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[小儿泌尿外科实践中尿路感染病原体的耐药性及抗菌治疗的选择]

[Resistance of urinary tract infection pathogens and choice of antibacterial therapy in pediatric urologic practice].

作者信息

Katosova L K, Zorkin S N, Alekhina V M, Chashchina I L, Abramov K S

出版信息

Antibiot Khimioter. 2004;49(11):34-9.

Abstract

The data on antibiotic resistance of the main uropathogens isolated from patients with urinary tract infection in an urologic department (319 isolates) and outpatient and diagnostic units (360 isolates) are presented. It was shown that by the antibiotic resistance the Escherichia coli isolates from the urologic department patients and outpatients did not practically differ: 44.1 and 47.8% of the isolates were resistant to ampicillin, 26.7 and 23.4% were resistant to amoxycillin/clavulanate, 28.9 and 24.9% were resistant to co-trimoxazole and 26.5% was resistance to cefuroxime (outpatients). The basic differences referred to Pseudomonas aeruginosa: resistance to ceftazidime in 38.5% of the isolates and resistance to gentamicin in 36.2% of the isolates. The activity against P. aeruginosa could be arranged as follows in the decreasing order: amikacin = meropenem > imipenem > cefepime = cefoperazone/sulbactam > gentamicin = ceftazidime. Resistance of P. aeruginosa to fluoroquinolones (ciprofloxacin and levofloxacin) remained low (7.4 and 8.0% respectively). No ampicillin resistance was revealed in the isolates of Enterococcus faecalis.

摘要

本文展示了从泌尿科患者(319株分离菌)以及门诊和诊断科室患者(360株分离菌)中分离出的主要尿路病原体的抗生素耐药性数据。结果表明,泌尿科患者和门诊患者分离出的大肠杆菌在抗生素耐药性方面实际上没有差异:44.1%和47.8%的分离菌对氨苄西林耐药,26.7%和23.4%对阿莫西林/克拉维酸耐药,28.9%和24.9%对复方新诺明耐药,26.5%(门诊患者)对头孢呋辛耐药。主要差异在于铜绿假单胞菌:38.5%的分离菌对头孢他啶耐药,36.2%的分离菌对庆大霉素耐药。对铜绿假单胞菌的活性按降序排列如下:阿米卡星 = 美罗培南 > 亚胺培南 > 头孢吡肟 = 头孢哌酮/舒巴坦 > 庆大霉素 = 头孢他啶。铜绿假单胞菌对氟喹诺酮类药物(环丙沙星和左氧氟沙星)的耐药性仍然较低(分别为7.4%和8.0%)。粪肠球菌分离菌未发现对氨苄西林耐药。

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