Öztürk Reyhan, Tazegul Gokhan
Infectious Diseases, Ankara Polatlı Duatepe State Hospital, Ankara, TUR.
Internal Medicine, Ankara Polatlı Duatepe State Hospital, Ankara, TUR.
Cureus. 2021 Sep 6;13(9):e17753. doi: 10.7759/cureus.17753. eCollection 2021 Sep.
Introduction Clinicians should know the frequency and resistance patterns of bacteria that cause urinary tract infections (UTI) to provide patients with appropriate treatment and antibiotic management. However, the frequency of culture reproducing organisms and resistance patterns change in each community. Therefore, these data must be determined locally to make better treatment decisions. Herein, we aimed to determine the frequency of UTI-causing agents and current antimicrobial resistance profiles in outpatients attending our hospital. Methods This retrospective descriptive study included three hundred eight outpatients attending under the diagnosis of UTI between March and October 2020 who had a positive urine culture for bacterial growth. Age, sex, laboratory tests, urinalysis results, microorganisms grown in urine culture, and antibiograms were evaluated from the patients' medical records. Data were analyzed using SPSS version 23.0 (IBM Corp., Armonk, NY) for Windows. Results In urine culture results, ( and species are the most commonly detected agents. The growth in 71 (23%) of the 308 cultures was extended-spectrum beta-lactamase (ESBL) positive. In the growths, the susceptibility rates to fosfomycin, gentamicin, nitrofurantoin, trimethoprim-sulfamethoxazole, and ampicillin were 95.2%, 90.3%, 95.3%, 76.8%, and 49.3%, respectively. The susceptibility of species to gentamicin was as high as 93.7%, similar to that of , whereas its susceptibility rates to fosfomycin, trimethoprim-sulfamethoxazole, and nitrofurantoin were lower than those of (76.1%, 48.4%, and 68.4%, respectively). Of the 71 ESBL-positive growths, 52 were (17.3% of all UTIs), and 14 were species (4.6% of all UTIs). Of the ESBL-positive strains, 88.7%, 81%, and 76.1% were susceptible to fosfomycin and nitrofurantoin, respectively, and 64.9% and 45.7% were sensitive to cefoxitin and trimethoprim-sulfamethoxazole. Conclusion UTIs are among the most common causes of hospital admission and infections for which empirical antibiotic administration is initiated. The increasing rates of ESBL positivity and resistance to antibiotics such as ampicillin, cephalosporins, trimethoprim-sulfamethoxazole, and quinolones, especially in and strains, which are the most common pathological agents of UTI in our region, have limited the use of these treatments. However, the high susceptibility of growths to fosfomycin and nitrofurantoin and susceptibility of growths to gentamicin may make these antibiotics stand out as suitable options for the empirical treatment of UTI in our setting.
引言 临床医生应了解引起尿路感染（UTI）的细菌的频率和耐药模式，以便为患者提供适当的治疗和抗生素管理。然而，每个社区中培养出的生物体的频率和耐药模式都会发生变化。因此，必须在当地确定这些数据，以便做出更好的治疗决策。在此，我们旨在确定我院门诊患者中引起UTI的病原体的频率和当前的抗菌药物耐药情况。
方法 这项回顾性描述性研究纳入了2020年3月至10月期间诊断为UTI且尿培养细菌生长呈阳性的308名门诊患者。从患者的病历中评估年龄、性别、实验室检查、尿液分析结果、尿培养中生长的微生物以及抗菌谱。使用适用于Windows的SPSS 23.0版（IBM公司，纽约州阿蒙克）对数据进行分析。
结果 在尿培养结果中，（此处原文缺失具体菌种信息）和（此处原文缺失具体菌种信息）是最常检测到的病原体。308份培养物中有71份（23%）的生长物为超广谱β-内酰胺酶（ESBL）阳性。在（此处原文缺失具体菌种信息）的生长物中，对磷霉素、庆大霉素、呋喃妥因、甲氧苄啶-磺胺甲恶唑和氨苄西林的敏感率分别为95.2%、90.3%、95.3%、76.8%和49.3%。（此处原文缺失具体菌种信息）对庆大霉素的敏感率高达93.7%，与（此处原文缺失具体菌种信息）相似，而其对磷霉素、甲氧苄啶-磺胺甲恶唑和呋喃妥因的敏感率低于（此处原文缺失具体菌种信息）（分别为76.1%、48.4%和68.4%）。在71份ESBL阳性生长物中，52份为（此处原文缺失具体菌种信息）（占所有UTI的17.3%），14份为（此处原文缺失具体菌种信息）（占所有UTI的4. %）。在ESBL阳性菌株中，分别有88.7%、81%和76.1%对磷霉素和呋喃妥因敏感，64.9%和45.7%对头孢西丁和甲氧苄啶-磺胺甲恶唑敏感。
结论 UTI是住院和开始经验性使用抗生素治疗的感染的最常见原因之一。ESBL阳性率以及对氨苄西林、头孢菌素、甲氧苄啶-磺胺甲恶唑和喹诺酮等抗生素的耐药率不断上升，尤其是在我们地区UTI最常见的病原体（此处原文缺失具体菌种信息）和（此处原文缺失具体菌种信息）菌株中，限制了这些治疗方法的使用。然而，（此处原文缺失具体菌种信息）生长物对磷霉素和呋喃妥因的高敏感性以及（此处原文缺失具体菌种信息）生长物对庆大霉素的敏感性可能使这些抗生素成为我们环境中UTI经验性治疗的合适选择。
