Kahlmeter G
Department of Clinical Microbiology, Central Hospital, SE-351 85 Växjö, Sweden.
J Antimicrob Chemother. 2003 Jan;51(1):69-76. doi: 10.1093/jac/dkg028.
The ECO.SENS study is the first international survey to investigate the prevalence and susceptibility of pathogens causing community-acquired acute uncomplicated urinary tract infections (UTIs). Midstream urine samples were taken for culture and for testing for the presence of leucocytes from 4734 women not older than 65 years presenting with symptoms of acute UTI at 252 community health care centres in 17 countries. Recognized urinary tract pathogens were identified and the susceptibility to 12 antimicrobials determined. Pathogens were present in 3278 (69.2%) patients, Escherichia coli accounting for 77.0% of isolates. In E. coli, 42% of the isolates were resistant to one or more of the 12 antimicrobial drugs investigated. Resistance was most common to ampicillin (29.8%) and sulfamethoxazole (29.1%), followed by trimethoprim (14.8%), trimethoprim/sulfamethoxazole (14.1%) and nalidixic acid (5.4%). Resistance in E. coli to co-amoxiclav, mecillinam, cefadroxil, nitrofurantoin, fosfomycin, gentamicin and ciprofloxacin was <3%. However, co-amoxiclav resistance was apparent in Portugal (9.3%) as was resistance to the quinolones, nalidixic acid and ciprofloxacin, in Portugal (11.6% and 5.8%, respectively) and Spain (26.7% and 14.7%, respectively). Overall, Proteus mirabilis were less resistant to ampicillin (16.1%) and more resistant to trimethoprim (25.5%) than E. coli, whereas Klebsiella spp. were more resistant to ampicillin (83.5%) and fosfomycin (56.7%). 'Other Enterobacteriaceae' were more resistant to the broad spectrum beta-lactams (ampicillin 45.9%, co-amoxiclav 21.3% and cefadroxil 24.6%), nitrofurantoin (40.2%) and fosfomycin (15.6%). In Staphylococcus saprophyticus resistance development was rare. Overall, antimicrobial resistance was lowest in the Nordic countries and Austria and highest in Portugal and Spain.
ECO.SENS研究是首项调查引起社区获得性急性单纯性尿路感染（UTI）病原体的患病率和药敏性的国际研究。在17个国家的252个社区医疗中心，采集了4734名年龄不超过65岁、有急性UTI症状的女性的中段尿样本进行培养及白细胞检测。鉴定出公认的尿路病原体，并测定了其对12种抗菌药物的药敏性。3278名（69.2%）患者检出病原体，其中大肠杆菌占分离株的77.0%。在大肠杆菌中，42%的分离株对所研究的12种抗菌药物中的一种或多种耐药。对氨苄西林（29.8%）和磺胺甲恶唑（29.1%）的耐药最为常见，其次是甲氧苄啶（14.8%）、甲氧苄啶/磺胺甲恶唑（14.1%）和萘啶酸（5.4%）。大肠杆菌对阿莫西林克拉维酸、美西林、头孢羟氨苄、呋喃妥因、磷霉素、庆大霉素和环丙沙星的耐药率<３%。然而，在葡萄牙，阿莫西林克拉维酸耐药率明显为9.3%，在葡萄牙和西班牙，对喹诺酮类药物萘啶酸和环丙沙星的耐药率分别为11.6%和5.8%以及26.7%和14.7%。总体而言，奇异变形杆菌对氨苄西林的耐药性（16.1%）低于大肠杆菌，对甲氧苄啶的耐药性（25.5%）高于大肠杆菌，而克雷伯菌属对氨苄西林（83.5%）和磷霉素（56.7%）的耐药性更高。“其他肠杆菌科细菌”对广谱β-内酰胺类药物（氨苄西林45.9%、阿莫西林克拉维酸21.3%和头孢羟氨苄24.6%）、呋喃妥因（40.2%）和磷霉素（15.6%）的耐药性更高。腐生葡萄球菌很少出现耐药。总体而言，北欧国家和奥地利的抗菌药物耐药性最低，葡萄牙和西班牙最高。
