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Adane Bitew, 1 Nuhamen Zena, 2 Abera Abdeta31 Sashen Kimiyyar Kimiyyar Kiwon Lafiyar Kiwon Lafiyar Kiwon Lafiyar Jama'a, Kwalejin Kimiyyar Lafiya, Jami'ar Addis Ababa, Addis Ababa, Habasha;2 Microbiology, Makarantar Magunguna ta Millennium, Asibitin St Paul, Addis Ababa, Sashen Habasha;3 Laboratory Reference National for Clinical Bacteriology and Mycology, Cibiyar Kiwon Lafiyar Jama'a ta Habasha, Addis Ababa, Habasha Mawallafin Mawallafi: Abera Abdeta, Laboratory Reference for Clinical Bacteriology and Mycology, Habasha Cibiyar Kiwon Lafiyar Jama'a, PO Box: 1242, Addis Ababa, Ethiopia , +251911566420, imel [email protected] Bayan fage: UTIs sune cututtuka na yau da kullum a cikin ilimin yara. Sanin abubuwan da ke haifar da cututtuka na urinary fili, tsarin su na rashin lafiyar ƙwayoyin cuta, da abubuwan haɗari masu haɗari a cikin takamaiman saituna na iya ba da shaida don dacewa da maganin lokuta.Maƙasudi. : Wannan binciken ya yi nufin sanin ilimin ilimin cututtuka na yau da kullum da kuma yaduwar cututtuka na uropathogens da cututtuka na urinary fili, da kuma kwayoyin cututtuka na ƙwayoyin cuta na ƙwayoyin cuta, da kuma gano abubuwan da ke tattare da cututtuka na urinary fili a cikin marasa lafiya na yara.Materials da hanyoyin: Nazarin. An gudanar da shi daga Oktoba 2019 zuwa Yuli 2020 a Makarantar Magunguna ta Millennium, Asibitin St. Paul. Ana tattara fitsari na marasa lafiya a hankali, a sanya shi a kan kafofin watsa labaru, kuma a sanya shi a 37 ° C na tsawon sa'o'i 18-48. An gano kwayoyin cuta da yisti bisa ga misali. hanyoyin da ake amfani da su.Tsarin gwajin cutar ƙwayoyin cuta na ƙwayoyin cuta ta hanyar amfani da hanyar rarraba diski na Kirby Bauer.An yi amfani da ƙididdigar ƙididdiga da ƙididdige ƙididdiga don ƙididdige ƙimar raƙuman ruwa tare da 95% tazara ta amincewa. Sakamakon darajar P: An lura da ci gaban ƙwayar cuta / fungal mai mahimmanci a cikin samfurori na 65 tare da wani samfurin. yawan 28.6%, wanda 75.4% (49/65) da 24.6% (16/65) sune kwayoyin cuta da fungal pathogens. 100%), cefazolin (92.1%) da trimethoprim-sulfamethoxazole (84.1%), waɗanda aka saba amfani da su a cikin empirically a Habasha. Tsawon zaman asibiti (P=0.01) da catheterization (P= 0.04) sun kasance masu alaƙa da ƙididdiga tare da kamuwa da cutar urinary. Ƙarshe: Bincikenmu ya lura da yawan cututtuka na urinary tract.Enterobacteriaceae sune manyan abubuwan da ke haifar da cututtuka na tsarin urinary. Tsawon zaman asibiti da catheterization sun kasance da alaka da kamuwa da cutar urinary. Dukansu Gram-negative da Gram-positive kwayoyin sun kasance masu tsayayya sosai. ampicillin da trimethoprim-sulfamethoxazole.Keywords: Tsarin kamuwa da ƙwayoyin cuta, Likitan Yara, Cututtukan Urinary, Habasha
