Jensen Maria L V, Siersma Volkert, Søes Lillian M, Nicolaisdottir Dagny, Bjerrum Lars, Holzknecht Barbara J
Department of Clinical Microbiology, Copenhagen University Hospital-Herlev and Gentofte, 2730 Herlev, Denmark.
The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, 1014 Copenhagen, Denmark.
Antibiotics (Basel). 2022 Oct 9;11(10):1382. doi: 10.3390/antibiotics11101382.
We investigated whether prior use of antibiotics affects the risk of mecillinam/trimethoprim/nitrofurantoin/multi-resistant urinary tract infection (UTI) among elderly patients in general practice. Data on urine culture came from urine samples performed in general practice and sent to hospitals in the Capital Region of Denmark, and prescription data came from a nationwide prescription database. The study population consisted of patients with UTI episodes ( = 41,027) caused by that received a concurrent antibiotic prescription against UTI from 2012 to 2017. We used a case-control design. Cases were UTI episodes caused by mecillinam, trimethoprim, nitrofurantoin or multi-resistant and controls were UTI episodes caused by not displaying the respective resistance pattern. We analyzed whether exposure to antibiotics in a period of 8-90 days prior to the UTI episode affected the risk of antibiotic resistant uropathogenic . The analyses were adjusted for age, sex, hospital admission and nursing home status. The odds of resistance to all of the four antibiotics increased significantly after exposure to antibiotics within 90 days prior to the UTI episode. In general, mecillinam showed the lowest increase in the odds for selection of resistance. The results indicate that mecillinam is a favorable antibiotic choice in terms of selection of resistance.
我们调查了在全科医疗中，先前使用抗生素是否会影响老年患者发生美西林/甲氧苄啶/呋喃妥因/多重耐药性尿路感染（UTI）的风险。尿培养数据来自全科医疗中采集并送往丹麦首都地区医院的尿样，处方数据来自全国性的处方数据库。研究人群包括2012年至2017年期间因[具体病原体未提及]引发UTI发作（n = 41,027）且同时接受了针对UTI的抗生素处方的患者。我们采用了病例对照设计。病例为美西林、甲氧苄啶、呋喃妥因或多重耐药性引起的UTI发作，对照为未表现出相应耐药模式的[具体病原体未提及]引起的UTI发作。我们分析了UTI发作前8 - 90天内接触抗生素是否会影响耐抗生素尿路致病性[具体病原体未提及]的风险。分析对年龄、性别、住院情况和养老院状态进行了调整。在UTI发作前90天内接触抗生素后，对所有四种抗生素耐药的几率显著增加。总体而言，美西林在选择耐药性方面显示出最低的几率增加。结果表明，就耐药性选择而言，美西林是一种有利的抗生素选择。
