Miotla Pawel, Romanek-Piva Katarzyna, Bogusiewicz Michal, Markut-Miotla Ewa, Adamiak Aneta, Wróbel Andrzej, Zebrowska Małgorzata, Wawrysiuk Sara, Mendyk Katarzyna, Rechberger Ewa, Jakubczak Agata, Rechberger Tomasz
2nd Department of Gynaecology, Medical University of Lublin, Lublin, Poland.
Department of Paediatric Pulmonology and Rheumatology, Medical University of Lublin, Lublin, Poland.
Biomed Res Int. 2017;2017:4192908. doi: 10.1155/2017/4192908. Epub 2017 Apr 13.
. Urinary tract infection (UTI) is considered one of the most common bacterial infections in women. The aim of this study was to investigate the types of uropathogens present, as well as the degree of antimicrobial drug resistance seen among premenopausal ( = 2748) and postmenopausal ( = 1705) women with uncomplicated UTI. . Urinary samples ( = 4453) collected from women with UTI were analyzed in terms of uropathogens present. These were considered as positive if bacterial growth was ≥10 colony forming units (CFUs)/mL. Susceptibility and resistance testing for commonly used antibiotics was subsequently assessed. . The most common uropathogens cultured from urine samples were (65.5%), followed by (12.2%), (4.7%), and (4.2%). The resistance to ampicillin exceeded 40%, independently of menopausal status. Of note, resistance to ciprofloxacin exceeded 25% among postmenopausal patients. Moreover, resistance of all uropathogens to commonly used antimicrobials was significantly higher in postmenopausal women. . Due to the high resistance rate, ampicillin, ciprofloxacin, and the trimethoprim/sulfamethoxazole combination should be avoided in treating postmenopausal women affected by UTI without being indicated by initial urine culture report. Finally, cephalexin and cefuroxime are promising alternatives as initial treatment in postmenopausal women.
尿路感染(UTI)被认为是女性中最常见的细菌感染之一。本研究的目的是调查绝经前(n = 2748)和绝经后(n = 1705)患有单纯性UTI的女性中存在的尿路病原体类型,以及所观察到的抗菌药物耐药程度。对从患有UTI的女性中收集的尿液样本(n = 4453)进行了尿路病原体分析。如果细菌生长≥10菌落形成单位(CFU)/mL,则认为这些样本为阳性。随后评估了常用抗生素的敏感性和耐药性测试。从尿液样本中培养出的最常见尿路病原体是大肠杆菌(65.5%),其次是肺炎克雷伯菌(12.2%)、粪肠球菌(4.7%)和奇异变形杆菌(4.2%)。无论绝经状态如何,对氨苄西林的耐药率均超过40%。值得注意的是,绝经后患者中对环丙沙星的耐药率超过25%。此外,绝经后女性中所有尿路病原体对常用抗菌药物的耐药性均显著更高。由于耐药率高,在治疗受UTI影响的绝经后女性时,如果初始尿液培养报告未表明,应避免使用氨苄西林、环丙沙星和甲氧苄啶/磺胺甲恶唑组合。最后,头孢氨苄和头孢呋辛作为绝经后女性的初始治疗方法是有前景的替代药物。