尿培养分离大肠埃希菌抗生素谱的评价

Sedanur Sari, S. Mıstık, P. Sağıroğlu
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摘要

目的:本研究的目的是确定该地区已知最常引起尿路感染的大肠杆菌菌株的抗菌药物耐药谱,获得其现状的微生物学数据,并为预防和管理这些感染的临床策略的发展做出贡献。材料和方法:我们的研究包括从尿液培养中分离出大肠杆菌的患者。在这项研究中,对2019年1月至2020年1月期间患者的尿液培养和抗生素谱进行了回顾性扫描。662名18岁以上的患者被纳入研究。对纳入研究的患者档案、系统登记信息和预填表格进行检查,包括检查年龄、性别、尿培养生殖状况、ESBL状况、抗生素谱、住院情况、入院门诊、住院原因、慢性及其他疾病、症状状况、尿试纸检查血液、亚硝酸盐、白细胞参数和开始抗生素治疗。结果:对大肠杆菌耐药最多的抗生素为头孢呋辛(88.5%)、妥布霉素(75%)、头孢他啶(72.9%)、头孢吡肟(59.5%)和氨苄西林(57.5%)。敏感性最高的抗生素为亚胺培南(100%)、阿米卡星(99.1%)、美罗培南(98.2%)、呋喃妥英(96.3%)和磷霉素(96.3%)。结果显示,25.7%的大肠杆菌ESBL阳性。结论:大肠杆菌是尿路感染最常见的病原体,对许多常用抗生素具有高耐药性。在经验性治疗中考虑局部耐药率,并在开始治疗时进行尿液培养,将指导治疗。根据我们的研究,我们认为在尿路感染的经验治疗中,在非并发症感染中使用磷霉素和呋喃妥因,在并发症感染和累及上尿路时使用碳青霉烯类和氨基糖苷类抗生素是合适的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
EVALUATION OF ANTIBIOGRAMS OF Escherichia coli STRAINS ISOLATED FROM URINARY CULTURES
Aim: Our aim in this study is to determine the antimicrobial resistance profiles of E. coli strains known to cause urinary tract infections most frequently in the region, to obtain microbiological data about their current status, and to contribute to the development of clinical strategies for the prevention and management of these infections. Materials and methods: Our study includes patients with Escherichia coli isolated from urine cultures. In the study, urine cultures and antibiograms of patients between January 2019 and January 2020 were scanned retrospectively. 662 patients over the age of 18 were included in the study. The files of the patients included in the study, the information registered in the system and the pre-filled forms were examined by examining age, gender, reproductive status in urine cultures, ESBL status, antibiograms, hospitalization status, admission outpatient clinic, reason for hospitalization, chronic and additional diseases, symptom status, the blood, nitrite, leukocyte parameters in the urinary dipstick test and the antibiotic treatment started were recorded. Results: The antibiotics most frequently resistant to E. coli strains were cefuroxime (88.5%), tobramycin (75%), ceftazidime (72.9%), cefepime (59.5%) and ampicillin (57.5%). The antibiotics with the highest sensitivity were imipenem (100%), amikacin (99.1%), meropenem (98.2%), nitrofurantoin (96.3%) and fosfomycin (96.3%). It was observed that 25.7% of E. coli strains were ESBL positive. Conclusion: Our findings showed that E. coli strains, which are the most common causative agents of urinary tract infections, have high resistance to many antibiotics commonly used in treatment. Considering the local resistance rates in empirical treatment and starting the treatment by making a urine culture will guide the treatment. As a result of our research, we think that the use of fosfomycin and nitrofurantoin in uncomplicated infections and the use of carbapenems and aminoglycoside antibiotics in complicated infections and upper urinary tract involvement are appropriate in the empirical treatment of urinary tract infections.
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