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比较三级医院常见尿路病原体的流行病学和耐药趋势:一项为期 10 年的监测研究。

Comparative Epidemiology and Resistance Trends of Common Urinary Pathogens in a Tertiary-Care Hospital: A 10-Year Surveillance Study.

机构信息

Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, Eötvös utca 6., 6720 Szeged, Hungary.

Institute of Clinical Microbiology, Faculty of Medicine, University of Szeged, Semmelweis utca 6., 6725 Szeged, Hungary.

出版信息

Medicina (Kaunas). 2019 Jul 9;55(7):356. doi: 10.3390/medicina55070356.

Abstract

Urinary tract infections (UTIs) are common in human medicine, affecting large patient populations worldwide. The principal cause of UTIs is uropathogenic (UPEC) and , both in community and nosocomial settings. The assessment of local data on prevalence and resistance is essential to evaluate trends over time and to reflect on the national situation, compared to international data, using the methods of analytical epidemiology. The aim of this study was to assess resistance trends and epidemiology of UTIs caused by and species in inpatients and outpatients at a tertiary-care hospital in Hungary, using microbiological data. To evaluate resistance trends, several antibiotics were chosen as indicator drugs, based on local utilization data. was the most prevalent isolate, representing 56.75 ± 4.86% for outpatients and 42.29 ± 2.94% for inpatients. For , the ratio of resistant strains for several antibiotics was significantly higher in the inpatient group, while in , similar trends were only observed for gentamicin. Extended-spectrum β-lactamase (ESBL)-producing isolates were detected in 4.33-9.15% and 23.22-34.22% from outpatient, 8.85-38.97% and 10.89-36.06% from inpatient samples for and , respectively. Resistance developments in common UTI pathogens (especially to fosfomycin, sulfamethoxazole-trimethoprim, fluoroquinolones, and 3rd generation cephalosporins), seriously curb therapeutic options, especially in outpatient settings.

摘要

尿路感染(UTI)在人类医学中很常见,影响着全球大量的患者群体。UTI 的主要病因是尿路致病性大肠杆菌(UPEC)和肠杆菌属,无论是在社区还是医院环境中。评估当地关于患病率和耐药性的数据对于评估随时间推移的趋势以及将国家情况与国际数据进行比较至关重要,使用分析流行病学的方法。本研究旨在使用微生物学数据评估匈牙利一家三级保健医院住院和门诊患者中由大肠杆菌和肠杆菌属引起的 UTI 的耐药趋势和流行病学。为了评估耐药趋势,根据当地利用数据选择了几种抗生素作为指示药物。大肠杆菌是最常见的分离株,代表门诊患者的 56.75±4.86%和住院患者的 42.29±2.94%。对于肠杆菌属,几种抗生素的耐药菌株比例在住院患者组中显著更高,而在大肠杆菌属中,仅观察到庆大霉素有类似的趋势。门诊患者中分离出的产超广谱β-内酰胺酶(ESBL)的菌株分别占 4.33-9.15%和 23.22-34.22%,住院患者中分别占 8.85-38.97%和 10.89-36.06%。常见 UTI 病原体(尤其是磷霉素、磺胺甲恶唑-甲氧苄啶、氟喹诺酮类和第三代头孢菌素)的耐药性发展严重限制了治疗选择,尤其是在门诊环境中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7357/6681214/96adabaed924/medicina-55-00356-g001.jpg

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