Cututtukan Urinary tract (UTIs) da kwayoyin cuta da yisti ke haifarwa na daya daga cikin cututtukan da suka fi yawa a cikin yara.A kasashe masu tasowa, shi ne na uku mafi yawan kamuwa da cutar a cikin yaran yara bayan kamuwa da cutar numfashi da na ciki.2 Ciwon hanji ga yara. suna hade da cututtuka na gajeren lokaci, ciki har da zazzabi, dysuria, gaggawa, da ƙananan ciwon baya.Yana iya haifar da lalacewar koda na dogon lokaci, irin su ciwon koda na dindindin da matsalolin lokaci mai tsawo, ciki har da hawan jini da gazawar koda. 3 Wennerstrom et al15 sun bayyana raunin koda a cikin kimanin 15% na yara bayan UTI na farko, yana nuna mahimmancin ganewar gaggawa da gaggawar maganin cututtuka na urinary fili. Bugu da ƙari, kashe kudi akan kula da urinary fili da ke hade da kiwon lafiya yana da yawa.3, 4 Yawancin bincike na UTIs na yara a kasashe masu tasowa daban-daban sun nuna cewa yawancin UTIs ya bambanta daga 16% zuwa 34%.5-9 Bugu da ƙari, har zuwa 8% na yara masu shekaru 1 zuwa 11 shekaru za su bunkasa akalla UTI10 guda ɗaya, kuma kusan kashi 30 cikin 100 na jarirai da yara an san suna da kamuwa da cututtuka a cikin watanni 6-12 na farko bayan farkon UTI .11
Gram-negative da Gram-positive kwayoyin cuta, da kuma wasu nau'in Candida, na iya haifar da cututtuka na urinary tract.E.coli shine mafi yawan abin da ke haifar da cututtuka na urinary fili, sannan Klebsiella pneumoniae.12 Bincike ya nuna cewa nau'in Candida, musamman Candida albicans, sun kasance mafi yawan sanadin Candida UTI a cikin yara. Abubuwan da ke haifar da UTIs a cikin yara.Saurayi sun fi sauƙi a cikin shekarun farko na rayuwa, bayan haka, saboda bambance-bambance a cikin sassan jima'i, abin da ya faru ya fi girma a cikin 'yan mata, kuma jarirai maza marasa kaciya suna cikin haɗari mafi girma.1,33 Hanyoyin kamuwa da ƙwayoyin cuta. na uropathogens sun bambanta a tsawon lokaci, wurin wurin haƙuri, ƙididdigar alƙaluma, da halayen asibiti.
Cututtuka kamar UTIs ana tsammanin su ne ke haifar da 26% na mutuwar duniya, 98% na faruwa a cikin kasashe masu karamin karfi.14 Binciken marasa lafiya na yara a Nepal da Indiya ya ba da rahoton yawan UTI na 57%15 da 48 %,16.Binciken da aka yi a asibiti a kan yaran Afirka ta Kudu ya nuna cewa ciwon yoyon fitsari ya kai kashi 11% na cututtukan kiwon lafiya.17 Wani bincike da aka yi a Kenya ya gano cewa ciwon yoyon fitsari ya kai kusan kashi 11.9% na nauyin kamuwa da cutar zazzabin cizon sauro a kananan yara.18
Ƙananan bincike sun gano UTIs a cikin marasa lafiya na yara a Habasha: nazarin a asibitin Hawassa Referral, Yekatit 12 Hospital, Felege-Hiwot Specialist Hospital da Gondar University Hospital ya nuna 27.5%, 19 15.9%, 20 16.7%, 21 and 26.45% and 22, bi da bi. .A kasashe masu tasowa ciki har da Habasha, rashin al'adun fitsari a matakai daban-daban na tsaftar muhalli ba zai yi tasiri ba saboda suna da tarin albarkatu.Saboda haka, ba a san nau'in cutar UTI ba da kuma yanayin saurin kamuwa da muggan kwayoyi a Habasha. binciken da aka yi niyya don sanin yawan cututtukan cututtukan urinary, nazarin ƙwayoyin cuta da ƙwayoyin fungal da ke da alaƙa da UTIs, ƙayyadaddun bayanan cututtukan cututtukan ƙwayoyin cuta na keɓancewar ƙwayoyin cuta, da kuma gano manyan abubuwan haɗari masu alaƙa da UTIs.
Daga Oktoba 2019 zuwa Yuli 2020, an gudanar da wani bincike-bincike na asibiti a Sashen Kula da Lafiyar Yara na St Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Habasha.
A lokacin binciken, an ga duk marasa lafiya na yara da marasa lafiya a cikin likitocin yara.
