like (78.5%) e Aubron et al.28, ʻoiai ua ʻokoʻa ka laha ʻana o nā UTI ma nā ʻāina e ulu nei ma ke aʻo ʻana a me ka ʻāina, me ka ʻole o nā ʻokoʻa kūloko o nā pathogen bacteria a me nā fungal e hoʻoulu ai i ka UTI. pneumoniae.6,29,30 Kūlike me nā haʻawina mua like, 29,30 ua hōʻike pū kā mākou noiʻi ʻana ʻo Escherichia coli ka bacteria maʻamau. ʻO ka maʻi bacterial Escherichia coli ka mea maʻamau maʻamau i nā UTI i loaʻa i ke kaiāulu a me ka haukapila (57.1% a me 42.9%). ʻO nā maʻi maʻi urinary tract ma nā halemai, a ʻo ka candida ka mea maʻamau i nā keʻena mālama koʻikoʻi.31-33 Ma kā mākou noiʻi, ʻo Candida ka 7% o UTI, 94% o ia mau nosocomial-loaʻa, a ʻo 62.5% i nānā ʻia i nā maʻi ICU ʻO Candida albicans ke kumu nui o ka candidiasis, a ʻo 81.1% o Candida i hoʻokaʻawale ʻia mai ka mālama ʻana i ka moʻomeheu mimi maikaʻi a me ka ICU i loaʻa i nā ʻano moʻomeheu mimi maikaʻi. nā maʻi immunocompromised e like me nā maʻi ICU.
I loko o kēia haʻawina, ua ʻoi aku ka maʻalahi o nā wahine ma mua o nā kāne i ka maʻi urinary tract, a ʻoi aku ka maʻalahi o nā maʻi i ka makahiki 12-15. Akā naʻe, ʻaʻole i helu ʻia ka ʻokoʻa ma waena o nā kūlana ʻelua. ʻO ka nele o ka pilina ma waena o UTI a me ke kāne a Hiki ke wehewehe ʻia ka makahiki e ka pūʻulu makahiki mua kahi i kiʻi ʻia ai nā maʻi. Ma muli o nā ʻano maʻi maʻi i ʻike ʻia o ka UTI, ʻike pinepine ʻia ka nui o nā kāne a me nā wahine i ka wā kamaliʻi, me ka nui o nā kāne i ka wā neonatal a me ka nui o ka wahine i ka wā kamaliʻi. a i ka wā hoʻomaʻamaʻa halepaku. Ma waena o nā kumu pilikia i hoʻopaʻa ʻia i ka helu helu, ʻo ka noho ʻana o ka haukapila o 3-30 mau lā i pili pū me UTI (P=0.01). Ua ʻike ʻia kahi pilina ma waena o ka lōʻihi o ka noho maʻi a me ka UTI i nā haʻawina ʻē aʻe.34,35 UTI ma ʻO kā mākou haʻawina i pili nui pū me ka catheterization (P = 0.04). Wahi a Gokula et al.35 a me Saint et al.36, hoʻonui ka catheterization i ka hoʻoweliweli o nā UTI ma 3 a 10%, ma muli o ka lōʻihi o ka hoʻopaʻa ʻana.
I ka wā o ke aʻo ʻana, ʻoi aku ka nui o nā maʻi pediatric ma lalo o ʻekolu mau makahiki i komo i ka haukapila me nā hōʻailona o ka maʻi urinary tract ma mua o nā hui makahiki ʻē aʻe. 39
I loko o kēia noiʻi ʻana, ʻo nā bacteria Gram-negative ka mea kūʻē loa i ka ampicillin a me ka trimethoprim-sulfamethoxazole, me ka nui o ke kū'ē ʻana o 100% a me 84.1%, pakahi. trimethoprim-sulfamethoxazole (81.0%).Pēlā, ʻo ka helu kūʻē kiʻekiʻe kiʻekiʻe loa (100%) i ka Gram-positive bacteria i ʻike ʻia ma trimethoprim/sulfamethoxazole. Ua hoʻohana nui ʻia ʻo Ampicillin a me trimethoprim-sulfamethoxazole ma ke ʻano he lāʻau lapaʻau mua o nā maʻi maʻi urinary. ma nā keʻena olakino a pau ma ʻAitiopia, e like me ka ʻōlelo ʻia e ke Kuhina Ola ʻo Standard Treatment Guidelines (STG).40-42 Resistance rate of gram-negative and gram-positive bacteria to ampicillin and trimethoprim-sulfamethoxazole in this study. ke hoʻonui nei ke kaiāulu i ke koho a mālama ʻana i nā ʻano mea kūʻē i kēlā ʻano. -Bacteria maikaʻi. Lawe ʻia ka ʻikepili ma kēia ʻatikala mai kahi pepa i paʻi ʻole ʻia e Nuhamen Zena, i hoʻouka ʻia i ka Addis Ababa University Institutional Repository.46
Ma muli o ke kaohi ʻana i nā kumuwaiwai, ʻaʻole hiki iā mākou ke hana i ka hoʻāʻo ʻana i ka antifungal susceptibility i nā pathogens fungal i ʻike ʻia ma kēia noiʻi.
He 28.6% ka laha nui o na UTI, a he 75.4% (49/65) o na UTI pili i ka bacteria a he 24.6% (19/65) he mau UTI kumu hu. Enterobacteriaceae ke kumu nui o na ma'i ma'i urinary tract. albicans a me non-albicans C. albicans ua pili pū me ka hū-i hoʻokomo ʻia i ka UTI, ʻoi aku hoʻi i nā poʻe maʻi ICU. ʻO ka lōʻihi o ka noho ʻana i ka haukapila a me ka catheterization o 3 a 6 mau mahina ua pili nui me ka UTI. kū'ē i ka ampicillin a me ka trimethoprim-sulfamethoxazole i ʻōlelo ʻia e ke Kuhina Ola no ka mālama ʻana i nā UTI.
Ua mālama ʻia ke aʻo ʻana e like me ka Declaration of Helsinki. Ua hoʻoponopono pono ʻia nā noʻonoʻo pono a me nā kuleana āpau a ua mālama ʻia ka noiʻi me ka ʻae kūpono a me ka ʻae SPHMMC mai ka Papa Hoʻoponopono Kūloko o ka Department of Medical Laboratory Sciences, Faculty of Health Sciences, Addis Ke Kulanui o Ababa. No ka mea, ua pili kā mākou haʻawina i nā keiki (ma lalo o 16 mau makahiki), ʻaʻole hiki iā lākou ke hāʻawi i ka ʻae palapala maoli. No laila, e hoʻopiha ʻia ka palapala ʻae e ka makua / kahu. Ua wehewehe pono ʻia nā pōmaikaʻi i kēlā me kēia makua. ʻAʻole ʻae lākou e komo i ka haʻawina. Ke ʻae lākou e komo i ke aʻo ʻana a ʻaʻole makemake lākou e hoʻomau, hiki iā lākou ke haʻalele i ka haʻawina i kēlā me kēia manawa i ka wā o ke aʻo ʻana.
Makemake mākou e hoʻomaikaʻi aku i ka pediatrician e hele ana ma ke kahua aʻo no ka loiloi koʻikoʻi o nā maʻi mai kahi hiʻohiʻona hōʻike hōʻike. e unuhi i ka ʻikepili koʻikoʻi mai kāna noiʻi ʻaʻole i paʻi ʻia, i hoʻouka ʻia i ka waihona waihona ʻo Addis Ababa University.
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