O uiga faʻamaʻi ma faʻamaʻi o faʻamaʻi pipisi o le urinary i maʻi tamaiti

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Adane Bitew, 1 Nuhamen Zena, 2 Abera Abdeta31 Matagaluega o Suʻesuʻega Faʻasaienisi Faʻatekonolosi, Faculty of Health Sciences, Addis Ababa University, Addis Ababa, Etiopia;2 Microbiology, A'oga Meleniuma o Vailaau Fa'afomai, Falemai St Paul, Addis Ababa, Matagaluega a Etiopia;3 National Reference Laboratory for Clinical Bacteriology and Mycology, Ethiopian Institute of Public Health, Addis Ababa, Etiopia Faʻasalalau Tusitala: Abera Abdeta, National Reference Laboratory for Clinical Bacteriology and Mycology, Ethiopian Institute of Public Health, PO Box: 1242, Addis Ababa, Etiopia , +251911566420, imeli [imeli puipuia] Faʻamatalaga: UTI o faʻamaʻi masani i tamaiti. O le malamalama i mafuaʻaga masani o faʻamaʻi pipisi o le urinary, o latou mamanu o faʻamaʻi faʻamaʻi faʻamaʻi, ma aʻafiaga e aʻafia ai i tulaga faʻapitoa e mafai ona maua ai faʻamaoniga mo togafitiga talafeagai o mataupu. : O lenei suʻesuʻega e faʻamoemoe e fuafua le masani masani ma le faʻateleina o uropathogens e fesoʻotaʻi ma faʻamaʻi pipisi o le urinary, faʻapea foʻi ma faʻamatalaga faʻamaʻi faʻamaʻi faʻamaʻi o faʻamaʻi pipisi, ma ia iloa ai tulaga lamatia e fesoʻotaʻi ma faʻamaʻi pipisi o le urinary i tamaiti maʻi. na faia mai ia Oketopa 2019 ia Iulai 2020 i le Millennium School of Medicine, St. Paul's Hospital. O le mimi o le maʻi e aoina aseptically, tui i luga o ala o faasalalauga, ma incubated i le 37 ° C mo le 18-48 itula. O siama ma le fefete na iloa e tusa ai ma tulaga masani. fa'ata'ita'iga. Fa'ata'ita'iga susceptibility antibiotic o fa'ama'i fa'ama'i e fa'aaoga ai le Kirby Bauer disc diffusion method. Fa'amatalaga fa'amatalaga ma logistic regression na fa'aogaina e fa'atatau ai fua fa'atatau ma 95% fa'atuatuaina vaeluaga.P-value taunu'uga: Fa'atupu tele siama / fungal na matauina i 65 fa'ata'ita'iga ma se fa'ateleina o le 28.6%, o le 75.4% (49/65) ma le 24.6% (16/65) o siama siama ma fungal pathogens, i le faasologa. E tusa ma le 79.6% o etiologies siama o Escherichia coli ma Klebsiella pneumoniae. Resistance na maualuga i ampicillin ( 100%), cefazolin (92.1%) ma trimethoprim-sulfamethoxazole (84.1%), lea e masani ona faʻaaogaina faʻamalosi i Etiopia. Le umi o le falemaʻi (P = 0.01) ma le faʻamaʻi (P = 0.04) na faʻatatauina faʻatasi ma faʻamaʻi pipisi o le urinary. Fa'ai'uga: O la matou su'esu'ega na maitauina ai le maualuga o le fa'ama'i o le urinary tract infections.Enterobacteriaceae o le mafua'aga autu lea o fa'ama'i pipisi.O le umi o le nofo i le falema'i ma le catheterization na matua feso'ota'i ma fa'ama'i pipisi. ampicillin ma trimethoprim-sulfamethoxazole. Upu autu: Fa'ata'ita'iga fa'ama'i fa'ama'i, Pediatrics, Fa'ama'i fa'ama'i toto, Etiopia
