韩国急性单纯性膀胱炎中大肠杆菌的抗生素敏感性和耐药性患病率：系统评价和荟萃分析。
Prevalence of antibiotic susceptibility and resistance of Escherichia coli in acute uncomplicated cystitis in Korea: Systematic review and meta-analysis.
作者信息
Kim Jae Heon, Sun Hwa Yeon, Kim Tae Hyong, Shim Sung Ryul, Doo Seung Whan, Yang Won Jae, Lee Eun Jung, Song Yun Seob
机构信息
Department of Urology Department of Internal Medicine Institute for Clinical Molecular Biology Research, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea.
出版信息
Medicine (Baltimore). 2016 Sep;95(36):e4663. doi: 10.1097/MD.0000000000004663.
BACKGROUND
The aim of this study is to determine the prevalence of antibiotic susceptibility and resistance of Escherichia coli Escherichia coli (E coli) in female uncomplicated cystitis in Korea using meta-analysis.
METHODS
A cross-search of the literature was performed with MEDLINE for all relevant data published before October 2015 and EMBASE from 1980 to 2015, the Cochrane Library, KoreaMed, RISS, KISS, and DBPia were also searched. Observational or prospective studies that reported the prevalence of antimicrobial susceptibility and resistance of E coli were selected for inclusion. No language or time restrictions were applied. We performed a meta-analysis using a random effects model to quantify the prevalence of antimicrobial susceptibility and resistance of E coli.
RESULTS
Ten studies were eligible for the meta-analysis, which together included a total of 2305 women with uncomplicated cystitis. The overall resistance rate to antibiotics was 0.28 (95% confidence interval [CI]: 0.25, 0.32). The pooled resistance rates were 0.08 (95% CI: 0.06, 0.11) for cephalosporin, 0.22 (95% CI: 0.18, 0.25) for fluoroquinolone (FQ), and 0.43 (95% CI: 0.35, 0.51) for trimethoprim/sulfamethoxazole (TMP/SMX). Regression analysis showed that resistance to FQ is increasing (P = 0.014) and resistance to TMP/SMX is decreasing (P = 0.043) by year. The generation of cephalosporin was not a significant moderator of differences in resistance rate.
CONCLUSION
The resistance rate of FQ in Korea is over 20% and is gradually increasing. Although the resistance rate of TMP/SMX is over 40%, its tendency is in decreasing state. Antibiotic strategies used for the treatment of uncomplicated cystitis in Korea have to be modified.
背景
本研究旨在通过荟萃分析确定韩国女性单纯性膀胱炎中大肠杆菌的抗生素敏感性和耐药性患病率。
方法
对MEDLINE进行文献交叉检索，获取2015年10月之前发表的所有相关数据，并检索1980年至2015年的EMBASE，同时检索Cochrane图书馆、韩国医学数据库、韩国研究信息服务系统、韩国学术信息数据库和韩国期刊全文数据库。纳入报告大肠杆菌抗菌药物敏感性和耐药性患病率的观察性或前瞻性研究。不设语言或时间限制。我们使用随机效应模型进行荟萃分析，以量化大肠杆菌抗菌药物敏感性和耐药性的患病率。
结果
10项研究符合荟萃分析条件，共纳入2305例单纯性膀胱炎女性。抗生素总体耐药率为0.28（95%置信区间[CI]：0.25，0.32）。头孢菌素的合并耐药率为0.08（95%CI：0.06，0.11），氟喹诺酮（FQ）为0.22（95%CI：0.18，0.25），甲氧苄啶/磺胺甲恶唑（TMP/SMX）为0.43（95%CI：0.35，0.51）。回归分析显示，每年对FQ的耐药性在增加（P = 0.014），对TMP/SMX的耐药性在下降（P = 0.043）。头孢菌素的代别不是耐药率差异的显著调节因素。
结论
韩国FQ的耐药率超过20%且呈逐渐上升趋势。虽然TMP/SMX的耐药率超过40%，但其趋势呈下降状态。韩国用于治疗单纯性膀胱炎的抗生素策略必须进行调整。
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