Antibiotic resistance patterns of outpatient pediatric urinary tract infections.
Antibiotic resistance patterns of outpatient pediatric urinary tract infections.
复制标题
门诊小儿尿路感染的抗生素抗性模式。
DOI：
10.1016/j.juro.2013.01.069
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发表时间：
2013-07
影响因子：
6.6
通讯作者：
Copp, Hillary L.
中科院分区：
文献类型：
--
作者：
Edlin, Rachel S.;Shapiro, Daniel J.;Hersh, Adam L.;Copp, Hillary L.
关键词：
我们描述了目前全国门诊儿科尿路感染的抗生素耐药模式。我们在2009年使用Surveillance Network®检查了18岁以下患者的门诊尿液分离株，该数据库包含来自195家美国医院的抗生素敏感性结果和患者人口统计学数据。我们确定了6种最常见的尿路病原体的患病率和抗生素耐药模式，即大肠埃希菌、奇异变形杆菌、克雷伯菌、肠杆菌、铜绿假单胞菌和肠球菌。我们使用卡方分析比较了男性和女性之间泌尿系病原体患病率的差异。我们确定了25，418个门诊尿液分离株。E.大肠埃希菌是最常见的泌尿道病原体，但大肠埃希菌的患病率高于其他病原体。大肠埃希菌阳性率女性（83%）高于男性（50%）（P <0.001）。其他常见种属为肠球菌（17%）、奇异变形杆菌（11%）和克雷伯菌（10%）。然而，这些泌尿道病原体各占女性分离株的5%或更少（p <0.001）。E.大肠埃希菌对甲氧苄啶-磺胺甲恶唑的耐药率最高（24%），呋喃妥因（<1%）和头孢噻吩（15%）的耐药率较低。与2002年监测网络数据相比，E.大肠埃希菌对甲氧苄啶-磺胺甲恶唑的耐药率上升（男性从23%上升到31%，女性从20%上升到23%），对环丙沙星的耐药率上升（分别从1%上升到10%，从0.6%上升到4%）。E.大肠杆菌仍然是最常见的小儿泌尿道病原体。虽然广泛使用，但由于高耐药率，在许多地区，甲氧苄啶-磺胺甲恶唑是儿科尿路感染的一种不良经验选择。第一代头孢菌素和呋喃妥因是适当的窄谱替代品，因为它们的耐药率较低。应使用局部尿路造影来辅助经验性尿路感染治疗。
We characterize the current national patterns of antibiotic resistance of outpatient pediatric urinary tract infection. We examined outpatient urinary isolates from patients younger than 18 years in 2009 using The Surveillance Network®, a database with antibiotic susceptibility results and patient demographic data from 195 United States hospitals. We determined the prevalence and antibiotic resistance patterns for the 6 most common uropathogens, ie Escherichia coli, Proteus mirabilis, Klebsiella, Enterobacter, Pseudomonas aeruginosa and Enterococcus. We compared differences in uropathogen prevalence between males and females using chi-square analysis. We identified 25,418 outpatient urinary isolates. E. coli was the most common uropathogen overall but the prevalence of E. coli was higher among females (83%) than males (50%, p <0.001). Other common species among males were Enterococcus (17%), P. mirabilis (11%) and Klebsiella (10%). However, these uropathogens each accounted for 5% or less of female isolates (p <0.001). Resistance among E. coli was highest for trimethoprim-sulfamethoxazole (24%) but lower for nitrofurantoin (less than 1%) and cephalothin (15%). Compared to 2002 Surveillance Network data, E. coli resistance rates increased for trimethoprim-sulfamethoxazole (from 23% to 31% in males and from 20% to 23% in females) and ciprofloxacin (from 1% to 10% and from 0.6% to 4%, respectively). E. coli remains the most common pediatric uropathogen. Although widely used, trimethoprim-sulfamethoxazole is a poor empirical choice for pediatric urinary tract infections in many areas due to high resistance rates. First-generation cephalosporins and nitrofurantoin are appropriate narrow-spectrum alternatives given their low resistance rates. Local antibiograms should be used to assist with empirical urinary tract infection treatment.
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影响因子：
11.8
作者：
Gupta, Kalpana;Hooton, Thomas M.;Soper, David E.
通讯作者：
Soper, David E.
影响因子：
4.4
作者：
Caterino, Jeffrey M.;Weed, Sarah Grace;Camargo, Carlos A., Jr.
通讯作者：
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影响因子：
5.2
作者：
Kahlmeter, G
通讯作者：
Kahlmeter, G
影响因子：
3.2
作者：
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通讯作者：
Gesteland, Per Hans
DOI：
10.1016/j.diagmicrobio.2008.12.016
发表时间：
2009-05-01
影响因子：
2.9
作者：
McGregor, Jessina C.;Dumyati, Ghinwa;Klevens, R. Monina
通讯作者：
Klevens, R. Monina