O fa'ama'i pipisi o le urinary tract (UTIs) e mafua mai i siama ma le fefete o se tasi lea o fa'ama'i fa'ama'i masani i tamaiti. e fesoʻotaʻi ma faʻamaʻi puʻupuʻu, e aofia ai le fiva, dysuria, faanatinati, ma le maualalo o le tiga i tua. 3 Wennerstrom et al15 faʻamatalaina le maʻila o le fatu i le tusa ma le 15% o tamaiti pe a maeʻa le UTI muamua, faʻamamafaina le taua o le vave suʻesuʻeina ma le vave togafitiga o faʻamaʻi pipisi o le urinary. 4 Le tele o suʻesuʻega o tamaiti UTI i atunuʻu atinaʻe eseese ua faʻaalia ai o le taatele o UTI e eseese mai le 16% i le 34%.5-9 E le gata i lea, e oʻo atu i le 8% o tamaiti mai le 1 masina i le 11 tausaga o le a atiaʻe a itiiti ifo ma le tasi le UTI10, ma e oo atu i le 30% o pepe ma tamaiti ua iloa e toe maua pea i totonu o le 6-12 masina muamua ina ua uma le uluai UTI .11
Gram-negative ma Gram-positive bacteria, fa'apea fo'i ma nisi ituaiga o Candida, e mafai ona mafua ai fa'ama'i pipisi o le urinary tract.E.coli o le mafuaʻaga sili ona taatele o faʻamaʻi pipisi o le urinary, sosoo ai ma le Klebsiella pneumoniae.12 O suʻesuʻega ua faʻaalia ai o ituaiga o Candida, aemaise lava Candida albicans, o loʻo tumau pea le mafuaʻaga masani o le Candida UTI i tamaiti. mea taua mo UTI i tamaiti.O tama e sili atu ona vaivai i le tausaga muamua o le olaga, a maeʻa, ona o eseesega i totoga feusuaʻiga, o le aʻafiaga e sili atu ona maualuga i teine, ma o tama tane e leʻi peritomeina e maualuga atu le lamatiaga. ole uropathogens e fesuisuia'i ile taimi, nofoaga fa'afanua o tagata ma'i, fa'asologa o tagata, ma uiga fa'afoma'i.​​​1
O faʻamaʻi pipisi e pei o UTI e manatu e mafua ai le 26% o maliu i le lalolagi, 98% o ia mea e tupu i atunuu maualalo tupe maua.14 O se suʻesuʻega o tamaiti maʻi i Nepal ma Initia na lipotia ai le faʻateleina o UTI o le 57%15 ma le 48 %, 16. O se suesuega a le falemai o tamaiti Aferika i Saute na faaalia ai o faamai o le urinary tract na mafua ai le 11% o faamai o le soifua maloloina.17 O se isi suesuega i Kenya na maua ai o faamai o le urinary tract e tusa ma le 11.9% o le mamafa o faamai fiva i tamaiti laiti.18
E itiiti ni suʻesuʻega ua faʻaalia UTI i tamaiti maʻi i Etiopia: suʻesuʻega i le Hawassa Referral Hospital, Yekatit 12 Hospital, Felege-Hiwot Specialist Hospital ma Gondar University Hospital na faʻaalia 27.5%, 19 15.9%, 20 16.7%, 21 ma 26.45% ma 22, faasologa. .I atunuʻu atinaʻe, e aofia ai Etiopia, o le leai o ni aganuʻu urine i tulaga eseese o le tumama e tumau pea le le aoga ona o loʻo i ai le tele o punaoa. su'esu'ega e fa'atatau e iloa ai le fa'atuputeleina o fa'ama'i fa'ama'i, au'ili'ili fa'ama'i fa'ama'i ma fa'ama'i fa'ama'i e feso'ota'i ma UTI, fa'amautu fa'amatalaga e mafai ona fa'ama'i fa'ama'i fa'ama'i fa'ama'i, ma fa'ailoa mea taua e ono a'afia ma UTI.
Mai ia Oketopa 2019 ia Iulai 2020, na faia ai se suʻesuʻega faʻasolosolo faʻavae ile falemaʻi ile Paediatrics Department of St Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Etiopia.
I le vaitaimi o su'esu'ega, sa va'aia uma tamaiti i totonu o le falema'i ma gasegase i fafo i tamaiti.
I le vaitaimi o le su'esu'ega, sa auai uma tagata ma'i i totonu o tamaiti ma gasegase i fafo e iai fa'ailoga ma fa'ailoga UTI i le nofoaga o su'esu'ega.
