Increasing prevalence of antimicrobial resistance among uropathogens causing acute uncomplicated cystitis in women
Increasing prevalence of antimicrobial resistance among uropathogens causing acute uncomplicated cystitis in women
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DOI：
10.1001/jama.281.8.736
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发表时间：
1999-02-24
影响因子：
120.7
通讯作者：
Stamm, WE
中科院分区：
文献类型：
--
作者：
Gupta, K;Scholes, U;Stamm, WE
背景指南的管理急性单纯性膀胱炎的妇女，建议经验性治疗，在适当选择的病人依赖于预测剂引起膀胱炎和知识，其抗菌药物的敏感性patterns.Objective评估的患病率和趋势，在尿路病原体的抗菌药物耐药性引起明确发作的急性单纯性膀胱炎在一个大的妇女人口。5年期间收集的尿液分离株抗菌药物敏感性的横断面调查（1992年1月、5月和9月-1996年）。设置健康维护组织。患者年龄18至50岁的门诊诊断为急性膀胱炎的女性。主要结果测量显示体外对选定抗菌剂耐药性的泌尿病原体比例;结果大肠埃希菌和金黄色葡萄球菌是最常见的泌尿道致病菌，占所研究的4342株尿液分离株的90%。在每年的研究中，大肠杆菌和所有分离株对氨苄青霉素、头孢噻吩和磺胺甲恶唑的耐药率均超过20%。对甲氧苄啶和甲氧苄啶-磺胺甲恶唑的耐药流行率在大肠杆菌中从1992年的9%以上上升到1996年的18%以上，在所有分离株中从8%上升到16%。1992 ~ 1996年大肠埃希菌及所有分离株对氨苄西林的耐药率呈显著线性上升趋势（P
Context Guidelines for the management of acute uncomplicated cystitis in women that recommend empirical therapy in properly selected patients rely on the predictability of the agents causing cystitis and knowledge of their antimicrobial susceptibility patterns.Objective To assess the prevalence of and trends in antimicrobial resistance among uropathogens causing well-defined episodes of acute uncomplicated cystitis in a large population of women.Design Cross-sectional survey of antimicrobial susceptibilities of urine isolates collected during a 5-year period (January, May, and September 1992-1996).Setting Health maintenance organization.Patients Women aged 18 to 50 years with an outpatient diagnosis of acute cystitis.Main Outcome Measures Proportion of uropathogens demonstrating in vitro resistance to selected antimicrobials; trends in resistance over the 5-year study period.Results Escherichia coli and Staphylococcus saprophyticus were the most common uropathogens, accounting for 90% of the 4342 urine isolates studied. The prevalence of resistance among E coli and all isolates combined was more than 20% for ampicillin, cephalothin, and sulfamethoxazole in each year studied. The prevalence of resistance to trimethoprim and trimethoprim-sulfamethoxazole rose from more than 9% in 1992 to more than 18% in 1996 among E coli, and from 8% to 16% among all isolates combined. There was a statistically significant increasing linear trend in the prevalence of resistance from 1992 to 1996 among E coli and all isolates combined to ampicillin (P