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[单纯性尿路感染的病因及抗菌药物耐药性]

[Etiology and antimicrobial resistance of uncomplicated urinary tract infections].

作者信息

Bertoni Guillermo, Pessacq Pedro, Guerrini María Graciela, Calmaggi Aníbal, Barberis Fernanda, Jorge Laura, Bonvehi Pablo, Temporiti Elena, Herrera Fabián, Obed Mora, Alcorta Belén, Farías Juan, Mykietiuk Analía

机构信息

Hospital General de Agudos R. Rossi, La Plata, Argentina.

Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno (CEMIC), Buenos Aires, Argentina.

出版信息

Medicina (B Aires). 2017;77(4):304-308.

Abstract

Uncomplicated urinary tract infections rank among the most frequent bacterial infections in women in the outpatient setting and represent a major cause of antimicrobial prescription. The aims of this study were to assess frequencies and antimicrobial resistance of current uropathogens causing uncomplicated urinary tract infection. In a prospective multicenter study, patients were recruited in ambulatory settings of four participating hospitals between June 2011 and December 2013. We analyzed 138 patients that met clinical and bacteriological diagnostic criteria. The mean age was 28 years. Cystitis was defined in 70% (n: 97) and pyelonephritis in 30% (n: 41). Frequencies of isolated microorganisms were: Escherichia coli 70% (n: 97), Staphylococcus saprophyticus 17% (n: 24), Proteus spp. 7% (n: 10), Klebsiella spp. 4% (n: 5), Enterococcus spp. and Pseudomonas aeruginosa 1 (0.7%) each. The antimicrobial resistance was: ampicillin-sulbactam 37% (n: 51) cephalexin 28% (n: 39), trimethoprim/sulfamethoxazole 22% (n: 31), nitrofurantoin 12% (n: 17), gentamicin 7% (n: 10) and ciprofloxacin 5% (n: 7). The levels of resistance found for ampicillin-sulbactam, trimethoprim/sulfamethoxazole and cephalexin were higher than those previously reported in Argentina. A better knowledge of the etiology and local antimicrobial susceptibility allows the design of more adequate guidelines for empirical treatment.

摘要

单纯性尿路感染是门诊女性中最常见的细菌感染之一,也是抗菌药物处方的主要原因。本研究的目的是评估当前引起单纯性尿路感染的尿路病原体的频率和抗菌药物耐药性。在一项前瞻性多中心研究中,于2011年6月至2013年12月期间在四家参与医院的门诊环境中招募患者。我们分析了138例符合临床和细菌学诊断标准的患者。平均年龄为28岁。膀胱炎的定义为70%(n:97),肾盂肾炎为30%(n:41)。分离出的微生物频率为:大肠埃希菌70%(n:97),腐生葡萄球菌17%(n:24),变形杆菌属7%(n:10),克雷伯菌属4%(n:5),肠球菌属和铜绿假单胞菌各1例(0.7%)。抗菌药物耐药率为:氨苄西林-舒巴坦37%(n:51),头孢氨苄28%(n:39),甲氧苄啶/磺胺甲恶唑22%(n:31),呋喃妥因12%(n:17),庆大霉素7%(n:10),环丙沙星5%(n:7)。氨苄西林-舒巴坦、甲氧苄啶/磺胺甲恶唑和头孢氨苄的耐药水平高于阿根廷此前报道的水平。更好地了解病因和当地的抗菌药物敏感性有助于设计更合适的经验性治疗指南。

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