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[摩洛哥马拉喀什产超广谱β-内酰胺酶尿路致病性肠杆菌流行病学特征的近期演变]

[Recent evolution of the epidemiological profile of extended-spectrum β-lactamase producing uropathogenic enterobacteria in Marrakech, Morocco].

作者信息

El Bouamri M C, Arsalane L, Kamouni Y, Berraha M, Zouhair S

机构信息

Laboratoire de bactériologie et virologie, hôpital militaire et universitaire Avicenne, Marrakech, Maroc; Faculté de médecine et de pharmacie, université Mohammed V-Souissi-Rabat, Souissi-Rabat, Maroc.

Laboratoire de bactériologie et virologie, hôpital militaire et universitaire Avicenne, Marrakech, Maroc; Faculté de médecine et de pharmacie, université Cadi Ayyad-Marrakech, Marrakech, Maroc.

出版信息

Prog Urol. 2014 Jun;24(7):451-5. doi: 10.1016/j.purol.2013.11.010. Epub 2014 Jan 6.

DOI:10.1016/j.purol.2013.11.010
PMID:24861685
Abstract

INTRODUCTION

Urinary tract infection by extended-spectrum β-lactamase producing enterobacteriaceae (ESBL-E) is a growing infection risk and may even lead in many cases to therapeutic impasses because of their multidrug resistance.

AIM OF THE STUDY

Follow, over a 5-year period, the evolution of the epidemiological profile of uropathogenic ESBL-E and describe their current level of antibiotic resistance.

MATERIALS AND METHODS

A retrospective work was made over a period of 5 years (from 1st January 2008 to 31st December 2012). It focused on all the ESBL-E strains isolated from all the urinary samples at the microbiology laboratory of Avicenne hospital, Marrakech (Morocco).

RESULTS

We noticed in 5 years, an important increase in the prevalence of ESBL-E. The higher prevalence of ESBL-E (51%) was recorded in the urology department. The study of the antibiotic resistance of the ESBL-E had shown antibiotic co-resistances to the ciprofloxacin (82%), to sulfamethoxazole-trimethropim (85%), to gentamicin (74%), to amikacine (51%). Our results also showed, for the first time in our region, an emergence in the resistance of enterobacteria producing ESBL to imipenem (10%).

CONCLUSION

The significant increase in the prevalence of ESBL-E has become a concern at the hospitals and in community medicine as well. The study of the resistance of ESBL-E strains antibiotics showed high rates of co-resistance to antibiotics, including the usual urology molecules.

LEVEL OF PROOF

摘要

引言

产超广谱β-内酰胺酶肠杆菌科细菌(ESBL-E)引起的尿路感染是一种日益增长的感染风险,由于其多重耐药性,在许多情况下甚至可能导致治疗困境。

研究目的

在5年期间跟踪尿路致病性ESBL-E的流行病学特征演变,并描述其当前的抗生素耐药水平。

材料与方法

进行了一项为期5年(从2008年1月1日至2012年12月31日)的回顾性研究。研究重点是从摩洛哥马拉喀什阿维森纳医院微生物实验室的所有尿液样本中分离出的所有ESBL-E菌株。

结果

我们注意到在5年中,ESBL-E的患病率显著增加。泌尿外科记录的ESBL-E患病率最高(51%)。对ESBL-E的抗生素耐药性研究表明,其对环丙沙星(82%)、磺胺甲恶唑-甲氧苄啶(85%)、庆大霉素(74%)、阿米卡星(51%)存在抗生素共同耐药性。我们的结果还首次在我们地区显示,产ESBL的肠杆菌对亚胺培南的耐药性出现(10%)。

结论

ESBL-E患病率的显著增加已成为医院和社区医学关注的问题。对ESBL-E菌株抗生素耐药性的研究表明,其对包括常用泌尿外科药物在内的抗生素存在高共同耐药率。

证据水平

5级

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