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本文引用的文献

1
Impact of Empirical Antibiotic Therapy on Outcomes of Outpatient Urinary Tract Infection Due to Nonsusceptible .经验性抗生素治疗对非敏感性门诊尿路感染结局的影响。
Microbiol Spectr. 2022 Feb 23;10(1):e0235921. doi: 10.1128/spectrum.02359-21. Epub 2022 Feb 9.
2
Increasing rates of extended-spectrum B-lactamase-producing Escherichia coli and Klebsiella pneumoniae in uncomplicated and complicated acute pyelonephritis and evaluation of empirical treatments based on culture results.产超广谱β-内酰胺酶大肠埃希菌和肺炎克雷伯菌在单纯性和复杂性急性肾盂肾炎中的发生率增高及基于培养结果的经验性治疗评估。
Eur J Clin Microbiol Infect Dis. 2022 Mar;41(3):421-430. doi: 10.1007/s10096-021-04392-2. Epub 2022 Jan 3.
3
Risk Factors of Extended-Spectrum Beta-Lactamases-Producing Community Acquired Urinary Tract Infections: A Systematic Review.产超广谱β-内酰胺酶的社区获得性尿路感染的危险因素:一项系统综述
Infect Drug Resist. 2020 Nov 3;13:3945-3955. doi: 10.2147/IDR.S269033. eCollection 2020.
4
The Clinical Significance of High Antimicrobial Resistance in Community-Acquired Urinary Tract Infections.社区获得性尿路感染中高抗菌药物耐药性的临床意义
Can J Infect Dis Med Microbiol. 2020 Jun 4;2020:2967260. doi: 10.1155/2020/2967260. eCollection 2020.
5
Personal clinical history predicts antibiotic resistance of urinary tract infections.个人临床病史可预测尿路感染的抗生素耐药性。
Nat Med. 2019 Jul;25(7):1143-1152. doi: 10.1038/s41591-019-0503-6. Epub 2019 Jul 4.
6
Investigation of risk factors for community-acquired urinary tract infections caused by extended-spectrum beta-lactamase and species.社区获得性产超广谱β-内酰胺酶和 种属的尿路感染危险因素研究
Investig Clin Urol. 2019 Jan;60(1):46-53. doi: 10.4111/icu.2019.60.1.46. Epub 2018 Nov 23.
7
Clinical patterns, epidemiology and risk factors of community-acquired urinary tract infection caused by extended-spectrum beta-lactamase producers: a prospective hospital case-control study.产超广谱β-内酰胺酶大肠埃希菌所致社区获得性尿路感染的临床特征、流行病学及危险因素:一项前瞻性医院病例对照研究。
Infection. 2018 Aug;46(4):495-501. doi: 10.1007/s15010-018-1148-y. Epub 2018 May 10.
8
Multi-drug-resistant Gram-negative bacteria causing urinary tract infections: a review.引起尿路感染的多重耐药革兰氏阴性菌:综述
J Chemother. 2017 Dec;29(sup1):2-9. doi: 10.1080/1120009X.2017.1380395.
9
Drug-resistant gram-negative uropathogens: A review.耐药革兰阴性尿路病原体:综述。
Biomed Pharmacother. 2017 Oct;94:982-994. doi: 10.1016/j.biopha.2017.08.006. Epub 2017 Aug 12.
10
Recurrent urinary tract infections in women: risk factors, etiology, pathogenesis and prophylaxis.女性复发性尿路感染:危险因素、病因、发病机制及预防
Future Microbiol. 2017 Mar;12:239-246. doi: 10.2217/fmb-2016-0145. Epub 2017 Feb 27.

社区获得性尿路感染的致病微生物及产超广谱β-内酰胺酶菌株感染发生的危险因素

Causative Microorganisms in Community-Acquired Urinary Tract Infections and Risk Factors for the Development of Infection with Extended-Spectrum β-Lactamase-Producing Species.

作者信息

Korkmazer Rüveyda, Kayaaslan Bircan, Kaya-Kalem Ayşe, Oktay Zeynep, Eser Fatma, Hasanoğlu İmran, Güner Rahmet

机构信息

Department of Infectious Disease and Clinical Microbiology, Yıldırım Beyazıt University School of Medicine, Ankara City Hospital, Ankara, Türkiye.

出版信息

Infect Dis Clin Microbiol. 2024 Jun 28;6(2):112-122. doi: 10.36519/idcm.2024.340. eCollection 2024 Jun.

DOI:10.36519/idcm.2024.340
PMID:39005695
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11243775/
Abstract

OBJECTIVE

This study aimed to determine the microorganisms grown in the urine cultures of patients followed up with the diagnosis of community-acquired urinary tract infection (CA-UTI), their antibiotic susceptibility, and the risk factors that cause extended-spectrum β-lactamase (ESBL) production in microorganisms.

MATERIALS AND METHODS

Patients diagnosed with CA-UTI in the Yıldırım Beyazıt University City Hospital Infectious Diseases and Clinical Microbiology Clinic between February 2019 and February 2020 were prospectively analyzed. The microorganisms grown in the urine cultures and antibiotic susceptibility rates were examined. The clinical and demographic characteristics of the patients were compared in terms of the isolated agent producing ESBL.

RESULTS

(63.8%) and (22.0%) were the most common microorganisms detected in the urine cultures; the rate of those producing ESBL was 46.6%. Antibiotics with high resistance rates were ampicillin (74.2%), cefuroxime (49.6%), and ceftriaxone (49%). Male gender, complicating factors, immunosuppression, kidney transplantation and history of antibiotic use were determined as significant risk factors for ESBL production. Male gender, immunosuppression, and history of antibiotic use were also independent risk factors. ROC analysis of risk factors showed ESBL-producing bacteria were isolated at a high rate in patients having ≥3 risk factors.

CONCLUSION

The resistance rates in our study are quite high. Male gender, history of antibiotic use and immunosuppression status were found to be independent risk factors for ESBL positivity in patients with CA-UTI, and the more risk factors a patient has, the higher the risk of ESBL positivity.

摘要

目的

本研究旨在确定被诊断为社区获得性尿路感染(CA-UTI)并接受随访的患者尿液培养物中生长的微生物、它们的抗生素敏感性,以及导致微生物产生超广谱β-内酰胺酶(ESBL)的危险因素。

材料与方法

对2019年2月至2020年2月间在耶尔德勒姆·贝亚泽特大学城市医院传染病与临床微生物学诊所被诊断为CA-UTI的患者进行前瞻性分析。检查尿液培养物中生长的微生物及抗生素敏感性率。根据分离出的产ESBL病原体,比较患者的临床和人口统计学特征。

结果

尿液培养物中检测到的最常见微生物为(63.8%)和(22.0%);产ESBL的比例为46.6%。耐药率较高的抗生素为氨苄西林(74.2%)、头孢呋辛(49.6%)和头孢曲松(49%)。男性、并发症因素、免疫抑制、肾移植和抗生素使用史被确定为产生ESBL的重要危险因素。男性、免疫抑制和抗生素使用史也是独立危险因素。危险因素的ROC分析显示,有≥3个危险因素的患者中分离出产ESBL细菌的比例较高。

结论

我们研究中的耐药率相当高。男性、抗生素使用史和免疫抑制状态被发现是CA-UTI患者ESBL阳性的独立危险因素,患者的危险因素越多,ESBL阳性的风险越高。