Temporal trends and risks factors for antimicrobial resistant Enterobacteriaceae urinary isolates from outpatients in Guadeloupe.
Temporal trends and risks factors for antimicrobial resistant Enterobacteriaceae urinary isolates from outpatients in Guadeloupe.
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DOI：
10.1186/s12866-016-0749-9
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发表时间：
2016-06-24
期刊：
影响因子：
4.2
通讯作者：
Talarmin A
中科院分区：
文献类型：
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作者：
Guyomard-Rabenirina S;Malespine J;Ducat C;Sadikalay S;Falord M;Harrois D;Richard V;Dozois C;Laboratory working group;Breurec S;Talarmin A
尿路感染是社区中最常见的细菌感染。尿路病原体对常用抗生素的耐药率在世界范围内有所增加，但没有关于瓜德罗普岛社区获得性尿路感染分离菌株耐药性的公开数据。为了评估瓜德罗普门诊患者分离的肠杆菌科菌株的药敏模式，我们对2012年12月至2014年5月在私人和公共实验室进行尿液分析的门诊患者进行了前瞻性研究。测定了大肠杆菌对阿莫西林、第三代头孢菌素和环丙沙星耐药的危险因素。为了研究近10年来大肠杆菌耐药率的变化趋势，我们还收集了2003 - 2014年三个主要实验室的大肠杆菌药敏型数据进行回顾性研究。在前瞻性研究中，我们从门诊患者尿液中分离出1293株细菌进行尿液分析。最常见的分离细菌是大肠杆菌（57%）和肺炎克雷伯菌（15.5%）。37%的大肠杆菌菌株对阿莫西林具有耐药性。大肠杆菌和其他肠杆菌科细菌对第三代头孢菌素的耐药率较低（分别为3.1%和12.2%），这主要是由于存在一种广谱β -内酰胺酶。对复方新诺明和环丙沙星的耐药率为中等，分别为17.8%和15.6%。然而，大肠杆菌对环丙沙星的耐药率在过去10年中显著增加。危险因素与先前报道的数据一致，特别是随着年龄的增长，环丙沙星耐药性增加。瓜德罗普的全科医生需要更好地了解情况，以支持使用磷霉素-曲美醇处方，以减少对氟喹诺酮类药物耐药的风险。
Urinary tract infections are bacterial infections most commonly encountered in the community. The resistance rate of uropathogens to commonly prescribed antibiotics has increased worldwide but there are no published data concerning the resistance of strains isolated from community-acquired UTI in Guadeloupe. To assess the susceptibility patterns of Enterobacteriaceae strains isolated from outpatients in Guadeloupe we conducted a prospective study from December 2012 to May 2014 among outpatients consulting at private and public laboratories for urine analysis. Risk factors for E. coli resistance to amoxicillin, third-generation cephalosporin, and ciprofloxacin were also determined. To study the trends of E. coli resistance rates over the past 10 years, data on the susceptibility patterns of E. coli from 2003 to 2014 were also collected from three major laboratories for a retrospective study. During the prospective study, we isolated 1293 bacterial strains from the urine of outpatients presenting for urine analysis. The most commonly isolated bacteria were E. coli (57 %) and Klebsiella pneumoniae (15.5 %). Thirty seven per cent of the E. coli strains were resistant to amoxicillin. Resistance rates to third generation cephalosporin were low for E. coli and other Enterobacteriaceae (3.1 and 12.2 % respectively) and mostly due to the presence of an Extended Spectrum Beta-lactamase. Resistance to cotrimoxazole and ciprofloxacin was moderate (17.8 and 15.6 % respectively). However, the resistance rate of E. coli to ciprofloxacin has significantly increased during the last 10 years. Risk factors were consistent with previously reported data, especially for the increasing ciprofloxacin resistance with age. General practitioners in Guadeloupe need to be better informed to favor the prescription of fosfomycin-trometamol to reduce the risk of resistance to fluoroquinolones.