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[大肠杆菌对环丙沙星耐药性的九年趋势:哥伦比亚一家医院的横断面研究]

[Nine-year trend in Escherichia coli resistance to ciprofloxacin: cross-sectional study in a hospital in Colombia].

作者信息

Villalobos Emy Shilena Torres, Ossa José Alberto Mendivil De la, Meza Yolima Pertuz, Gulloso Andres Camilo Rojas

机构信息

Universidad Cooperativa de Colombia, Santa Marta, Colombia.

出版信息

Cad Saude Publica. 2024 Aug 26;40(7):e00031723. doi: 10.1590/0102-311XES031723. eCollection 2024.

Abstract

Ciprofloxacin is a critically important antibiotic for human health. The increase of Escherichia coli resistance to ciprofloxacin is a global public health problem due to its importance in the treatment of complicated urinary tract infections and other serious infections; however, its prescription is high in the Colombian Caribbean. The objective was to determine the resistance trend of E. coli to ciprofloxacin in a Colombian hospital of high complexity. From antibiogram reports, isolates were categorized according to Clinical and Laboratory Standards Institute criteria for each year studied; proportions were calculated and differences in sensitivity were explored using the χ2 test. The Cochran-Armitage test was used to evaluate the resistance trend. Significance was considered when p-value ≤ 0.05. In total, 6,848 isolates were analyzed, and 49.31% resistance was found. According to origin, the highest resistance was in community samples (51.96% - 95%CI: 50.51; 53.41), and by type of sample, in skin and tissues (61.76% - 95%CI: 56.96; 66.35) and urine (48.97% - 95%CI: 47.71; 50.23). Increasing trends were observed for resistance per year (p < 0.0001), community samples (p = 0.0002) and urine (p < 0.0001). Resistance to ciprofloxacin is high and tends to increase in the community and in urine, exceeding the limit established for its use at the ambulatory level, which is of concern due to the high prescription of fluoroquinolones in the locality.

摘要

环丙沙星是对人类健康至关重要的抗生素。由于其在治疗复杂性尿路感染和其他严重感染中的重要性,大肠杆菌对环丙沙星耐药性的增加是一个全球公共卫生问题;然而,在哥伦比亚加勒比地区其处方量很高。目的是确定一家高复杂性哥伦比亚医院中大肠杆菌对环丙沙星的耐药趋势。根据抗菌谱报告,按照临床和实验室标准协会标准对所研究的每年分离株进行分类;计算比例,并使用χ2检验探索敏感性差异。采用 Cochr an - Armitage检验评估耐药趋势。当p值≤0.05时认为具有显著性。总共分析了6848株分离株,发现耐药率为49.31%。按来源,社区样本中的耐药率最高(51.96% - 95%CI:50.51;53.41),按样本类型,皮肤和组织中的耐药率最高(61.76% - 95%CI:56.96;66.35),尿液中的耐药率为(48.97% - 95%CI:47.71;50.23)。观察到每年的耐药率呈上升趋势(p < 0.0001),社区样本(p = 0.0002)和尿液(p < 0.0001)。环丙沙星耐药率很高且在社区和尿液中呈上升趋势,超过了门诊使用所规定的限度,鉴于该地区氟喹诺酮类药物的高处方量,这令人担忧。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e97/11349281/b177ddbbd96e/1678-4464-csp-40-07-ES031723-gf1.jpg

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