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尿路感染患者中产超广谱β-内酰胺酶尿路病原体的患病率及危险因素

Prevalence and risk factors for extended spectrum Beta-lactamase-producing uropathogens in patients with urinary tract infection.

作者信息

Lee Dong Sup, Lee Chung Bum, Lee Seung-Ju

机构信息

Department of Urology, St. Vincent's Hospital, The Catholic University of Korea, School of Medicine, Suwon, Korea.

出版信息

Korean J Urol. 2010 Jul;51(7):492-7. doi: 10.4111/kju.2010.51.7.492. Epub 2010 Jul 20.

Abstract

PURPOSE

The aim of this study was to determine the prevalence and risk factors of extended spectrum beta-lactamase (ESBL)-producing microorganisms in urinary tract infection.

MATERIALS AND METHODS

total of 2,312 patients older than 25 years and diagnosed from January 2007 to December 2009 as having urinary tract infection were studied. The prevalence of ESBL-producing microorganisms including Escherichia coli and the antimicrobial susceptibility of E. coli were examined. Univariate analyses were performed with gender, age, inpatient status, previous hospitalization, recent history of urinary catheterization, recent exposure to specific antibiotics, and past history of urogenital organ operation as risk factors for the emergence of ESBL-producing microorganisms. Then, multivariate analysis was performed with all significant variables.

RESULTS

In outpatient urinary tract infection, the antimicrobial susceptibility of E. coli to each of the third-generation cephalosporins, cefotaxime, ceftazidime, and ceftriaxone, was 87.6%, 93.4%, and 87.7%, respectively, and the prevalence of ESBL-producing E. coli was 12.1%. In inpatient urinary tract infection, the susceptibility of E. coli was 78%, 84.5%, and 76.9%, respectively, and the prevalence was 23.1%.

CONCLUSIONS

The overall prevalence of ESBL-producing microorganism was 12.6% and the risk appeared to be increased in cases with a previous hospitalization, a recent history of urinary catheterization, inpatient status, cefaclor medication, cefminox administration, and female gender.

摘要

目的

本研究旨在确定尿路感染中产超广谱β-内酰胺酶(ESBL)微生物的患病率及危险因素。

材料与方法

对2007年1月至2009年12月期间诊断为尿路感染的2312例25岁以上患者进行研究。检测包括大肠杆菌在内的产ESBL微生物的患病率及大肠杆菌的抗菌药敏情况。将性别、年龄、住院状态、既往住院史、近期导尿史、近期使用特定抗生素情况以及泌尿生殖器官手术史作为产ESBL微生物出现的危险因素进行单因素分析。然后,对所有显著变量进行多因素分析。

结果

在门诊尿路感染中,大肠杆菌对第三代头孢菌素头孢噻肟、头孢他啶和头孢曲松的抗菌药敏率分别为87.6%、93.4%和87.7%,产ESBL大肠杆菌的患病率为12.1%。在住院尿路感染中,大肠杆菌的药敏率分别为78%、84.5%和76.9%,患病率为23.1%。

结论

产ESBL微生物的总体患病率为12.6%,既往住院、近期导尿史、住院状态、服用头孢克洛、使用头孢米诺以及女性等情况的风险似乎增加。

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