Falagas Matthew E, Polemis Michael, Alexiou Vangelis G, Marini-Mastrogiannaki Alexandra, Kremastinou Jeni, Vatopoulos Alkiviadis C
Alfa Institute of Biomedical Sciences, Athens, Greece.
Med Sci Monit. 2008 Feb;14(2):CR75-79.
Most of antimicrobial susceptibility surveillance studies focus on isolates from hospitalized patients. A retrospective analysis of microbiological data of the antimicrobial susceptibility of Escherichia coli urinary isolates from primary care patients in Greece was performed here.
MATERIAL/METHODS: The in vitro susceptibility to ampicillin, amoxicillin/clavulanate, cefaclor, cefprozil, trimethoprim-sulfamethoxazole (cotrimoxazole), amikacin, and norfloxacin of 2460 E. coli isolates (01/2005-06/2005) from the urine specimens of patients tested at the laboratories of three Greek primary care diagnostic centers were analyzed. Only the first isolate per patient (2074 females and 386 males) were included in the analysis.
The proportion of E. coli urinary isolates that were resistant to cotrimoxazole was 20.8% and 26.4% for females and males, respectively. There were noteworthy differences between age groups; 37.8% isolates from females <15 years old were resistant to cotrimoxazole compared with 18.9%, 17%, and 23.3% for the 15-35, 35-45, and >55-year-old females, respectively (P<0.001). The proportion of isolates resistant to ampicillin was very high (from 32.1% to 45.3% and 38% to 63% for the urinary isolates from females and males, respectively, in the different age groups examined), while it was relatively low for amikacin (up to 4.1%); 17.8% and 5.5% of the isolates from males and females, respectively, were resistant to norfloxacin (18.2% for males >55 years old).
These findings offer help to clinicians in deciding the appropriate empirical treatment for primary care patients with urinary tract infection and emphasize the increasing problem of antimicrobial resistance even in the primary care setting in Greece.
大多数抗菌药物敏感性监测研究集中于住院患者的分离菌株。本文对希腊初级保健患者大肠埃希菌尿液分离株的抗菌药物敏感性微生物学数据进行了回顾性分析。
材料/方法：分析了来自希腊三个初级保健诊断中心实验室检测的患者尿液标本中2460株大肠埃希菌（2005年1月至2005年6月）对氨苄西林、阿莫西林/克拉维酸、头孢克洛、头孢丙烯、甲氧苄啶-磺胺甲恶唑（复方新诺明）、阿米卡星和诺氟沙星的体外敏感性。分析仅纳入每位患者的首个分离菌株（2074名女性和386名男性）。
大肠埃希菌尿液分离株对复方新诺明耐药的比例女性为20.8%，男性为26.4%。各年龄组之间存在显著差异；15岁以下女性分离株中37.8%对复方新诺明耐药，而15 - 35岁、35 - 45岁和55岁以上女性的这一比例分别为18.9%、17%和23.3%（P<0.001）。对氨苄西林耐药的分离株比例非常高（在所检查的不同年龄组中，女性尿液分离株为32.1%至45.3%，男性尿液分离株为38%至63%），而对阿米卡星耐药比例相对较低（高达4.1%）；男性和女性分离株中分别有17.8%和5.5%对诺氟沙星耐药（55岁以上男性为18.2%）。
这些发现有助于临床医生为患有尿路感染的初级保健患者决定合适的经验性治疗方案，并强调了即使在希腊的初级保健环境中抗菌药物耐药性问题也日益严重。