O le tele o faʻataʻitaʻiga na fuafuaina e faʻaaoga ai se fua faʻatatau o le fua faʻatatau o le lapoʻa faʻatasi ma le 95% taimi faʻamaonia, 5% margin o mea sese, ma le faʻateleina o UTI i galuega muamua [15.9% poʻo P = 0.159)] Merga Duffa et al20 i Addis Ababa , e pei ona faaalia i lalo.
Z α / 2 = 95% faʻamaonia taimi taua taua mo le tufatufaina masani, tutusa ma le 1.96 (Z tau ile α = 0.05);
D = pito o mea sese, tutusa ma le 5%, α = o le maualuga o mea sese e naunau tagata e faʻafeiloaʻi;fa'apipi'i nei mea i le fua fa'atatau, n= (1.96)2 0.159 (1–0.159)/(0.05)2=206 ma fa'apea 10% e le'i taliina pe a n = 206+206/10 = 227.
Sa fa'aogaina se metotia fa'ata'ita'iga talafeagai i lenei su'esu'ega. Aoina fa'amaumauga se'ia maua le tele o fa'ata'ita'iga mana'omia.
Na aoina mai faʻamatalaga ina ua uma ona maua le faʻatagaga tusitusia mai matua. O uiga faʻa-sociodemographic (tausaga, itupa, ma le nofoaga e nofo ai) ma faʻalavelave faʻalavelave faʻapitoa (catheter, UTI muamua, tulaga o le virus immunodeficiency tagata (HIV), peritomeina, ma le umi o le falemaʻi). o tagata suʻesuʻe sa aoina e tausisoifua agavaa e faʻaaoga ai faʻamaumauga muamua.O se su'esu'ega fa'atulagaina mo le su'ega. Fa'ailoga ma fa'ailoga o le ma'i ma fa'ama'i o lo'o i lalo na fa'amauina e le foma'i o lo'o auai.
Aʻo leʻi suʻesuʻeina: uiga sociodemographic (tausaga, itupa, ma isi) ma faʻamatalaga falemaʻi ma togafitiga o tagata suʻesuʻe na aoina mai fesili.
Iloiloga: O le faʻatinoga o le autoclave, incubator, reagents, microscope, ma le microbiological quality of the medium (sterility of the medium and growth performance of their medium) sa iloiloina e tusa ai ma tulaga masani aʻo leʻi faʻaaogaina.Aoina ma felauaiga o faʻataʻitaʻiga faʻataʻitaʻiga e faia. pe a maeʻa faʻataʻitaʻiga aseptic.O le tui o faʻataʻitaʻiga faʻataʻitaʻiga na faia i lalo o se kapoti saogalemu lona lua.
Fa'ata'ita'iga Fa'ata'ita'iga: O fa'amatalaga uma e maua mai (e pei o fa'ai'uga o su'esu'ega) e siakiina mo le agava'a, atoatoa ma le tumau ma fa'amaumauina a'o le'i ulufale i meafaigaluega fa'afuainumera. SOP) a le St. Paul's Hospital Millennium Medical College (SPHMMC).
O faʻamaumauga uma mo suʻesuʻega sa faʻailogaina, faʻalua faʻapipiʻi, ma auʻiliʻili i le faʻaogaina o le Statistical Package for the Social Sciences (SPSS) software version 23. Faʻaaoga fuainumera faʻamatalaga ma faʻasologa faʻasologa e faʻatatau ai fua faʻatatau ma 95% vaʻa mautinoa mo fesuiaiga eseese.P tau ​<0.05 na manatu taua.