A lokacin binciken, duk marasa lafiya na yara da marasa lafiya tare da alamun UTI da alamun bayyanar sun halarci wurin binciken.
An ƙididdige girman samfurin ta amfani da dabarar ƙididdige ƙididdiga mai ƙima guda ɗaya tare da tazara ta 95% amincewa, 5% gefen kuskure, da yawan UTIs a cikin aikin farko [15.9% ko P=0.159)] Merga Duffa et al20 a Addis Ababa , kamar yadda aka nuna a kasa.
Z α / 2 = 95% amincewa tazara mahimmanci mahimmanci don rarrabawa ta al'ada, daidai da 1.96 (darajar Z a α = 0.05);
D = gefen kuskure, daidai da 5%, α = shine matakin kuskuren mutane suna son jurewa;toshe waɗannan a cikin dabarar, n = (1.96)2 0.159 (1-0.159)/(0.05)2=206 kuma ɗauka 10% ba a amsa ba inda n = 206+206/10 = 227.
An yi amfani da hanyar da ta dace a cikin wannan binciken.Tattara bayanai har sai an sami girman samfurin da ake so.
An tattara bayanai bayan samun izini a rubuce daga iyaye.Halayen zamantakewar zamantakewa (shekaru, jinsi, da wurin zama) da abubuwan haɗari masu haɗari (catheter, UTI na baya, ƙwayar cuta ta mutum (HIV), yanayin kaciya, da tsawon zaman asibiti) An tattara mahalarta binciken ta ƙwararrun ma'aikatan jinya ta amfani da bayanan da aka riga aka ƙayyade.Tambayoyin da aka tsara don gwajin. Alamu da alamun marasa lafiya da cututtukan da ke ciki an rubuta su ta wurin likitan yara masu halartar.
Kafin bincike: halayen zamantakewa (shekaru, jinsi, da dai sauransu) da kuma bayanan asibiti da magani na mahalarta binciken an tattara su daga tambayoyin tambayoyi.
Analysis: Ayyukan autoclave, incubator, reagents, microscope, da microbiological quality na matsakaici (matsayi na matsakaici da girma na kowane matsakaici) an kimanta su bisa ga daidaitattun hanyoyin kafin amfani. Ana yin tattarawa da jigilar samfurori na asibiti. bayan hanyoyin aseptic. An yi allurar samfuran asibiti a ƙarƙashin ma'aikatar tsaro ta biyu.
Bayan-Bincike: Duk bayanan da aka fitar (kamar sakamakon binciken dakin gwaje-gwaje) ana duba su don cancanta, cikawa da daidaito kuma an rubuta su kafin shigar da kayan aikin ƙididdiga. Ana kuma adana bayanan a cikin amintaccen wuri. An adana keɓancewar ƙwayoyin cuta da yisti bisa ga Ka'idar Tsarin Aiki (Aikin Aiki). SOP) na St. Paul's Hospital Millennium Medical College (SPHMMC).
Dukkan bayanan binciken an ƙididdige su, an shigar da su sau biyu, kuma an bincika su ta amfani da sigar software na Ƙididdiga don Kimiyyar Jama'a (SPSS). <0.05 an yi la'akari da mahimmanci.
An tattara samfuran fitsari daga kowane majiyyaci na yara ta hanyar amfani da kwantena na fitsari mara kyau.An ba iyaye ko masu kula da mahalarta nazarin umarnin da suka dace game da yadda za a tattara samfuran fitsari na tsaka-tsaki mai tsabta. , An dauki samfurori zuwa dakin gwaje-gwaje na microbiology na SPHMMC don ci gaba da aiki. An yi amfani da sassan samfurori a kan faranti na MacConkey agar (Oxoid, Basingstoke da Hampshire, Ingila) da jini agar (Oxoid, Basingstoke da Hampshire, Ingila) a cikin ma'aikatar tsaro ta amfani da 1 μL calibration madauki.Sauran samfuran an sanya su a kan jiko na zuciya agar agar da aka kara da chloramphenicol (100 µgml-1) da gentamicin (50 μgml-1) (Oxoid, Basingstoke, da Hampshire, Ingila).
