摘要
目的分析近五年引起复发性泌尿系感染(RUTI)大肠埃希菌的耐药性变迁规律,为临床治疗RUTI提供参考。方法回顾性分析医院2011年-2015年间216例符合条件的RUTI病例;分析引起RUTI的大肠埃希菌(UPEC)对临床常用抗菌药物的敏感性。结果共分离UPEC菌株216株,这些UPEC对青霉素类、喹诺酮类、一代头孢菌素、三代头孢菌素(除外头孢他啶)、磺胺类、四环素类的耐药率均在60%以上;对氨基糖苷类、碳青霉烯类、含β-内酰胺酶抑制剂类、硝基呋喃类药物较为敏感;五年间,UPEC对上述药物的耐药率呈逐年递增的趋势,且与这些菌株的超广谱β-内酰胺酶(ESBL)阳性率递增趋势相一致。此外,UPEC对环丙沙星和阿米卡星的耐药率则逐年下降。结论引起RUTI的UPEC对临床常用抗菌药物的耐药率逐年增高;菌株产ESBL与其耐药率变化趋势一致,可作为经验性用药的参考指标之一;青年患者的菌株较老年患者的菌株呈现出更高的耐药率。
OBJECTIVE To understand the change of drug resistance of Escherichia coli causing recurrent urinary tract infection （RUTI） in the past five years so as to provide guidance for clinical treatment of RUTL METHODS From 2011 to 2015, a total of 216 patients with RUTI who were eligible for the inclusion criteria were retrospec- tively analyzed. The susceptibility of the E. coli causing RUTI to the commonly used antibiotics was observed. RESULTS Totally 216 strains of UPEC were isolated. The drug resistance rates of the UPEC strains to penicillins, quinolones, first generation cephalosporins, third generation cephalosporins （except ceftazidime）, sulfonamides, and tetracyclines were more than 60% the strains were highly susceptible to aminogycosides, carbapenems, anti- biotics containing β-lactamase inhibitors, and nitrofurans. The drug resistance rates of the UPEC strains to the a- bove antibiotics increased year by year during the five years and were consistent with the increase of positive rate of extended-spectrum β-lactamase （ESBL）. Furthermore, the drug resistance rates of the UPEC strains to ciprofloxa- cin and amikacin were decreased year by year. CONCLUSION The drug resistance rates of the UPEC strains cau- sing RUTI to the commonly used antibiotics increase year by year. The change of positive rate of ESBL is consist- ent with the change of the drug resistance rate, which can be used as a reference index for empirical medication. The drug resistance rate of the strains isolated from the young patients is higher than that of the strains isolated from the elderly patients.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第21期4835-4836,4840,共3页
Chinese Journal of Nosocomiology
基金
国家自然科学基金资助项目(8157080364)
关键词
复发性泌尿系感染
致泌尿系感染大肠埃希菌
耐药
Recurrent urinary tract infection
uropathogenic
Escherichia coli
Drug resistance
