Smaoui Hanène, Mahjoubi Faouzia, Boutiba Ilhem, Jouaihia Wafa, Thabet Lamia, Znazen Abir, Kammoun Aouatef, Mezghanni Senda, Triki Ouahid, Hammami Adnène, Ben Hassen Assia, Kechrid Amel, Ben Redjeb Saida
Laboratoire Résistance aux antibiotiques-Faculté de Médecine, Tunis.
Tunis Med. 2003 Jun;81(6):390-4.
E. coli is the most frequently isolate species in community as well as in nosocomial acquired urinary tract infections (UTI). Trimethoprim-sulfamethoxazole (TMP-SMX), is commonly used as empiric treatment for managing uncomplicated UTI whereas the rate of resistance to amoxicilline is increasing. A multicentric retrospective study was conducted from January 1st 1999 to December 31st 2000 to evaluate the prevalence of E. coli isolates from UTI and to guide empiric therapies. Among 6994 urinary isolates, 62.6% were resistant to amoxicilline, this rate fell to 33.6% when amoxicilline was associated to clavulanic acide, 2.7% were producing extended spectrum b-lactamases (BLSE), higher than reported in France and USA. 37.3% were resistant to TMP-SMX. The high prevalence of antimicrobial resistance among UTI E. coli isolates emphasizes the necessity to review the empiric therapies. Fluoroquinolones can be considered as an alternative therapy according to their excellent tissue penetration and their wide spectrum of activity.
大肠杆菌是社区获得性以及医院获得性尿路感染(UTI)中最常分离出的菌种。甲氧苄啶-磺胺甲恶唑(TMP-SMX)通常用作治疗非复杂性UTI的经验性用药,而对阿莫西林的耐药率正在上升。1999年1月1日至2000年12月31日进行了一项多中心回顾性研究,以评估UTI中分离出的大肠杆菌的流行情况并指导经验性治疗。在6994株尿液分离菌中,62.6%对阿莫西林耐药,当阿莫西林与克拉维酸联合使用时,这一比例降至33.6%,2.7%产生超广谱β-内酰胺酶(BLSE),高于法国和美国的报道。37.3%对TMP-SMX耐药。UTI大肠杆菌分离株中抗菌药物耐药性的高流行率强调了审查经验性治疗方法的必要性。根据氟喹诺酮类药物出色的组织穿透力和广泛的活性,可以将其视为一种替代疗法。