Susceptibility patterns and ESBL rates of Escherichia coli from urinary tract infections in Canada and the United States, SMART 2010-2014
Susceptibility patterns and ESBL rates of Escherichia coli from urinary tract infections in Canada and the United States, SMART 2010-2014
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DOI：
10.1016/j.diagmicrobio.2016.04.022
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发表时间：
2016-08-01
影响因子：
2.9
通讯作者：
Sahm, Daniel F.
中科院分区：
文献类型：
--
作者：
Lob, Sibylle H.;Nicolle, Lindsay E.;Sahm, Daniel F.
尿路感染（UTI）中抗菌素耐药性的增加是一个令人担忧的问题。为了评价耐药性趋势，2010年至2014年在加拿大和美国（US）的抗菌药物耐药性趋势监测研究（SMART）中收集了3498株大肠埃希菌UTI分离株。采用CLSI微量稀释法和折点法测定ESBL表型和敏感性。2010-2014年，美国ESBL发生率增加（7.8- 18.3%，P < 0.0001），尤其是在医院相关（HA）感染、男性和老年患者（>= 65岁）中。总体而言，加拿大的ESBL率没有显示出显著趋势（10.4- 13.0%）。P = 0.079），近年来低于美国的发病率，但在社区相关（CA）感染、女性和老年患者中显著增加。在美国，但不是加拿大，2013-2014年分离株对头孢菌素类和氟喹诺酮类的敏感性在HA分离株中显著低于CA UTI，男性显著低于女性，≥ 65岁者显著低于
Increasing antimicrobial resistance in urinary tract infections (UTI) is a concern. To evaluate resistance trends, 3498 Escherichia coli UTI isolates were collected from 2010 to 2014 in the Study for Monitoring Antimicrobial Resistance Trends (SMART) in Canada and United States (US). ESBL phenotype and susceptibility were determined using CLSI microdilution and breakpoints. US ESBL rates increased in 2010-2014 (7.8-18.3%, P < 0.0001), especially among hospital-associated (HA) infections, males, and older patients (>= 65 years). Overall, ESBL rates in Canada showed no significant trend (10.4-13.0%. P = 0.079), and were lower than US rates in recent years, but increased significantly among community-associated (CA) infections, females, and older patients. In the US, but not Canada, susceptibility to cephalosporins and fluoroquinolones among 2013-2014 isolates was significantly lower in isolates from HA than CA UTI, males than females, and >= 65- than