Na aoina mai faʻataʻitaʻiga mai i tamaiti maʻi taʻitasi e faʻaaoga ai pusa urine mama. Na tuʻuina atu i matua poʻo leoleo o tagata suʻesuʻe ni faʻatonuga talafeagai i le auala e aoina mai ai faʻataʻitaʻiga o le urine mama. , O faʻataʻitaʻiga na ave i le fale suʻesuʻe microbiology a le SPHMMC mo le faʻaogaina atili. O vaega o faʻataʻitaʻiga na tui i luga o le MacConkey agar plates (Oxoid, Basingstoke ma Hampshire, Egelani) ma le toto agar (Oxoid, Basingstoke ma Hampshire, Egelani) ala o faasalalauga i totonu o se kapoti saogalemu e faʻaaoga ai se 1 μL calibration loop. O faʻataʻitaʻiga na totoe na faʻapipiʻiina i luga o le faiʻai fatu infusion agar faaopoopo i le chloramphenicol (100 μgml-1) ma le gentamicin (50 μgml-1) (Oxoid, Basingstoke, ma Hampshire, Egelani).
O ipu faʻamaʻi uma na faʻafefeteina i le 37 ° C mo le 18-48 itula ma siaki mo siama ma / poʻo le fefete tuputupu aʻe. O le aofaʻi o kolone o siama poʻo le fefete e maua ai le ≥105 cfu / mL urine na manatu i le tuputupu ae taua. e le'i iloiloina mo nisi su'esu'ega.
O vavae mama o siama faʻamaʻi na muamua faʻaalia i le colony morphology, Gram staining.Gram-positive bacteria na sili atu ona faʻaalia e faʻaaoga ai le catalase, bile aescin, pyrrolidinopeptidase (PRY) ma lapiti plasma.Gram-negative bacteria e ala i suʻesuʻega masani biochemical e pei ole (suega urease, su'ega indole, su'ega fa'aoga citrate, su'ega u'amea trisaccharide, su'ega gaosiga o le hydrogen sulfide (H2S), su'ega lysine iron agar, su'ega motility ma su'ega su'ega oxidase) i le tulaga o ituaiga).
Fa'afefete na iloa i le fa'aogaina o metotia fa'ata'ita'i masani e pei o le fa'ailogaina o le Gram, su'esu'ega o le embryo tube, fa'afefeteina o le carbohydrate ma su'esu'ega fa'aogaina e fa'aaoga ai le chromogenic medium (CHROMagar Candida medium, bioM'erieux, Farani) e tusa ai ma faatonuga a le gaosiga.
O su'esu'ega a le antimicrobial susceptibility na faia e le Kirby Bauer disc diffusion i luga o Mueller Hinton agar (Oxoid, Basingstoke, Egelani) e tusa ai ma taʻiala a le Clinical Laboratory Standards Institute (CLSI) 24. O faʻamalologa faʻamaʻi o vavae taʻitasi na saunia i le 0.5 mL o le sua suamalie ma fetuunai mo le pala fetaui ma le 0.5 McFarland standard e maua ai pe tusa ma le 1 × 106 colony-forming units (CFUs) i le mL o le biomass. Fufulu se swab sterile i totonu o le taofi ma aveese mea sili atu e ala i le oomiina i le itu o le paipa. le totonugalemu o se ipu Mueller Hinton agar ma tufatufa tutusa i luga o le medium.O tisiki antibiotic sa tuu i luga o Mueller Hinton agar fatu ma vavae taitasi i totonu o le 15 minute o le inoculation ma incubated i le 35-37 °C mo le 24 itula. Faaaoga se caliper e fua ai le le lautele o le sone o le faʻalavelave. Diameter-area inhibition na faauigaina o se maʻaleʻale (S), intermediate (I), poʻo le teteʻe (R) e tusa ai ma taʻiala a le Clinical and Laboratory Standards Institute (CLSI)24.Staphylococcus aureus (ATCC 25923), Escherichia coli (ATCC 25922) ma Pseudomonas aeruginosa (ATCC 27853) na faʻaaogaina e avea ma faʻataʻitaʻiga lelei e siaki ai le aoga o vailaau faʻamaʻi.
Mo siama Gram-negative, matou te faʻaogaina ipu faʻamaʻi: 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).
Tisiketi antibacterial mo fa'esea Gram-lelei o: penicillin (10 iunite);cefoxitin (30 μg);nitrofurantoin (300 μg);vancomycin (30 μg);trimethoprim-sulfamethoxazole (1.25/g) 23.75 μg);Ciprofloxacin (5 μg);Doxycycline (30 μg) .O tisiki antimicrobial uma na faʻaaogaina i la matou suʻesuʻega o oloa ia o Oxide, Basingstoke ma Hampshire, Egelani.
