Antibiotic resistance of Escherichia coli isolated from uncomplicated UTI in general practice patients over a 10-year period
Antibiotic resistance of Escherichia coli isolated from uncomplicated UTI in general practice patients over a 10-year period
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DOI：
10.1007/s10096-019-03655-3
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发表时间：
2019-11-01
影响因子：
4.5
通讯作者：
Verbon, A.
中科院分区：
文献类型：
--
作者：
van Driel, A. A.;Notermans, D. W.;Verbon, A.
推荐首选抗生素治疗需要基于实际的抗生素敏感性数据。我们测定了女性无并发症尿路感染中大肠杆菌的抗生素敏感性，并将结果与2004年和2009年进行了比较。在Nivel初级保健数据库的30个哨点全科医生诊所中，收集了具有无并发症尿路感染症状的妇女的尿液样本。分析患者特征、大肠杆菌敏感性和ESBL产生情况。收集了689份尿液样本；大肠杆菌是分离最多的尿路病原体（83%）。除环丙沙星药敏率（2004年为96%，2009年为97%，2014年为94%，P < 0.05）外，其他药敏率均稳定。2004年、2009年和2014年对共阿莫昔拉夫的敏感性分别为88%、87%和92%。产esbl大肠杆菌的感染率由2004年的0.1%上升至2014年的2.2% （P < 0.05）。各地区对复方新诺明的药敏差异以西部最高（88%），北部最低（72%,P = 0.021）。环丙沙星敏感性与过去3个月的抗生素使用情况（97%未使用对90%使用，P = 0.002）和年龄（P = 0.005）有关。2014年磷霉素的处方比2009年增加（14.3%比5.6%），而联合阿莫昔拉、联合新诺明和氟喹诺酮类药物的处方增加（P < 0.05）。尽管大肠杆菌和ESBLs的流行率显著增加，但对大多数抗菌药物的敏感性百分比在10年内保持稳定。有必要定期进行一次调查。
Recommendations of first choice antibiotic therapy need to be based on actual antibiotic susceptibility data. We determined the antibiotic susceptibility of E. coli in uncomplicated UTI among women and compared the results with 2004 and 2009. In 30 sentinel general practitioner practices of Nivel Primary Care database, urine samples were collected from women with symptoms of uncomplicated UTI. Patient characteristics, E. coli susceptibility, and ESBL production were analyzed. Six hundred eighty-nine urine samples were collected; E. coli was the most isolated uropathogen (83%). Antibiotic susceptibility was stable over time except for ciprofloxacin (96% in 2004, 97% in 2009, and 94% in 2014; P < 0.05). The susceptibility to co-amoxiclav was 88%, 87%, and 92% in 2004, 2009, and 2014, respectively. The prevalence of ESBL-producing E. coli increased from 0.1% in 2004 to 2.2% in 2014 (P < 0.05). Regional differences in antibiotic susceptibility for co-trimoxazole were found being the highest in the west (88%) and the lowest in the north (72%, P = 0.021). Ciprofloxacin susceptibility was related to antibiotic use in the past 3 months (97% no use versus 90% use, P = 0.002) and age > 70 years (P = 0.005). In 2014, prescription of fosfomycin increased compared to 2009 (14.3% versus 5.6%) at the expense of co-amoxiclav, co-trimoxazole, and fluoroquinolones (P < 0.05). The susceptibility percentages to most antimicrobial agents tested were stable over 10 years' period although the prevalence of E. coli and ESBLs significantly increased. Performance of a survey with regular intervals is warranted.