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泌尿外科医院获得性尿路感染的耐药模式:泌尿外科全球感染患病率研究的8年结果

Resistance patterns of nosocomial urinary tract infections in urology departments: 8-year results of the global prevalence of infections in urology study.

作者信息

Tandogdu Zafer, Cek Mete, Wagenlehner Florian, Naber Kurt, Tenke Peter, van Ostrum Edgar, Johansen Truls Bjerklund

机构信息

Department of Urology, Taksim Teaching Hospital, Istanbul, Turkey,

出版信息

World J Urol. 2014 Jun;32(3):791-801. doi: 10.1007/s00345-013-1154-8. Epub 2013 Aug 24.

Abstract

OBJECTIVE

To present the worldwide antibiotic resistance rates of uropathogens reported in nosocomial urinary tract infections (NAUTI) during the period of 2003-2010.

MATERIALS AND METHODS

Data from the Global Prevalence Study of Infections in Urology from the period of 2003-2010 were analyzed to evaluate the resistance rates of pathogens causing NAUTI. The web-based application was used to record data of investigators from urology departments participating in the study every year during the days allocated in November. Each center was allowed to enter data on a single day of the study. The point prevalence data was used to find differences among geographic regions and years by utilizing multiple logistic regression analysis.

RESULTS

A total of 19,756 patients were hospitalized during the study period, and in 1,866 of them, NAUTI was reported. Proof of infection was reported in 1,395 patients. Resistance rates of all antibiotics tested other than imipenem against the total bacterial spectrum were higher than 10 % in all regions. Resistance to almost all pathogens was lowest in North Europe, and there is no single year where an outbreak of resistance has been detected.

CONCLUSION

The resistance rates of most of the uropathogens against the antibiotics tested did not show significant trends of increase or decrease with Asia exhibiting the highest rates in general. The only antibiotic tested with an overall resistance rate below 10 % was imipenem. Knowledge of regional and local resistance data and prudent use of antibiotics are necessary to optimize antibiotic therapy in urological patients with NAUTI.

摘要

目的

呈现2003年至2010年期间医院获得性尿路感染(NAUTI)中报告的全球尿路病原体抗生素耐药率。

材料与方法

分析2003年至2010年全球泌尿外科感染患病率研究的数据,以评估导致NAUTI的病原体的耐药率。基于网络的应用程序用于记录每年11月指定日期参与研究的泌尿外科部门研究人员的数据。每个中心在研究的单日录入数据。利用多元逻辑回归分析,采用点患病率数据来发现地理区域和年份之间的差异。

结果

在研究期间共有19756名患者住院,其中1866名报告发生了NAUTI。1395名患者报告有感染证据。除亚胺培南外,所有测试抗生素对全细菌谱的耐药率在所有地区均高于10%。北欧对几乎所有病原体的耐药性最低,且未发现有耐药性爆发的单一年份。

结论

大多数尿路病原体对测试抗生素的耐药率未显示出显著的上升或下降趋势,总体上亚洲的耐药率最高。唯一一种总体耐药率低于10%的测试抗生素是亚胺培南。了解区域和当地的耐药数据以及谨慎使用抗生素对于优化NAUTI泌尿外科患者的抗生素治疗是必要的。

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