E pei ona faʻaalia i le Laulau 1, o lenei suʻesuʻega na lesitalaina ai le 227 (227) tamaiti maʻi na faʻaalia pe na matua masalomia le i ai o se UTI ma ausia tuʻutuʻuga filifilia. faʻatasi ai ma le faʻatusatusaga o le tamaʻitaʻi i le tane o le 1.6: 1. O le aofaʻi o mataupu suʻesuʻe na fesuisuiaʻi i vaitausaga uma, ma le ˂ 3-tausaga le matutua o loʻo i ai le tele o gasegase (119; 52.4%), sosoo ai ma le 13-15- tausaga (37; 16.3%) ma le 3-6-tausaga le matutua vaega (31; 13.7%), i le faasologa. O mea suʻesuʻe o le tele o taulaga, faʻatasi ai ma le 2.4: 1 (Table 1).
Fuafuaga 1 Uiga fa'ale-agafesootai o mata'upu su'esu'e ma fa'atele o fa'ata'ita'iga lelei fa'ale-aganu'u (N= 227)
O le tele o siama / fefete tuputupu aʻe na matauina i le 65 o le 227 (227) urine samples mo le lautele lautele o le 28.6% (65/227), lea e 21.6% (49/227) o siama siama, ae 7 % (16/227) O le fa'ama'i o le UTI na maualuga i le 13-15 tausaga le matutua i le 17/37 (46.0%) ma i le 10-12 tausaga le matutua na maualalo i le 2/21 (9.5%). Siata 2) .O fafine sa i ai le maualuga maualuga o UTI, 30/89 (33.7%), fa'atusatusa i le 35/138 (25.4%) tane.
Mai le 49 siama siama, 79.6% (39/49) o Enterobacteriaceae, lea o Escherichia coli o le siama sili ona taatele e maua ai le 42.9% (21/49) o le aofaʻi o siama siama, sosoo ai ma le Klebsiella pneumoniae siama, faʻamauina mo le 34.6% ( 17/49) o vaega fa'ama'i. E fa (8.2%) fa'aesea na fa'atusalia e Acinetobacter, o le Gram-negative bacillus e le fa'afefete. 60.0%) o Enterococcus. Mai le 16 fa'afefete fa'afefete, 6 (37.5%) na fa'atusalia e C. albicans. Mai le 26 uropathogens na maua e le nu'u, 76.9% (20/26) o Escherichia coli ma Klebsiella pneumoniae. O le 20 uarota. -ua maua uropathogens, 15/20 o siama siama. O le 19 ICU-maua uropathogens, 10/19 o fefete. O le 65 aganuu-positive urine samples, 39 (60.0%) na maua ile falemaʻi ma 26 (40.0%). maua e nuu (Laulaula 3).
Fuafuaga 3: Su'esu'ega fa'aletonu o le logistic o a'afiaga e feso'ota'i ma fa'ama'i o le urinary tract i tamaiti ma'i ma le SPHMMC (n = 227)
I totonu o le 227 tamaiti maʻi, 129 na taofia i le falemaʻi mo le itiiti ifo i le 3 aso, lea e 25 (19.4%) o aganuʻu-lelei, 120 na faʻatagaina i le falemaʻi i fafo, e 25 (20.8%) o aganuʻu-lelei, ma 63 na maua. se tala'aga o le fa'ama'i o le urinary tract.Faatasi ai ma i latou, 23 (37.70%) na lelei mo aganuu, 38 mo le faʻaogaina o le catheter, 20 (52.6%) lelei mo aganuu, ma le 71 na lelei mo le vevela o le tino> 37.5 ° C, lea e 21 (29.6%). sa lelei mo aganuu (Laulau 3).
