Department of Urology, Akashi Municipal Hospital, Akashi, Japan.
J Infect Chemother. 2011 Oct;17(5):646-51. doi: 10.1007/s10156-011-0241-2. Epub 2011 Apr 14.
Overuse of antibiotics can cause the emergence of resistant bacterial strains. This study retrospectively investigated recent trends in Escherichia coli causing urinary tract infections (UTIs), focusing on antibiotic use and antibiotic susceptibilities. Patients diagnosed with UTIs caused by E. coli in Akashi Municipal Hospital between April 2004 and March 2010 were enrolled in the study. A total of 858 UTI cases were examined. Antibiotics used in our hospital during that period and the antibiotic susceptibilities of E. coli in UTI cases were assessed. We analyzed the data on a yearly basis, with the year being defined as the period from April to the following March (e.g., in this study the period from April 2004 to March 2005 represents 2004). The first 3 years (2004-2006) were compared to the last 3 years (2007-2009). The use of piperacillin, cephazolin, amikacin, oral cefotiam, and levofloxacin decreased significantly and the use of imipenem, gentamicin (GM), cefcapene, and oral minocycline (MINO) increased significantly in the last 3 years compared to the previous 3 years. The susceptibilities of MINO in complicated cystitis significantly increased and those of GM in uncomplicated pyelonephritis significantly decreased in these 3 years (2007-2009) compared to the previous 3 years (2004-2006) (P < 0.05). Additionally, extended-spectrum β-lactamase (ESBL)-producing E. coli tended to be isolated more often; this was statistically significant in the last 3 years (2007-2009) compared to the previous 3 years (2004-2006) (P < 0.05). In conclusion, we found changes in our pattern of antibiotic use associated with changes in antibiotic susceptibilities and an increase in ESBL-producing E. coli isolated from our UTI cases. Monitoring of antibiotic use and emergence of resistant strains should be continued.
抗生素的过度使用会导致耐药菌株的出现。本研究回顾性调查了近年来引起尿路感染（UTI）的大肠埃希菌的趋势，重点关注抗生素的使用和抗生素的敏感性。研究纳入了 2004 年 4 月至 2010 年 3 月在明石市医院诊断为大肠埃希菌引起的 UTI 的患者。共检查了 858 例 UTI 病例。评估了我院在该期间使用的抗生素和 UTI 病例中大肠埃希菌的抗生素敏感性。我们按年度进行数据分析，一年定义为从 4 月到次年 3 月的时间段（例如，在本研究中，2004 年 4 月至 2005 年 3 月代表 2004 年）。将前 3 年（2004-2006 年）与后 3 年（2007-2009 年）进行比较。与前 3 年相比，在后 3 年中，哌拉西林、头孢唑林、阿米卡星、口服头孢替坦和左氧氟沙星的使用显著减少，而亚胺培南、庆大霉素（GM）、头孢卡品和口服米诺环素（MINO）的使用显著增加。在这 3 年中（2007-2009 年），复杂性膀胱炎中 MINO 的敏感性显著增加，而复杂性膀胱炎中 GM 的敏感性显著降低（2007-2009 年）与前 3 年（2004-2006 年）相比（P<0.05）。此外，产超广谱β-内酰胺酶（ESBL）的大肠埃希菌的分离率趋于增加；与前 3 年（2004-2006 年）相比，在后 3 年（2007-2009 年）中这一趋势具有统计学意义（P<0.05）。总之，我们发现抗生素使用模式的变化与抗生素敏感性的变化以及从我们的 UTI 病例中分离出的产 ESBL 大肠埃希菌的增加有关。应继续监测抗生素的使用和耐药菌株的出现。