Dukkanin faranti da aka yi amfani da su an sanya su cikin iska a 37 ° C na tsawon sa'o'i 18-48 kuma an bincika don ci gaban ƙwayoyin cuta da / ko yisti. Ƙididdigar ƙwayoyin cuta na ƙwayoyin cuta ko yisti da ke samar da ≥105 cfu / mL fitsari an dauke su da girma girma. Samfurin fitsari yana samar da nau'i uku ko fiye. ba a yi la'akari da ƙarin bincike ba.
Tsabtace masu tsafta na ƙwayoyin cuta na ƙwayoyin cuta an fara nuna su ta hanyar ilimin halittar mallaka, Gram staining.Gram-positive kwayoyin an kara halin amfani da catalase, bile aescin, pyrrolidinopeptidase (PRY) da zomo plasma.Gram-korau kwayoyin ta hanyar yau da kullum biochemical gwaje-gwaje kamar (urease gwajin,). gwajin indole, gwajin amfani da citrate, gwajin ƙarfe na trisaccharide, gwajin samar da hydrogen sulfide (H2S), gwajin agar ƙarfe na lysine, gwajin motsi da gwajin gwajin oxidase) zuwa matakin jinsin).
An gano yeasts ta hanyar amfani da hanyoyin bincike na yau da kullun kamar tabon Gram, gwajin bututun amfrayo, fermentation carbohydrate da assimilation assays ta amfani da matsakaicin chromogenic (CHROMagar Candida matsakaici, bioM'erieux, Faransa) bisa ga umarnin masana'anta.
Kirby Bauer disc diffusion ya yi gwajin kamuwa da cuta ta ƙwayoyin cuta akan Mueller Hinton agar (Oxoid, Basingstoke, Ingila) bisa ga ka'idodin Cibiyar Nazarin Lafiya ta Clinical (CLSI). daidaita ma'aunin 0.5 McFarland don samun kusan 1 × 106 raka'a masu kafa mulkin mallaka (CFUs) a kowace ml na biomass. Sanya swab bakararre a cikin dakatarwar kuma cire abubuwan da suka wuce gona da iri ta danna shi a gefen bututun. tsakiyar wani farantin Mueller Hinton agar kuma an rarraba shi a ko'ina a kan matsakaici. An sanya diski na rigakafi a kan Mueller Hinton agar agar tare da kowane ware a cikin minti 15 na inoculation kuma an sanya shi a 35-37 ° C don 24 hours. Yi amfani da caliper don aunawa. diamita na yanki na hanawa. An fassara hanawar diamita a matsayin m (S), matsakaici (I), ko resistant (R) bisa ga ka'idodin Clinical and Laboratory Standards Institute (CLSI)24.Staphylococcus aureus (ATCC 25923), Escherichia coli (ATCC 25922) da Pseudomonas aeruginosa (ATCC 27853) an yi amfani da su azaman nau'in kula da inganci don duba ingancin maganin rigakafi.
Ga kwayoyin cutar Gram-korau, muna amfani da faranti na rigakafi: 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).
Fayafai na ƙwayoyin cuta don warewar gram-tabbatacce sune: penicillin (raka'a 10);cefoxitin (30 μg);nitrofurantoin (300 μg);vancomycin (30 μg);trimethoprim-sulfamethoxazole (1.25/g) 23.75 μg;Ciprofloxacin (5 μg);Doxycycline (30 μg) .Dukan fayafai na antimicrobial da aka yi amfani da su a cikin bincikenmu sune samfuran Oxide, Basingstoke da Hampshire, Ingila.
Kamar yadda aka nuna a cikin Table 1, wannan binciken ya shiga 227 (227) marasa lafiya na yara waɗanda suka nuna ko kuma ana zargin su da samun UTI kuma sun cika sharuddan zaɓi. tare da mace da namiji rabo na 1.6: 1. Adadin batutuwan binciken sun bambanta a cikin ƙungiyoyin shekaru, tare da ˂ 3 mai shekaru ƙungiyar da ke da mafi yawan marasa lafiya (119; 52.4%), sannan 13-15- shekara (37; 16.3%) da 3-6 shekaru kungiyoyin (31; 13.7%), bi da bi.A binciken abubuwa ne yafi birane, tare da birane-kauye rabo na 2.4: 1 (Table 1).