O suʻesuʻega o le UTI sa suʻesuʻeina faʻalua, ma sa i ai a latou faʻasologa o faʻamaumauga mo le umi o le nofo 3-6 masina (COR 2.122; 95% CI: 3.31-3.43; P = 0.002) ma le catheterization (COR= 3.56; 95)% CI : 1.73–7.1;P = 0.001) .Na faia le tele o suʻesuʻega faʻasolosolo i luga ole vaʻaiga taua tele o le UTI faʻatasi ai ma le faʻasologa o le faʻaogaina o le logistic: umi o le nofo 3-6 masina (AOR = 6.06, 95% CI: 1.99-18.4; P = 0.01) ma le catheterization ( AOR = 0.28; 95% CI: 0.13-0.57, P = 0.04) .O le umi o le falemaʻi o le 3-6 masina sa faʻamauina faʻatusatusaina faʻatasi ma UTI (P = 0.01) . P=0.04).Ae ui i lea, o le nofomau, itupa, tausaga, puna o le ulufale, talaʻaga muamua o le UTI, tulaga o le HIV, vevela o le tino, ma faʻamaʻi pipisi e leʻi maua e fesoʻotaʻi tele ma UTI (Table 3).
O le laulau 4 ma le 5 o loʻo faʻamatalaina ai le aofaʻi o le antimicrobial susceptibility patterns o Gram-negative ma Gram-positive bacteria i le iva antibiotic na iloiloina. Amikacin ma meropenem o vailaʻau sili ona aoga na faʻataʻitaʻiina e faasaga i siama Gram-negative, ma fua faʻatatau o le 4.6% ma le 9.1%, I totonu o vailaʻau faʻataʻitaʻi uma, o siama Gram-negative na sili ona tetee i le ampicillin, cefazolin, ma le trimethoprim-sulfamethoxazole, faʻatasi ai ma fua faʻatatau o le 100%, 92.1%, ma le 84.1%, faasologa.E.coli, o le ituaiga sili ona taatele o le toe maua mai, sa maualuga lona tetee atu i le ampicillin (100%), cefazolin (90.5%), ma le trimethoprim-sulfamethoxazole (80.0%). O Klebsiella pneumoniae o le siama lona lua e sili ona vavae ese, ma le fua faatatau o le tetee o le 94.1% i le cefazolin ma le 88.2% i le trimethoprim / sulfamethoxazole Laulau 4. O le maualuga maualuga o le maualuga o le tetee (100%) o siama Gram-positive na matauina i le trimethoprim / sulfamethoxazole, ae o vaega uma o siama Gram-positive (100%) na aʻafia i le oxacillin ( laulau 5).
O fa'ama'i fa'ama'i ile urinary tract (UTIs) o lo'o tumau pea le tasi o mafua'aga masani o le fa'ama'i ile fa'ata'ita'iga a tamaiti.O le su'esu'eina vave ole UTI i tamaiti e taua tele aua e mafai ona avea ma fa'ailoga ole fa'aletonu o fatuga'o e pei ole ma'ila, toto maualuga, ma fa'ama'i fa'ai'u. a matou suʻesuʻega, o le faʻateleina o faʻamaʻi pipisi o le urinary tract o le 28.6%, o le 21.6% na mafua mai i siama siama ma le 7% i fungal pathogens. I a matou suʻesuʻega, o le maualuga o faʻamaʻi pipisi o le urinary tract e mafua mai i siama na maualuga atu nai lo le 15.9% o loʻo lipotia mai. i Etiopia e Merga Duffa et al.E faapena foi, 27.5% et al 19 O le aʻafiaga o UTI ona o le fefete i Etiopia, aemaise lava tamaiti, e le o iloa mo la tatou faʻamatalaga. E mafua ona o faʻamaʻi faʻamaʻi e masani ona manatu e itiiti ifo le taua nai lo faʻamaʻi siama ma viral i Etiopia. O le mea lea, o le aʻafiaga o le fefete - faʻamaʻi pipisi urinary tract i tamaiti maʻi na lipotia mai i lenei suʻesuʻega o le 7%, o le muamua i totonu o le atunuʻu. al.25 Ae ui i lea, na lipotia mai e Zarei o le 16.5% ma le 19.0% - Mahmoudabad et al 26 ma Alkilani et al 27 i Iran ma Aikupito. ma le leai o se tausaga e fiafia i ai. O eseesega i le taatele o UTI i totonu o suʻesuʻega e ono mafua mai i le eseesega i le mamanu o suʻesuʻega, uiga o le sociodemographic o mataupu suʻesuʻe, ma comorbidities.
