2000年至2005年泰国尿液中分离出的大肠杆菌的抗菌耐药性

Antimicrobial resistance of Escherichia coli isolated from urine in Thailand from 2000 to 2005.

作者信息

Polwichai Pitimon, Dejsirilert Surang, Panpetch Sirikul, Sawanpanyalert Pathom, Aswapokee Nalinee, Mootsikapun Piroon

机构信息

National Institute of Health, Department of Medical Sciences, Nonthaburi, Thailand.

出版信息

J Med Assoc Thai. 2009 Aug;92 Suppl 4:S59-67.

PMID:21298846

Abstract

OBJECTIVE

To study the trends of antimicrobial resistance of Escherichia coli in Thailand during 2000 and 2005.

MATERIAL AND METHOD

All isolates of E. coli from 28 hospitals across Thailand from 2000 to 2005 were tested for their susceptibility to aminoglycosides, beta-lactams, fluoroquinolones, and trimethoprim-sulfamethoxazole by the disk diffusion method (Kirby Bauer). The relevant data were collected and analyzed by the WHONET software program supported by the World Health Organization.

RESULTS

The rate of resistance to ampicillin, ceftriaxone, ceftazidime gentamicin, and ciprofloxacin increased from 79.3% to 85.3%, 12.7% to 28.5%, 10.7% to 15.2%, 25% to 32.9%, and 45.1% to 51% during the 6-year period from 2000 to 2005 among isolates from catheterized urine, respectively. The rate of resistance to gentamicin and ceftriaxone increased from 23.2% to 28.9% and 6.8% to 24.2%, from 2000 to 2005 respectively among isolates in non-intensive care units (non-ICUs). The rate of resistance to gentamicin increased from 18% to 26.1%, and 24.2% to 29.6% among isolates in out-patient department (OPD) and non-OPD, respectively. The rate of resistance to ceftriaxone increased from 2.5% to 15.4%, and 7.9% to 25.9% among isolates in OPD and non-OPD, respectively. The rate of resistance to gentamicin and ceftriaxone increased from 23.2% to 28.9%, and 6.8% to 24.2% among isolates in non-ICU, respectively. The rate of resistance to trimethoprim-sulfamethoxazole decreased from 71.2% to 62.6% among isolates in non-ICUs. Isolates from catheterized urine were significantly associated with imipenem resistance (p > 0.05).

CONCLUSION

The present study shows a significant correlation between ciprofloxacin resistance and fluoroquinolone use, and indicates that prior fluoroquinolone use seems to be the most important risk factor for ciprofloxacin-resistant E. coli bacteremia. Isolates from catheterized urine were significantly associated with resistance to imipenem, and the ICU hospitalization and OPD attention during the previous year were significantly associated with ofloxacin resistant E. coli.

摘要

目的

研究2000年至2005年期间泰国大肠杆菌的耐药趋势。

材料与方法

采用纸片扩散法（Kirby Bauer法）对2000年至2005年泰国28家医院分离出的所有大肠杆菌菌株进行氨基糖苷类、β-内酰胺类、氟喹诺酮类和甲氧苄啶-磺胺甲恶唑敏感性测试。相关数据由世界卫生组织支持的WHONET软件程序收集和分析。

结果

2000年至2005年的6年期间，导尿管尿液分离株中对氨苄西林、头孢曲松、头孢他啶、庆大霉素和环丙沙星的耐药率分别从79.3%升至85.3%、12.7%升至28.5%、10.7%升至15.2%、25%升至32.9%以及45.1%升至51%。非重症监护病房（非ICU）分离株中，2000年至2005年期间对庆大霉素和头孢曲松的耐药率分别从23.2%升至28.9%以及从6.8%升至24.2%。门诊（OPD）和非门诊分离株中，对庆大霉素的耐药率分别从18%升至26.1%以及从24.2%升至29.6%。门诊和非门诊分离株中，对头孢曲松的耐药率分别从2.5%升至15.4%以及从7.9%升至25.9%。非ICU分离株中，对庆大霉素和头孢曲松的耐药率分别从23.2%升至28.9%以及从6.8%升至24.2%。非ICU分离株中对甲氧苄啶-磺胺甲恶唑的耐药率从71.2%降至62.6%。导尿管尿液分离株与亚胺培南耐药显著相关（p>0.05）。