Doğru Arzu, Karatoka Belma, Ergen Pınar, Şen Aydın Özlem, Tigen Elif Tükenmez
Deparment of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, İstanbul Medeniyet University, İstanbul, Turkey.
Deparment of Microbiology, Faculty of Medicine, İstanbul Medeniyet University, İstanbul, Turkey.
Turk J Urol. 2013 Dec;39(4):237-43. doi: 10.5152/tud.2013.060.
More than 95% of all urinary tract infections are caused by a single bacterium. Although E. coli is the most common bacterium causing community-acquired infections, Klebsiella spp., enteric gram-negative bacteria and S. saprophyticus have been also identified. This study evaluated the microorganisms isolated from the urine cultures of patients admitted to our outpatient clinics in 2010 and assessed E. coli resistance and the frequency of extended-spectrum beta lactamase (ESBL)-producing bacteria.
In total, 7145 urine cultures were obtained from patients admitted to all clinics between 1 January 2010 and 31 December 2010. The double-disk synergy test was used to identify the presence of ESBL producers.
The most frequently isolated microorganisms were E. coli (60.6%), Enterococcus spp. (10.3%), Klebsiella spp. (7.3%), Pseudomonas spp. (4.8%), and Streptococcus spp. (3.3%). E. coli strains were more resistant to ciprofloxacin (45.12%), trimethoprim-sulfamethoxazole (44.8%) and amoxicillin-clavulanate (31.6%), but they were less likely to be resistant to meropenem (0%), imipenem (0.2%), and amikacin (0.7%). The frequency of ESBL-producing E. coli strains was 14%.
The choice of antibiotic treatment influences the overall success of treatment and the development of resistance, and it is also closely related to the cost of the treatment. As a result, there is a need to review the current treatment protocols. As resistance rates show regional differences, it is necessary to regularly examine regional resistance rates to determine the appropriate empiric antibiotic treatment and reduce costs.
超过95%的尿路感染由单一细菌引起。虽然大肠杆菌是引起社区获得性感染最常见的细菌,但克雷伯菌属、肠道革兰氏阴性菌和腐生葡萄球菌也已被确认。本研究评估了2010年入住我们门诊的患者尿培养中分离出的微生物,并评估了大肠杆菌的耐药性以及产超广谱β-内酰胺酶(ESBL)细菌的频率。
2010年1月1日至2010年12月31日期间,从所有门诊收治的患者中总共获取了7145份尿培养样本。采用双纸片协同试验来鉴定产ESBL细菌的存在。
最常分离出的微生物是大肠杆菌(60.6%)、肠球菌属(10.3%)、克雷伯菌属(7.3%)、假单胞菌属(4.8%)和链球菌属(3.3%)。大肠杆菌菌株对环丙沙星(45.12%)、甲氧苄啶-磺胺甲恶唑(44.8%)和阿莫西林-克拉维酸(31.6%)的耐药性更强,但对美罗培南(0%)、亚胺培南(0.2%)和阿米卡星(0.7%)的耐药可能性较小。产ESBL的大肠杆菌菌株频率为14%。
抗生素治疗的选择影响治疗的总体成功率和耐药性的发展,并且还与治疗成本密切相关。因此,有必要审查当前的治疗方案。由于耐药率存在地区差异,有必要定期检查地区耐药率,以确定合适的经验性抗生素治疗并降低成本。