Shafi na 1 Halayen zamantakewa da al'umma na batutuwan karatu da yawan samfuran ingantattun al'adu (N= 227)
An lura da girma mai girma na ƙwayar cuta / yisti a cikin 65 na 227 (227) samfurori na fitsari don yawan yawan 28.6% (65/227), wanda 21.6% (49/227) sun kasance kwayoyin cututtuka, yayin da 7 % (16/227) sun kasance cututtukan fungal.Yawancin UTI ya kasance mafi girma a cikin shekaru 13-15 a cikin 17 / 37 (46.0%) kuma a cikin shekaru 10-12 ya kasance mafi ƙasƙanci a 2/21 (9.5%).Table 2). .Mata sun sami mafi girma na UTIs, 30/89 (33.7%), idan aka kwatanta da 35/138 (25.4%) maza.
Daga cikin ɓangarorin 49 na ƙwayoyin cuta, 79.6% (39/49) sune Enterobacteriaceae, wanda Escherichia coli shine mafi yawan ƙwayoyin cuta wanda ke lissafin 42.9% (21/49) na jimlar ƙwayoyin cuta, sannan Klebsiella pneumoniae bacteria ta biyo baya, lissafin 34.6% 17/49) na bakteriya ware.Hudu (8.2%) wakilta aka wakilta da Acinetobacter, ba fermenting Gram-negative bacillus. 60.0%) sun kasance Enterococcus. Daga cikin keɓancewar yisti na 16, 6 (37.5%) sun wakilci C. albicans. Daga cikin 26 da aka samu uropathogens na al'umma, 76.9% (20/26) sune Escherichia coli da Klebsiella pneumoniae. -da aka samo uropathogens, 15/20 sun kasance kwayoyin cututtuka na kwayan cuta. Daga cikin 19 ICU-samun uropathogens, 10/19 sun kasance yeasts. Daga cikin 65 al'ada-tabbataccen fitsari samfurori, 39 (60.0%) sun sami asibiti da 26 (40.0%). al'umma-samun (Table 3).
Teburin 3 Binciken Ƙididdigar Ƙwararren Ƙwararren Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Yara tare da SPHMMC (n = 227)
Daga cikin marasa lafiya na yara 227, 129 sun kasance a asibiti kasa da kwanaki 3, wanda 25 (19.4%) na da al'ada, 120 an kwantar da su a asibitin marasa lafiya, wanda 25 (20.8%) sun kasance masu al'ada, kuma 63 suna da lafiya. tarihin kamuwa da cutar urinary.Daga cikin su, 23 (37.70%) sun kasance masu kyau ga al'ada, 38 sun kasance na catheter na ciki, 20 (52.6%) sun kasance masu kyau ga al'ada, kuma 71 sun kasance masu kyau ga zafin jiki> 37.5 ° C, wanda 21 (29.6%) sun kasance tabbatacce ga al'ada (Table 3).
An yi la'akari da masu tsinkaya na UTI bivariately, kuma suna da ƙididdiga masu ƙima na tsawon lokaci na tsawon watanni 3-6 (COR 2.122; 95% CI: 3.31-3.43; P = 0.002) da catheterization (COR = 3.56; 95)% CI : 1.73–7.1;P = 0.001) . An gudanar da bincike mai yawa a kan masu tsinkaye masu mahimmanci na UTI tare da ma'auni masu mahimmanci masu zuwa: tsawon tsawon watanni 3-6 (AOR = 6.06, 95% CI: 1.99-18.4; P = 0.01) da catheterization ( AOR = 0.28; 95% CI: 0.13-0.57, P = 0.04) . Tsawon lokacin zaman asibiti na watanni 3-6 ya kasance mai mahimmanci tare da UTI (P = 0.01) .Ƙungiyar UTI tare da catheterization kuma ta kasance mai mahimmanci. P = 0.04)
Tables na 4 da 5 sun bayyana yanayin rashin lafiyar ƙwayoyin cuta na ƙwayoyin cuta na Gram-negative da Gram-positive zuwa maganin rigakafi tara da aka kimanta. bi da bi.Daga cikin dukkan magungunan da aka gwada, kwayoyin cutar Gram-negative sune mafi juriya ga ampicillin, cefazolin, da trimethoprim-sulfamethoxazole, tare da juriya na 100%, 92.1%, da 84.1%, bi da bi.coli, nau'in nau'in nau'in nau'in da aka samu na yau da kullun, yana da juriya ga ampicillin (100%), cefazolin (90.5%), da trimethoprim-sulfamethoxazole (80.0%). zuwa cefazolin da 88.2% zuwa trimethoprim/sulfamethoxazole Table 4.Mafi girman jimlar juriya (100%) na kwayoyin cutar Gram-tabbatacce an lura dasu a cikin trimethoprim/sulfamethoxazole, amma duk warewar kwayoyin cutar Gram-tabbatacce (100%) sun kasance masu saukin kamuwa da oxacillin. tebur 5).
