2000年美国大肠杆菌多重耐药性尿路分离株的患病率及患者人口统计学特征
Multidrug-resistant urinary tract isolates of Escherichia coli: prevalence and patient demographics in the United States in 2000.
作者信息
Sahm D F, Thornsberry C, Mayfield D C, Jones M E, Karlowsky J A
机构信息
MRL, Herndon, Virginia 20171, USA.
出版信息
Antimicrob Agents Chemother. 2001 May;45(5):1402-6. doi: 10.1128/AAC.45.5.1402-1406.2001.
Concurrent resistance to antimicrobials of different structural classes has arisen in a multitude of bacterial species and may complicate the therapeutic management of infections, including those of the urinary tract. To assess the current breadth of multidrug resistance among urinary isolates of Escherichia coli, the most prevalent pathogen contributing to these infections, all pertinent results in The Surveillance Network Database-USA from 1 January to 30 September 2000 were analyzed. Results were available for 38,835 urinary isolates of E. coli that had been tested against ampicillin, cephalothin, ciprofloxacin, nitrofurantoin, and trimethoprim-sulfamethoxazole. Of these isolates, 7.1% (2,763 of 38,835) were resistant to three or more agents and considered multidrug resistant. Among the multidrug-resistant isolates, 97.8% were resistant to ampicillin, 92.8% were resistant to trimethoprim-sulfamethoxazole, 86.6% were resistant to cephalothin, 38.8% were resistant to ciprofloxacin, and 7.7% were resistant to nitrofurantoin. The predominant phenotype among multidrug-resistant isolates (57.9%; 1,600 of 2,793) included resistance to ampicillin, cephalothin, and trimethoprim-sulfamethoxazole. This was the most common phenotype regardless of patient age, gender, or inpatient-outpatient status and in eight of the nine U.S. Bureau of the Census regions. Rates of multidrug resistance were demonstrated to be higher among males (10.4%) than females (6.6%), among patients > 65 years of age (8.7%) than patients < or = 17 (6.8%) and 18 to 65 (6.1%) years of age, and among inpatients (7.6%) than outpatients (6.9%). Regionally, the rates ranged from 4.3% in the West North Central region to 9.2% in the West South Central region. Given the current prevalence of multidrug resistance among urinary tract isolates of E. coli in the United States (7.1%), continued local, regional, and national surveillance is warranted.
多种细菌物种中已出现对不同结构类别的抗菌药物的同时耐药性，这可能会使包括尿路感染在内的感染的治疗管理变得复杂。为评估导致这些感染的最常见病原体——大肠埃希菌尿路分离株中目前多重耐药的广度，对2000年1月1日至9月30日美国监测网络数据库中的所有相关结果进行了分析。有38835株大肠埃希菌尿路分离株的结果可供分析，这些分离株已针对氨苄西林、头孢噻吩、环丙沙星、呋喃妥因和甲氧苄啶 - 磺胺甲恶唑进行了检测。在这些分离株中，7.1%（38835株中的2763株）对三种或更多种药物耐药，被视为多重耐药。在多重耐药分离株中，97.8%对氨苄西林耐药，92.8%对甲氧苄啶 - 磺胺甲恶唑耐药，86.6%对头孢噻吩耐药，38.8%对环丙沙星耐药，7.7%对呋喃妥因耐药。多重耐药分离株中的主要表型（57.9%；2793株中的1600株）包括对氨苄西林、头孢噻吩和甲氧苄啶 - 磺胺甲恶唑耐药。无论患者年龄、性别或住院 - 门诊状态如何，以及在美国人口普查局的九个地区中的八个地区，这都是最常见的表型。多重耐药率在男性（10.4%）中高于女性（6.6%），在年龄大于65岁的患者（8.7%）中高于年龄小于或等于17岁（6.8%）和18至65岁（6.1%）的患者，在住院患者（7.6%）中高于门诊患者（6.9%）。在地区上，发生率从西北中部地区的4.3%到西南中部地区的9.2%不等。鉴于目前美国大肠埃希菌尿路分离株中多重耐药的流行率（7.1%），有必要继续进行地方、区域和国家监测。
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