Gupta Kalpana
Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington School of Medicine, BB1221, Box 356523, Seattle, WA 98195, USA.
Infect Dis Clin North Am. 2003 Jun;17(2):243-59. doi: 10.1016/s0891-5520(03)00006-0.
In vitro antimicrobial resistance is an evolving and growing problem in UTI. Much of the increase is occurring in acute uncomplicated cystitis, an infection that has traditionally been simple to treat. The current trend of rising TMP-SMX and beta-lactam resistance rates is worrisome. Of more concern, however, are the emerging issues of fluoroquinolone resistance and MDR among community-acquired urinary isolates. Judicious use of antibiotics and development of novel nonantimicrobial-based methods of prevention of UTI are important strategies to help slow the progression of resistance. In the meantime, ongoing surveillance of resistance trends and enhanced understanding of the determinants of resistance are crucial for optimal management of UTIs.
体外抗微生物耐药性是尿路感染中一个不断演变且日益严重的问题。耐药性增加的情况大多发生在急性单纯性膀胱炎，这种感染传统上易于治疗。目前甲氧苄啶-磺胺甲恶唑（TMP-SMX）和β-内酰胺耐药率上升的趋势令人担忧。然而，更令人担忧的是社区获得性尿分离株中氟喹诺酮耐药性和多重耐药性的新问题。合理使用抗生素以及开发新型非抗菌性预防尿路感染的方法是有助于减缓耐药性发展的重要策略。与此同时，持续监测耐药性趋势以及加深对耐药性决定因素的理解对于尿路感染的最佳管理至关重要。