Cutar cututtuka (UTIs) ta kasance daya daga cikin abubuwan da ke haifar da rashin lafiya a cikin aikin yara. Tun da farko na UTI a cikin yara yana da mahimmanci domin yana iya zama alamar rashin lafiyar koda kamar tabo, hauhawar jini, da cututtukan koda na ƙarshe. Binciken da muka gudanar ya nuna cewa yawan kamuwa da cutar yoyon fitsari ya kai kashi 28.6%, daga cikinsu kashi 21.6% na kwayoyin cuta ne, kashi 7% na cututtukan fungal. a Habasha ta Merga Duffa et al.Hakazalika, 27.5% et al 19 Abubuwan da ke faruwa na UTIs saboda yisti a Habasha, musamman yara, ba a san su ba don tunani. -Induced kamuwa da cutar urinary fili a cikin marasa lafiya na yara da aka ruwaito a cikin wannan binciken shine 7%, na farko a cikin kasar. Yawan UTI da ke haifar da yisti da aka ruwaito a cikin bincikenmu ya yi daidai da yawan 5.2% da aka ruwaito a cikin wani binciken a cikin yara ta Seifi et. al.25 Duk da haka, Zarei ya ba da rahoton yawan 16.5% da 19.0% - Mahmoudabad et al 26 da Alkilani et al 27 a Iran da Masar, bi da bi. Mafi girma a cikin waɗannan binciken guda biyu ba abin mamaki ba ne tun lokacin da aka haɗa da batutuwan binciken sun kasance marasa lafiya na ICU. ba tare da fifikon shekaru ba.Bambance-bambance a cikin yawancin UTIs tsakanin karatu na iya samo asali ne daga bambance-bambance a cikin zane-zane na nazarin, halayen zamantakewa na batutuwa na nazarin, da kuma cututtuka.
A cikin binciken na yanzu, 60% na UTIs an sami asibiti (nau'in kulawa mai zurfi da kuma asibiti) .Sakamako iri ɗaya (78.5%) sun lura da Aubron et al.28, ko da yake yawan UTI a kasashe masu tasowa ya bambanta ta hanyar nazari da kuma yanki, ba tare da bambance-bambancen yanki a cikin ƙwayoyin cuta da fungal da ke haifar da UTIs. Mafi yawan kwayoyin cutar da aka samo daga al'adun fitsari sune Gram-negative bacilli, musamman Escherichia coli, sannan Klebsiella ya biyo baya. pneumoniae.6,29,30 Daidai da irin wannan binciken da aka yi a baya,29,30 binciken mu kuma ya nuna cewa Escherichia coli ita ce mafi yawan kwayoyin cuta.Bakteriya na yau da kullum sun hada da 42.9% na jimlar kwayoyin cuta, sai Klebsiella pneumoniae, wanda ya kai 34.6% na kwayoyin cuta. cututtuka na urinary fili a cikin saitunan asibiti, kuma candida ya fi dacewa a cikin sassan kulawa mai tsanani.31-33 A cikin bincikenmu, Candida ya ƙunshi 7% na UTIs, 94% daga cikinsu sun sami nosocomial, wanda 62.5% aka lura a cikin marasa lafiya na ICU. .Candida albicans shine babban dalilin candidiasis, kuma 81.1% na Candida an ware su daga al'adun fitsari da aka samo asali da kuma ICU-samun samfurori na al'adun fitsari mai kyau. Sakamakonmu ba abin mamaki ba ne tun lokacin da Candida wata cuta ce mai dacewa da za ta iya haifar da rashin lafiya a ciki. marasa lafiya na rigakafi kamar marasa lafiya na ICU.
