Yamamichi Fukashi, Shigemura Katsumi, Matsumoto Minori, Nakano Yuzo, Tanaka Kazushi, Arakawa Soichi, Fujisawa Masato
Division of Urology, Department of Organs Therapeutics, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Urol Int. 2012;88(2):198-208. doi: 10.1159/000334976. Epub 2012 Jan 11.
Urinary tract infections (UTIs) can be hard to treat and treatment plans need to include accurate categorization such as uncomplicated or complicated UTI, or catheterized or uncatheterized UTI. We investigated the antibiotic susceptibilities of representative uropathogens in UTI categories.
We isolated uropathogens and analyzed their antimicrobial susceptibilities according to UTI categorization such as: (1) urology outpatients, urology inpatients, or other department inpatients; (2) uncomplicated or complicated UTIs; (3) upper or lower UTIs, and (4) non-catheterized or catheterized UTIs.
Escherichia coli, Enterococcus faecalis, and Pseudomonas aeruginosa were representative uropathogens. Susceptibilities to levofloxacin (LVFX) in E. coli in urology outpatients (p = 0.0179), those to ceftadizime in E. coli in other department inpatients (p = 0.0327), and those to LVFX in E. faecalis in complicated UTI (p = 0.0137) significantly decreased in these 3 years compared with the previous 3 years. Susceptibilities of upper UTI to LVFX in E. coli were significantly lower in the recent 4 years compared to lower UTI (p = 0.0452) and those of catheterized UTI to LVFX in E. faecalis were significantly lower than in non-catheterized UTI (p = 0.0153).
Data demonstrated different tendencies of uropathogens' antibiotic susceptibilities according to UTI categorizations and they could be useful for planning UTI treatments.
尿路感染（UTIs）可能难以治疗，治疗方案需要包括准确的分类，如单纯性或复杂性尿路感染，或导尿管相关或非导尿管相关尿路感染。我们调查了尿路感染分类中代表性尿路病原体的抗生素敏感性。
我们分离了尿路病原体，并根据尿路感染分类分析了它们的抗菌敏感性，分类如下：（1）泌尿外科门诊患者、泌尿外科住院患者或其他科室住院患者；（2）单纯性或复杂性尿路感染；（3）上尿路感染或下尿路感染，以及（4）非导尿管相关或导尿管相关尿路感染。
大肠埃希菌、粪肠球菌和铜绿假单胞菌是代表性尿路病原体。与前3年相比，这3年中泌尿外科门诊患者大肠埃希菌对左氧氟沙星（LVFX）的敏感性（p = 0.0179）、其他科室住院患者大肠埃希菌对头孢他啶的敏感性（p = 0.0327）以及复杂性尿路感染中粪肠球菌对LVFX的敏感性（p = 0.0137）显著降低。与下尿路感染相比，最近4年上尿路感染大肠埃希菌对LVFX的敏感性显著降低（p = 0.0452），导尿管相关尿路感染中粪肠球菌对LVFX的敏感性显著低于非导尿管相关尿路感染（p = 0.0153）。
数据表明，根据尿路感染分类，尿路病原体的抗生素敏感性存在不同趋势，这些趋势可能有助于规划尿路感染的治疗。
