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尿路感染中的抗生素耐药性:印度患者门诊治疗的趋势及影响因素研究

Antibiotic resistance in urinary tract infections: A study on trends and contributing factors in outpatient care among Indian patients.

作者信息

Sampathkumar Ramya, R Saranya, Gnanasekaran Deepika, Thakran Vanshikaa, Aslam Haroon, Pascal Shoraf

机构信息

Department of Internal Medicine, Blackpool Victoria Teaching Hospital, Blackpool, United Kingdom.

Department of Community Medicine, Madha Medical College and Research Institute, Chennai, Tamil Nadu, India.

出版信息

Bioinformation. 2024 Dec 31;20(12):1908-1912. doi: 10.6026/9732063002001908. eCollection 2024.

Abstract

UTIs are quite a common infection in outpatient care; however, the rise of antimicrobial resistance raises considerable challenge. This study determines the trend of resistance among UTI pathogens and considers factors contributing to it, such as prescribing, which often occurs in an outpatient setting. It was a single-setting retrospective analysis of 80 outpatient UTI cases. This involved bacterial isolation, antimicrobial susceptibility testing and analysis of potential factors that may have led to resistance, such as antibiotic prescribing and patient comorbidities. Descriptive statistics were therefore applied in SPSS for data analysis. The most common pathogen was Escherichia coli (70%) and exhibited significant resistance to trimethoprim-sulfamethoxazole at 30% and to fluoroquinolones at 22%. Extended-spectrum β-lactamase (ESBL)-producing strains comprised 8% of isolates. Higher resistance rates were associated with inappropriate antibiotic use (p = 0.001), frequent use of antibiotics (p = 0.004) and comorbid conditions such as diabetes (p = 0.002). The levels of resistance to antimicrobials in outpatient UTIs are rising, especially due to the inappropriate prescribing and health conditions. Improvement of stewardship of antibiotics and accuracy of diagnosis are required in controlling trends in resistance seen in outpatient care.

摘要

尿路感染是门诊护理中相当常见的一种感染;然而,抗菌药物耐药性的上升带来了相当大的挑战。本研究确定了尿路感染病原体的耐药趋势,并考虑了导致耐药的因素,如通常在门诊环境中发生的处方行为。这是一项对80例门诊尿路感染病例的单中心回顾性分析。这包括细菌分离、抗菌药物敏感性测试以及对可能导致耐药的潜在因素进行分析,如抗生素处方和患者合并症。因此,在SPSS中应用描述性统计进行数据分析。最常见的病原体是大肠杆菌(70%),对甲氧苄啶-磺胺甲恶唑的耐药率为30%,对氟喹诺酮类的耐药率为22%。产超广谱β-内酰胺酶(ESBL)的菌株占分离株的8%。较高的耐药率与不适当使用抗生素(p = 0.001)、频繁使用抗生素(p = 0.004)以及糖尿病等合并症(p = 0.002)有关。门诊尿路感染对抗菌药物的耐药水平正在上升,特别是由于不适当的处方和健康状况。在控制门诊护理中出现的耐药趋势方面,需要改善抗生素管理和提高诊断准确性。

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本文引用的文献

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