I le suʻesuʻega o loʻo i ai nei, o le 60% o UTI na maua ile falemaʻi (iunite maʻi tigaina ma le uarota-maua) .Iuga tutusa (78.5%) na matauina e Aubron et al.28, e ui lava o le faʻateleina o UTI i atunuʻu atinaʻe e fesuisuiaʻi e ala i suʻesuʻega ma le itulagi, e aunoa ma se eseesega faʻaitulagi i siama ma fungal pathogens e mafua ai le UTI. pneumoniae.6,29,30 O gatasi ma suʻesuʻega muamua,29,30 o la matou suʻesuʻega na faʻaalia ai foi o Escherichia coli o le siama sili ona taatele. O siama masani e 42.9% o le aofaʻi o siama siama, sosoo ai ma le Klebsiella pneumoniae, lea e 34.6% o faʻamaʻi faʻamaʻi. Escherichia coli o le faʻamaʻi pipisi sili ona taatele i totonu o nuʻu ma falemaʻi na maua i le UTI (57.1% ma le 42.9%, i le faasologa). E tele suʻesuʻega ua faʻaalia ai o Candida o le mafuaʻaga lea o le itiiti ifo i le 10-15% o le falemaʻi na maua. fa'ama'i pipisi o le urinary tract i totonu o falema'i, ma o le candida e masani lava ona taatele i potu mo gasegase tigaina.31-33 I la matou su'esu'ega, o Candida na maua ai le 7% o UTI, 94% o ia mea na maua mai i le nosocomial, lea e 62.5% na matauina i gasegase ICU. .Candida albicans o le mafuaaga autu lea o candidiasis, ma 81.1% o Candida na vavae ese mai le uarota-maua urine aganuu-lelei ma ICU-maua lelei urine aganuu samples.O matou taunuuga e le o se mea e ofo ai talu ai o Candida o se pathogen faʻapitoa e mafai ona mafua ai maʻi i totonu. ma'i immunocompromised pei o ma'i ICU.
I lenei suʻesuʻega, o fafine e sili atu ona faigofie nai lo alii i faʻamaʻi pipisi o le urinary tract, ma o tagata gasegase i le 12-15 tausaga na sili atu ona faigofie. tausaga e mafai ona faamatalaina e le vaega muamua o le matua lea na faafaigaluegaina ai tagata gasegase. Ona o le faʻamaʻi faʻamaʻi masani o UTI, o le aʻafiaga o tane ma fafine e masani ona foliga mai e tutusa i le pepe, ma le faʻatupuina o tama i le taimi o pepe faatoa fananau mai ma tamaitai i le amataga. ma i le taimi o aʻoaʻoga faletaele. Faatasi ai ma isi faʻataʻitaʻiga suʻesuʻega faʻalavelave faʻalavelave, o le falemaʻi nofo i le 3-30 aso na faʻamauina faʻatasi ma UTI (P = 0.01). O se faʻamaopoopo i le va o le umi o le falemaʻi ma UTI na matauina i isi suʻesuʻega.34,35 UTI i o la matou suʻesuʻega na matuaʻi fesoʻotaʻi foi ma le catheterization (P = 0.04). E tusa ai ma Gokula et al.35 ma Saint et al.36, catheterization faateleina le taufaamatau o UTIs i le 3 i le 10%, e faalagolago i le umi o le catheterization. Faʻafitauli o le puipuia o le faʻamaʻi i le taimi o le faʻapipiʻiina o le pipi, le suia o le faʻaogaina o le pipi, ma le le lelei o le tausiga o le pipi e ono mafua ai le faʻateleina o faʻamaʻi pipisi o le urinary tract.
