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[泌尿系统病原体抗生素敏感性分层在急诊科有用吗?]

[Is stratification of antibiotic susceptibility of urinary pathogens useful in the Emergency Department?].

作者信息

Hernández-Hermida Y, López-Muñoz N, Alós J I

机构信息

Juan-Ignacio Alós, Servicio de Microbiología, Hospital Universitario de Getafe, Carretera de Toledo km 12,500, 28905 Getafe, Madrid, Spain.

出版信息

Rev Esp Quimioter. 2020 Oct;33(5):379-382. doi: 10.37201/req/068.2020. Epub 2020 Aug 3.

DOI:10.37201/req/068.2020
PMID:32741192
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7528410/
Abstract

OBJECTIVE

The aim of the study wat to analyze the antibiotic susceptibility of the pathogens causing urinary tract infection (UTI) and to stratify the results in function of patient´s clinical and demographic dates.

METHODS

The susceptibility of the pathogens isolated in the urine of 144 patients with UTI randomly chosen was analyzed. The results were stratified in function of sex, age, type of UTI, previous UTI and previous antibiotic treatment.

RESULTS

The susceptibility of the all isolates and of the Escherichia coli isolates was analyzed. There were significant differences between groups in function of sex (fluoroquinolones), age (cefuroxime, ertapenem and gentamicin), type of UTI (cefuroxime, cefotaxime, ertapenem and fluoroquinolones), previous UTI and previous antibiotic treatment (cefotaxime, fluoroquinolones and fosfomycin).

CONCLUSIONS

The use of clinical and demographic data according to population and local resistance epidemiology of the pathogen causing UTI may help to select an adequate empirical treatment for UTI.

摘要

目的

本研究的目的是分析引起尿路感染(UTI)的病原体的抗生素敏感性,并根据患者的临床和人口统计学数据对结果进行分层。

方法

分析了随机选取的144例UTI患者尿液中分离出的病原体的敏感性。结果根据性别、年龄、UTI类型、既往UTI史和既往抗生素治疗情况进行分层。

结果

分析了所有分离株和大肠杆菌分离株的敏感性。在性别(氟喹诺酮类)、年龄(头孢呋辛、厄他培南和庆大霉素)、UTI类型(头孢呋辛、头孢噻肟、厄他培南和氟喹诺酮类)、既往UTI史和既往抗生素治疗情况(头孢噻肟、氟喹诺酮类和磷霉素)方面,各亚组之间存在显著差异。

结论

根据引起UTI的病原体的人群和当地耐药流行病学,利用临床和人口统计学数据可能有助于选择合适的UTI经验性治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/754e/7528410/0777f96ede25/revespquimioter-33-379-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/754e/7528410/0777f96ede25/revespquimioter-33-379-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/754e/7528410/0777f96ede25/revespquimioter-33-379-g001.jpg

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本文引用的文献

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2
Emergency Department Urinary Antibiograms Differ by Specific Patient Group.急诊科尿培养药敏结果因特定患者群体而异。
J Clin Microbiol. 2017 Sep;55(9):2629-2636. doi: 10.1128/JCM.00481-17. Epub 2017 Jun 14.
3
Executive summary of the diagnosis and treatment of urinary tract infection: Guidelines of the Spanish Society of Clinical Microbiology and Infectious Diseases (SEIMC).
泌尿道感染的诊断与治疗执行摘要:西班牙临床微生物学和传染病学会(SEIMC)指南
Enferm Infecc Microbiol Clin. 2017 May;35(5):314-320. doi: 10.1016/j.eimc.2016.11.005. Epub 2016 Dec 23.
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[Characteristics and epidemiological changes for patients with urinary tract infection in the emergency department].[急诊科尿路感染患者的特征及流行病学变化]
An Sist Sanit Navar. 2016 Apr 30;39(1):35-46. doi: 10.4321/S1137-6627/2016000100005.
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Changing epidemiology and management of infectious diseases in US EDs.美国急诊部门传染病流行病学与管理的变化
Am J Emerg Med. 2016 Jun;34(6):1059-65. doi: 10.1016/j.ajem.2016.03.024. Epub 2016 Mar 11.
6
Comparison of antibiotic susceptibility of Escherichia coli in urinary isolates from an emergency department with other institutional susceptibility data.急诊科尿液分离株中大肠杆菌的抗生素敏感性与其他机构药敏数据的比较。
Am J Health Syst Pharm. 2015 Dec 15;72(24):2176-80. doi: 10.2146/ajhp140832.
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Antibiotic Prescribing for Urinary Tract Infections in the Emergency Department Based on Local Antibiotic Resistance Patterns: Implications for Antimicrobial Stewardship.基于当地抗生素耐药模式的急诊科尿路感染抗生素处方:对抗菌药物管理的影响
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