Arreguín Virginia, Cebada Margarita, Simón Jesús I, Sifuentes-Osornio José, Bobadilla-del Valle Miriam, Macías Alejandro E
Laboratorio Clinico, Centro Médico ABC, DF México.
Rev Invest Clin. 2007 Jul-Aug;59(4):239-45.
To determine the antibiotic resistance of urinary pathogens in ambulatory patients from Mexico City, in order to infer therapeutic options in environments of high resistance.
Cross sectional survey performed between July 2006, and January 2007, in patients > or =3 year-old from a private institution. Cultured organisms were identified with a commercial biochemical system. For common antibiotics, susceptibility was performed by broth microdilution with a commercial system; for fosfomycin tromethamine, the disk diffusion test was performed.
From 1685 urine specimens, 257 (15.3%) yielded a positive culture; 215 (83.7%) from women and 42 (16.3%) from men. Global resistance was the following: ampicillin, 68.4%; co-amoxiclav, 19.5%; ciprofloxacin, 36.3%; cephalothin, 64.7%; ceftriaxone, 12.2%; cefuroxime, 18.7%; nitrofurantoin, 19%; trimethoprim-sulphamethoxazol, 53.4%; gentamicin, 18.9%; and fosfomycin tromethamine, 0.8%. Escherichia coli was the main pathogen, with 203 (79%) isolations; its specific resistance was similar to the global one, and its production of extended-spectrum beta-lactamases (ESBLs) was 9.4%.
The high resistance rate found is alarming; we have few options for the initial treatment of urinary tract infections in ambulatory patients. To control the problem, health authorities must regulate the indiscriminate use of antibiotics.
确定墨西哥城门诊患者尿路病原体的抗生素耐药性，以便推断在高耐药环境中的治疗选择。
于2006年7月至2007年1月对一家私立机构中年龄≥3岁的患者进行横断面调查。使用商业生化系统鉴定培养出的微生物。对于常见抗生素，采用商业系统通过肉汤微量稀释法进行药敏试验；对于磷霉素氨丁三醇，采用纸片扩散法进行试验。
在1685份尿液标本中，257份（15.3%）培养结果呈阳性；其中女性215份（83.7%），男性42份（16.3%）。总体耐药情况如下：氨苄西林，68.4%；阿莫西林克拉维酸，19.5%；环丙沙星，36.3%；头孢噻吩，64.7%；头孢曲松，12.2%；头孢呋辛，18.7%；呋喃妥因，19%；甲氧苄啶磺胺甲恶唑，53.4%；庆大霉素，18.9%；磷霉素氨丁三醇，0.8%。大肠埃希菌是主要病原体，分离出203株（79%）；其具体耐药情况与总体相似，产超广谱β-内酰胺酶（ESBLs）的比例为9.4%。
发现的高耐药率令人担忧；门诊患者尿路感染的初始治疗选择有限。为控制该问题，卫生当局必须规范抗生素的滥用。