A cikin wannan binciken, mata sun fi sauƙi fiye da maza zuwa cututtuka na urinary fili, kuma marasa lafiya a cikin shekaru 12-15 sun fi dacewa. Duk da haka, bambanci tsakanin yanayin biyu ba shi da mahimmanci.Rashin haɗin gwiwa tsakanin UTI da jinsi da kuma Za'a iya bayyana shekaru ta rukunin shekarun farko da aka ɗauki marasa lafiya a cikin su.Bisa ga sanannun alamun cututtukan cututtukan UTIs, abubuwan da suka faru na maza da mata gabaɗaya suna bayyana daidai a cikin jarirai, tare da fifikon maza a cikin lokacin haihuwa da fifikon mata a farkon yara. da kuma lokacin horo na bayan gida. Daga cikin wasu abubuwan haɗari da aka yi la'akari da ƙididdiga, zaman asibiti na kwanaki 3-30 yana da alaƙa da UTI (P = 0.01) . An lura da dangantaka tsakanin tsawon zaman asibiti da UTI a wasu nazarin.34,35 UTI a cikin Har ila yau bincikenmu yana da alaƙa da mahimmanci tare da catheterization (P=0.04) .A cewar Gokula et al.35 da Saint et al.36, catheterization ya karu da barazanar UTI ta 3 zuwa 10%, dangane da tsawon lokaci na catheterization. Abubuwan rigakafin rashin lafiya a lokacin shigar da catheter, maye gurbin catheter sau da yawa, da rashin kulawar catheter mara kyau na iya haifar da karuwa a cikin cututtukan cututtuka na urinary catheter.
A lokacin binciken, yawancin marasa lafiya na yara a ƙarƙashin shekaru uku an shigar da su a asibiti tare da alamun cututtuka na urinary tract fiye da sauran shekarun. 39
A cikin wannan binciken, kwayoyin cutar Gram-korau sun kasance mafi juriya ga ampicillin da trimethoprim-sulfamethoxazole, tare da juriya na 100% da 84.1%, bi da bi.Mafi yawan gano Escherichia coli da Klebsiella pneumoniae sun fi tsayayya da ampicillin (100%) kuma trimethoprim-sulfamethoxazole (81.0%). Hakazalika, mafi girman jimlar juriya (100%) a cikin kwayoyin cutar Gram-positive an lura da su a cikin trimethoprim/sulfamethoxazole. a duk wuraren kiwon lafiya a Habasha, kamar yadda Ma'aikatar Kiwon Lafiya ta Ma'aikatar Lafiya ta Shawarar Jagoran Jiyya (STG) .40-42 Adadin juriya na ƙwayoyin cuta gram-negative da gram-positive zuwa ampicillin da trimethoprim-sulfamethoxazole a cikin wannan binciken.Ci gaba da amfani da kwayoyi a cikin wannan binciken. al’umma na kara samun damar zabar da kuma kula da nau’ukan juriya a wannan wuri.43-45 A daya bangaren kuma, bincikenmu ya nuna cewa amikacin da meropenem sune magungunan da suka fi dacewa da kwayoyin cutar Gram-negative kuma oxacillin shine maganin da ya fi dacewa da Gram. -Bacteria mai kyau.An ɗauko bayanan da ke cikin wannan labarin daga wata takarda da Nuhamen Zena ta buga, wadda aka ɗora zuwa ma'ajiyar jami'ar Addis Ababa.46
Saboda ƙaƙƙarfan albarkatu, ba mu sami damar yin gwajin kamuwa da cututtukan fungal akan cututtukan fungal da aka gano a cikin wannan binciken ba.
