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新冠疫情是否改变了女性患者尿路病原体的抗生素耐药性?一场新的风暴?

Does the COVID Pandemic Modify the Antibiotic Resistance of Uropathogens in Female Patients? A New Storm?

作者信息

Mareș Cristian, Petca Răzvan-Cosmin, Petca Aida, Popescu Răzvan-Ionuț, Jinga Viorel

机构信息

Department of Urology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.

Department of Urology, "Prof. Dr. Th. Burghele" Clinical Hospital, 050659 Bucharest, Romania.

出版信息

Antibiotics (Basel). 2022 Mar 10;11(3):376. doi: 10.3390/antibiotics11030376.

Abstract

Urinary tract infections (UTIs) represent a common pathology among female patients, leading to overprescribing antibiotics, globally. The emergence of the COVID-19 pandemic has dramatically increased the incidence of this particular viral pneumonia with secondary bacterial superinfection, resulting in continuous therapeutic or prophylactic recommendations of antibiotic treatment; thus, an updated analysis of current antimicrobial resistance among uropathogens is mandatory. This cross-sectional retrospective study conducted in two university hospitals in Bucharest, Romania analyzed 2469 positive urine cultures, among two different periods of 6 months, before and during the COVID-19 pandemic. The most common pathogen was 1505 (60.95%), followed by spp. 426 (17.25%). spp. was the leading Gram-positive pathogen 285 (11.54%). In gram negative bacteria, in almost all cases, an increased in resistance was observed, but the highest increase was represented by quinolones in spp., from 16.87% to 35.51% and from 30.3% to 77.41%; a significant increase in resistance was also observed for carbapenems. Surprisingly, a decrease in resistance to Penicillin was observed in spp., but the overall tendency of increased resistance is also maintained for gram positive pathogens. The lack of data on the influence of the COVID-19 pandemic on uropathogens' resistance promotes these findings as important for every clinician treating UTIs and for every specialist in the medical field in promoting reasonable recommendations of antibiotic therapies.

摘要

尿路感染(UTIs)是女性患者中常见的病理状况,在全球范围内导致抗生素过度处方。新冠疫情的出现显著增加了这种伴有继发性细菌超级感染的特定病毒性肺炎的发病率,导致对抗生素治疗的持续治疗或预防性建议;因此,必须对目前尿路病原体的抗菌耐药性进行更新分析。这项横断面回顾性研究在罗马尼亚布加勒斯特的两家大学医院进行,分析了新冠疫情之前和期间两个不同的6个月时间段内的2469份阳性尿培养物。最常见的病原体是大肠埃希菌1505株(60.95%),其次是肺炎克雷伯菌属426株(17.25%)。粪肠球菌是主要的革兰氏阳性病原体,有285株(11.54%)。在革兰氏阴性菌中,几乎在所有情况下都观察到耐药性增加,但耐药性增加最高的是喹诺酮类药物在大肠埃希菌中的耐药性,从16.87%增至35.51%,肺炎克雷伯菌属从30.3%增至77.41%;碳青霉烯类药物的耐药性也显著增加。令人惊讶的是,在肺炎克雷伯菌属中观察到对青霉素的耐药性下降,但革兰氏阳性病原体的耐药性总体增加趋势也得以维持。缺乏关于新冠疫情对尿路病原体耐药性影响的数据,使得这些研究结果对于每位治疗UTIs的临床医生以及医学领域的每位专家在促进合理的抗生素治疗建议方面都很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0894/8944623/037d7b4cc9b6/antibiotics-11-00376-g001.jpg

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