突尼斯社区获得性尿路感染门诊患者的抗菌药物敏感性模式（2012 - 2018年）
Antimicrobial Susceptibility Patterns of among Tunisian Outpatients with Community-Acquired Urinary Tract Infection (2012-2018).
作者信息
Daoud Nawel, Hamdoun Manel, Hannachi Hela, Gharsallah Chedlia, Mallekh Wiem, Bahri Olfa
机构信息
Biochemistry and Microbiology Laboratory, Aziza Othmana Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.
出版信息
Curr Urol. 2020 Dec;14(4):200-205. doi: 10.1159/000499238. Epub 2020 Dec 18.
INTRODUCTION
Community-acquired urinary tract infection is one of the most common reasons for consultation in everyday practice; it represents a major source of antibiotic consumption. () is the main pathogen incriminated.
OBJECTIVE
The aim of this study was to evaluate antimicrobial susceptibility patterns of community-acquired uropathogenic throughout a 7-year period.
METHODOLOGY
All strains of isolated from urine samples between January 1st 2012 and December 31st 2018 were included. Presence of ≥ 10 CFU/ml in urine culture media was considered as significant for urinary tract infection. The identification of strains was realized using standard laboratory techniques. Antibiotic susceptibility testing was performed using the disk diffusion method according to the CA-SFM/ EUCAST criteria.
RESULTS
A total of 1,335 strains were isolated. Overall susceptibility rates to antimicrobial agents were as follows: ampicillin 39.1%, amoxicillin-clavulanic acid 64.9%, cefotaxime 94.9%, trimethoprim/sulfamethox-azole 67.6%, ciprofloxacin 89.2%, ofloxacin 86.9%, amikacin 98.6%, gentamicin 93.9%, nitrofurantoin 97.6% and fosfomycin 99.3%. All isolates were susceptible to carbapenems. The frequency of extended spectrum beta-lactamases-producing strains was 4.7%. Susceptibility rates of for ampicillin, trimethoprim/sulfamethoxazole and amikacin remained relatively stable over the study period, whereas susceptibility to amoxicillin-clavulanic acid, cefotaxime and fluoroquinolones showed a 2-phase pattern. As for gentamicin, a continuous decrease in susceptibility rates was observed.
CONCLUSION
Antimicrobial susceptibility profiles of uropathogenic are constantly changing, due to modifications in the antibiogram interpretation criteria and antibiotic prescription habits. Rigorous surveillance of resistance rate is necessary to determine appropriate empirical treatment and limit the spread of multiresistant strains.
引言
社区获得性尿路感染是日常医疗实践中最常见的就诊原因之一；它是抗生素消耗的主要来源。（）是主要的致病病原体。
目的
本研究的目的是评估7年期间社区获得性尿路致病性微生物的抗菌药敏模式。
方法
纳入2012年1月1日至2018年12月31日期间从尿液样本中分离出的所有菌株。尿培养基中≥10 CFU/ml被认为对尿路感染有意义。使用标准实验室技术对菌株进行鉴定。根据CA-SFM/EUCAST标准，采用纸片扩散法进行抗生素敏感性试验。
结果
共分离出1335株菌株。对抗菌药物的总体敏感率如下：氨苄西林39.1%，阿莫西林-克拉维酸64.9%，头孢噻肟94.9%，甲氧苄啶/磺胺甲恶唑67.6%，环丙沙星89.2%，氧氟沙星86.9%，阿米卡星98.6%，庆大霉素93.9%，呋喃妥因97.6%，磷霉素99.3%。所有分离株对碳青霉烯类均敏感。产超广谱β-内酰胺酶菌株的频率为4.7%。在研究期间，氨苄西林、甲氧苄啶/磺胺甲恶唑和阿米卡星的敏感率相对稳定，而对阿莫西林-克拉维酸、头孢噻肟和氟喹诺酮类的敏感性呈两阶段模式。至于庆大霉素，观察到敏感率持续下降。
结论
由于抗菌谱解释标准和抗生素处方习惯的改变，尿路致病性微生物的抗菌药敏谱在不断变化。严格监测耐药率对于确定合适的经验性治疗和限制多重耐药菌株的传播是必要的。
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