Gabaɗaya yawan UTIs shine 28.6%, wanda 75.4% (49/65) sune UTIs masu alaƙa da ƙwayoyin cuta kuma 24.6% (19/65) sune UTIs masu yisti.Enterobacteriaceae sune manyan abubuwan da ke haifar da cututtukan urinary. Dukan C. Albicans da wadanda ba albicans C. albicans an danganta su da yisti-induced UTIs, musamman a cikin marasa lafiya na ICU. Tsawon tsawon zaman asibiti da catheterization na 3 zuwa 6 months suna da alaka da UTI.Dukansu gram-negative da gram-positive kwayoyin suna da kyau sosai. resistant zuwa ampicillin da trimethoprim-sulfamethoxazole shawarar da Ma'aikatar Lafiya ta bayar don empiric jiyya na UTIs.Ya kamata a kara yin aiki a kan UTIs a cikin yara, da kuma ampicillin da trimethoprim-sulfamethoxazole ya kamata a sake la'akari a matsayin kwayoyi zabi ga empiric jiyya na UTIs.
An gudanar da binciken ne bisa ga sanarwar Helsinki. Dukkan la'akari da la'akari da wajibai an magance su yadda ya kamata kuma an gudanar da binciken tare da yarda da ɗabi'a da izinin SPHMMC daga Hukumar Kula da Ciki na Ma'aikatar Kimiyyar Lantarki na Likita, Faculty of Health Sciences, Addis Jami'ar Ababa.Tun da bincikenmu ya shafi yara (kasa da shekaru 16), ba su iya ba da izini na gaskiya a rubuce. Saboda haka, iyaye / masu kula da su za su cika fom ɗin amincewa. A takaice dai, manufar aikin da ta An bayyana fa'idodin a fili ga kowane iyaye/masu kula. Ana shawartar iyaye/masu kula da cewa za a adana bayanan sirrin kowane yaro. ba su yarda su shiga cikin binciken ba.Da zarar sun yarda su shiga cikin binciken kuma ba su da sha'awar ci gaba, suna da 'yanci su janye daga binciken a kowane lokaci yayin binciken.
Muna so mu gode wa likitan yara da ke halartar wurin binciken don yin nazari mai zurfi game da marasa lafiya daga hangen nesa na asibiti. Muna kuma godiya ga marasa lafiya da suka shiga cikin binciken. Muna kuma so mu gode wa Nuhamen Zena don ba mu damar yin hakan. fitar da muhimman bayanai daga bincikenta da ba a buga ba, wanda aka loda zuwa ma'ajiyar jami'ar Addis Ababa.
1. Shaikh N, Morone NE, Bost JE, Farrell MH.Yawancin cututtuka na urinary fili a cikin yara: meta-analysis.Pediatr Infect Dis J. 2008;27:302.doi:10.1097/INF.0b013e31815e4122
2. Srivastava RN, Bagga A. Ciwon fitsari. A cikin: Srivastava RN, Bagga A, eds. Pediatric Nephrology. Bugu na 4. New Delhi: Jaypee; 2005: 235-264.
3. Wennerstrom M, Hansson S, Jodal U, Stokland E. Na farko da kuma samun ciwon koda a cikin yara maza da 'yan mata tare da cututtuka na urinary fili.J Pediatrics.2000; 136: 30-34.doi: 10.1016 / S0022-3476(00) -3
4. Millner R, Becknell B. Ciwon fitsari. Yara Clinical Arewa AM.2019;66:1-13.doi:10.1016/j.pcl.2018.08.002
5. Rabasa AI, Shatima D. Ciwon fitsari ga yara masu fama da tamowa a asibitin koyarwa na Jami’ar Maiduguri.J Trop Pediatrics.2002;48:359–361.doi:10.1093/tropej/48.6.359
6. Shafi AL, de Rekeneire N, Sayadi S, et al.Kamuwa da cuta a cikin yara da aka kwantar da su a asibiti tare da matsanancin rashin abinci mai gina jiki a Nijar.PLoS One.2013;8:e68699.doi: 10.1371/journal.pone.0068699
7. Uwaezuoke SN, Ndu IK, Eze IC.Yawanci da haɗarin cututtuka na urinary fili a cikin yara marasa abinci mai gina jiki: nazari na yau da kullum da meta-analysis.BMC Pediatrics.2019;19:261.doi: 10.1186/s12887-019-1628-y
Lokacin aikawa: Afrilu-14-2022