I le taimi o suʻesuʻega, o le tele o tamaiti maʻi i lalo o le tolu tausaga na faʻatagaina i le falemaʻi ma faʻamaoniga o le faʻamaʻi o le urinary tract nai lo isi vaitausaga. 39
I lenei suʻesuʻega, o siama Gram-negative na sili ona tetee i le ampicillin ma le trimethoprim-sulfamethoxazole, ma le fua faatatau o le tetee o le 100% ma le 84.1%, i le faasologa. trimethoprim-sulfamethoxazole (81.0%). E fa'apea fo'i, o le maualuga maualuga o le tete'e fua (100%) i siama Gram-positive na matauina i le trimethoprim/sulfamethoxazole.Ampicillin ma trimethoprim-sulfamethoxazole ua fa'aaogaina lautele e avea ma togafitiga muamua o fa'ama'i pipisi o le urinary. i nofoaga uma o le soifua maloloina i Etiopia, e pei ona fautuaina e le Matagaluega o le Soifua Maloloina Taʻiala mo Togafitiga (STG) e fa'atuputeleina e le nu'u le avanoa e filifili ai ma tausia a'afiaga fa'asa'o i lena tulaga.43-45 I le isi itu, o la matou su'esu'ega na fa'aalia ai o le amikacin ma le meropenem o vaila'au sili ona aoga e tetee atu ai i siama Gram-negative ma oxacillin o le vaila'au sili ona aoga e faasaga i le Gram. -positive bacteria.O faʻamaumauga i lenei tusiga e aumai mai se pepa e leʻi faʻasalalau e Nuhamen Zena, lea na tuʻuina atu i le Addis Ababa University Institutional Repository.46
Ona o le utiuti o punaoa, na le mafai ai ona matou faia ni suʻega faʻamaʻi faʻamaʻi i luga o faʻamaʻi faʻamaʻi faʻaalia i lenei suʻesuʻega.
O le aofa'i o fa'ama'i pipisi e 28.6%, o le 75.4% (49/65) o fa'ama'i e feso'ota'i ma le 24.6% (19/65) o fa'afefete fa'ama'i UTI. Enterobacteriaceae o le mafua'aga sili lea o fa'ama'i pipisi. O C. albicans ma non-albicans C. albicans ua fesoʻotaʻi ma UTI faʻafefeteina, aemaise lava ile ICU. e tetee atu i le ampicillin ma le trimethoprim-sulfamethoxazole fautuaina e le Matagaluega o le Soifua Maloloina mo togafitiga malosi o UTIs.O isi galuega e tatau ona faia i UTI i tamaiti, ma o le ampicillin ma le trimethoprim-sulfamethoxazole e tatau ona toe iloiloina e avea ma fualaau o le filifiliga mo togafitiga faʻamalosi o UTI.
O le suʻesuʻega na faia e tusa ai ma le Tautinoga a Helsinki. Na faʻatautaia lelei uma iloiloga ma matafaioi ma le suʻesuʻega sa faia ma le faʻatagaina o le amio ma le SPHMMC faʻatagaga mai le Komiti Faʻafoe o Iloiloga a le Matagaluega o Faʻasaienisi Faʻafomaʻi, Faculty of Health Sciences, Addis Ababa University. Talu ai o la matou suʻesuʻega e aofia ai tamaiti (i lalo ifo o le 16 tausaga), na le mafai ona latou tuʻuina atu se faʻatagaga tusitusia moni. O le mea lea, o le pepa faʻatagaina e tatau ona faʻatumu e matua / tausi. o fa'amanuiaga o lo'o fa'amatala manino mai i matua/tausi ta'ito'atasi.Ua fautuaina matua/tagata tausi o le a fa'amaumau fa'amatalaga patino a tamaiti ta'ito'atasi.Ua logoina matua/tausi tamaiti e leai se noataga o lana tama e auai i le su'esu'ega pe a ia faia. le malie e auai i le suʻesuʻega. A maeʻa ona latou malilie e auai i le suʻesuʻega ma e le fiafia e faʻaauau, latou te saoloto e alu ese mai le suʻesuʻega i soʻo se taimi a o faagasolo le suʻesuʻega.
Matou te fia faʻafetai atu i le fomaʻi o loʻo auai i le nofoaga suʻesuʻe mo le suʻesuʻeina malosi o tagata mamaʻi mai se vaaiga faʻataʻitaʻiga. Matou te faʻafetai tele foi i tagata gasegase na auai i le suʻesuʻega. Matou te fia faʻafetai foi ia Nuhamen Zena mo le faʻatagaina i matou e aumai fa'amaumauga taua mai ana su'esu'ega e le'i fa'asalalauina, lea na tu'uina atu i le fale teu oloa a le Iunivesite o Addis Ababa.
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