Orrett F A, Davis G K
Department of Paraclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, Eric Williams Medical Sciences Complex, Champs Fleurs, Trinidad and Tobago, West Indies.
West Indian Med J. 2006 Mar;55(2):95-9. doi: 10.1590/s0043-31442006000200006.
Urinary tract infection is a common condition worldwide; responsible for significant morbidity in both hospitalized and community patients. The laboratory records, for microbial isolates of infected urine and their susceptibility profiles for the years 1999 and 2003 were retrospectively reviewed and compared. In 2003, there was a significant decline in recovery ofCitrobacter spp compared to 1999. Conversely, the proportion of K pneumoniae, E coli and Enterococci increased dramatically in 2003, in both practices. For Proteus vulgaris and Proteus mirabilis, rates of isolation were increased in 2003, in hospital practice and community practice, respectively. Significant changes in antimicrobial susceptibility were also evident. A greater proportion of isolates from both practices were resistant to ampicillin, amoxicillin-clavulanic acid, cefuroxime, ceftazidime and cotrimoxazole in 2003 when compared to 1999. With respect to E coli, there were significant increases in prevalence of resistance to cefuroxime and amoxicillin-clavulanic acid. The overall resistance rate for norfloxacin remained relatively low and was unchanged for E coli. Continued surveillance of uropathogen resistance trends is important and this information should be communicated to clinicians. The feasibility of using the fluoroquinolones as a first line of therapy in urinary tract infection should be considered.
尿路感染是一种全球范围内的常见病症,在住院患者和社区患者中都会导致显著的发病率。对1999年和2003年感染尿液的微生物分离株及其药敏谱的实验室记录进行了回顾性审查和比较。与1999年相比,2003年柠檬酸杆菌属的分离率显著下降。相反,2003年,两种情况下肺炎克雷伯菌、大肠杆菌和肠球菌的比例均大幅增加。对于普通变形杆菌和奇异变形杆菌,2003年在医院和社区的分离率分别有所上升。抗菌药敏性也有显著变化。与1999年相比,2003年两种情况下更多比例的分离株对氨苄西林、阿莫西林 - 克拉维酸、头孢呋辛、头孢他啶和复方新诺明耐药。就大肠杆菌而言,对头孢呋辛和阿莫西林 - 克拉维酸的耐药率显著上升。诺氟沙星的总体耐药率仍然相对较低,且大肠杆菌的耐药率没有变化。持续监测尿路病原体耐药趋势很重要,并且应将此信息传达给临床医生。应考虑将氟喹诺酮类药物用作尿路感染一线治疗药物的可行性。