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围手术期早期使用碳青霉烯类药物治疗产 ESBL 大肠埃希菌所致尿石症的作用。

The role of early use of Carbapenems perioperatively for urolithiasis with ESBL-producing Escherichia coli.

机构信息

Department of Urology, Foshan Women and Children Hospital, Foshan, Guangdong, China.

Department of Urology, Jiangmen Central Hospital, Jiangmen, Guangdong, China.

出版信息

BMC Urol. 2024 Sep 6;24(1):195. doi: 10.1186/s12894-024-01572-y.

Abstract

BACKGROUND

Urolithiasis combined with ESBL-producing E. coli is often difficult to control and leads to higher postoperative infection-related complications. This study was aim to explore the efficacy and necessity for early use of carbapenem antibiotics perioperatively in urolithiasis patients with urinary tract infections caused by ESBL-producing E. coli.

METHODS

The study included a total of 626 patients who were separated into two groups: Group I (the ESBL-producing E. coli group) and Group II (the non-ESBL-producing E. coli group). Antibiotic susceptibility testing was performed and the two groups induced postoperative infection-related events were recorded. the efficacy of perioperative antibiotics was evaluated.

RESULTS

All strains of E. coli in our research were sensitive to Carbapenems antibiotics. In addition to Carbapenems, the resistance rates of ESBL-producing E. coli to 6 other commonly used antibiotics were higher than those of non-ESBL-producing strains. Based on the preoperative antibiotic susceptibility test for the ESBL-producing E. coli group and the qSOFA score, the Carbapenems were more effective than the β-lactamase inhibitors (p = 0.08), while for the non-ESBL-producing E. coli group, there was no difference in the treatment effects between Carbapenems, β-lactamase inhibitors, Ceftazidime and Quinolones (p = 0.975).

CONCLUSIONS

Carbapenem antibiotics significantly reduced the incidence of postoperative infection-related events compared with other types of antibiotics for ESBL-producing E. coli infections in patient with urolithiasis.

摘要

背景

结石合并产 ESBL 大肠埃希菌感染往往难以控制,导致术后感染相关并发症较高。本研究旨在探讨产 ESBL 大肠埃希菌尿路感染患者围手术期早期使用碳青霉烯类抗生素的疗效和必要性。

方法

本研究共纳入 626 例患者,分为两组:Ⅰ组(产 ESBL 大肠埃希菌组)和Ⅱ组(非产 ESBL 大肠埃希菌组)。进行抗生素药敏试验,记录两组术后感染相关事件,评估围手术期抗生素的疗效。

结果

本研究中所有大肠埃希菌菌株均对碳青霉烯类抗生素敏感。除碳青霉烯类外,产 ESBL 大肠埃希菌对其他 6 种常用抗生素的耐药率高于非产 ESBL 株。根据产 ESBL 大肠埃希菌组的术前抗生素药敏试验和 qSOFA 评分,碳青霉烯类抗生素的疗效优于β-内酰胺酶抑制剂(p=0.08),而非产 ESBL 大肠埃希菌组,碳青霉烯类、β-内酰胺酶抑制剂、头孢他啶和喹诺酮类抗生素的治疗效果无差异(p=0.975)。

结论

与其他类型的抗生素相比,碳青霉烯类抗生素可显著降低结石合并产 ESBL 大肠埃希菌感染患者术后感染相关事件的发生率。

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