Community-acquired Lower Urinary Tract Infections: Etiology, Antimicrobial Resistance, and Treatment Results in Female Patients.
Community-acquired Lower Urinary Tract Infections: Etiology, Antimicrobial Resistance, and Treatment Results in Female Patients.
复制标题
DOI：
10.4103/jgid.jgid_86_17
复制
发表时间：
2018-07
影响因子：
1.6
通讯作者：
Topkaya AE
中科院分区：
文献类型：
--
作者：
Erdem I;Kara Ali R;Ardic E;Elbasan Omar S;Mutlu R;Topkaya AE
大多数社区获得性尿路感染（UTIs）通常凭经验治疗。了解引起UTI的微生物的抗生素耐药性模式对于确定经验性治疗是必不可少的。本研究的目的是确定从下尿路感染中分离的细菌菌株的分布及其对常用抗菌药物的耐药模式和女性患者的治疗结果。这是一项对土耳其Trakya地区一家三级护理医院2013年1月至2016年12月4年期间90例下尿路感染女性患者的医疗病例记录进行的回顾性分析。最常见的病原体是大肠埃希菌（66.6%的病例），其次是肺炎克雷伯菌（16.6%）。磷霉素对E.大肠杆菌（耐药分离株：5.5%），其次是呋喃妥因（耐药分离株：7.4%）。产超广谱β-内酰胺酶（ESBLs）29株（32.2%），其中大肠埃希菌22株（2.2%）; coli，K.肺炎中有1例，肠杆菌属中有1例）。产ESBL大肠埃希菌耐药率较高。对甲氧苄啶-磺胺甲恶唑、环丙沙星、磷霉素和呋喃妥因的耐药率分别为77.7%、72.7%、13.6%和18.2%（P <0.05）。呋喃妥因和磷霉素的估计微生物根除率分别为89.7%和83.8%。本研究的结果表明，呋喃妥因和磷霉素可以考虑在土耳其Trakya地区的经验性治疗下尿路感染。
Most community-acquired urinary tract infections (UTIs) are usually treated empirically. The knowledge of antibiotic resistance patterns of the microorganisms causing UTI is essential for defining the empirical treatment. The aim of the present study is to determine the distribution of bacterial strains isolated from lower UTIs and their resistance patterns against commonly used antimicrobial agents and treatment results in female patients. This is a retrospective analysis of medical case records of 90 female patients with lower UTI for a period of 4 years from January 2013 to December 2016 in a tertiary care hospital in the Trakya region of Turkey. The most common causative agent was Escherichia coli (66.6% of cases) followed by Klebsiella pneumoniae (16.6%). Fosfomycin was the most active agent against E. coli (resistant isolates: 5.5%), followed by nitrofurantoin (resistant isolates: 7.4%). Extended-spectrum beta-lactamases (ESBLs) production was observed in 29 (32.2%) isolates (22 in E. coli, 6 in K. pneumoniae, and 1 in Enterobacter spp.). The antimicrobial resistance rates among ESBL-producing E. coli isolates for trimethoprim-sulfamethoxazole, ciprofloxacin, fosfomycin, and nitrofurantoin were 77.7%, 72.7%, 13.6%, and 18.2%, respectively (P < 0.05). The estimated microbiological eradication rates for nitrofurantoin and fosfomycin were 89.7% and 83.8%, respectively. The results of the present study indicate that nitrofurantoin and fosfomycin may be considered for empirical therapy of lower UTIs in Trakya region of Turkey.