Grüneberg R N
Department of Clinical Microbiology, University College Hospital, London, UK.
J Antimicrob Chemother. 1994 May;33 Suppl A:1-8. doi: 10.1093/jac/33.suppl_a.1.
Unselected urinary pathogens from general practice and hospital have been tested for sensitivity to a range of antimicrobial agents for the last 22 years. There have been substantial changes. In general practice there has been a considerable increase in the proportion of staphylococcal infections from 5.1% to a peak of 14.8% in 1982 and a more recent decline to 4.0%. There has also been a decrease in the proportion caused by proteus mirabilis, from 9.2% to 4.3%. Similar, but smaller, changes have been observed in the proportions of hospital urinary tract infections caused by these organisms, while the proportion of hospital infections due to Klebsiella spp. and Enterobacter spp. has fallen from 16.8% to 7.3%. These and other changes have been reflected in the changing patterns of sensitivity to antibiotics. In particular, sensitivity of urinary pathogens to ampicillin/amoxycillin has continued to fall both in general practice and in hospital. Nalidixic acid resistance is becoming more important as the proportion of Gram-positive urinary pathogens (especially enterococci) increases. More organisms were sensitive to ciprofloxacin than the other drugs tested, with little evidence of increasing resistance.
在过去的22年里，对从全科医疗和医院采集的未经筛选的尿路病原体进行了一系列抗菌药物的敏感性测试。情况发生了很大变化。在全科医疗中，葡萄球菌感染的比例大幅上升，从5.1%升至1982年的峰值14.8%，最近又降至4.0%。奇异变形杆菌引起的感染比例也有所下降，从9.2%降至4.3%。在这些病原体引起的医院尿路感染比例中也观察到了类似但较小的变化，而克雷伯菌属和肠杆菌属引起的医院感染比例则从16.8%降至7.3%。这些变化以及其他变化都反映在对抗生素敏感性模式的改变上。特别是，尿路病原体对氨苄西林/阿莫西林的敏感性在全科医疗和医院中都持续下降。随着革兰氏阳性尿路病原体（尤其是肠球菌）比例的增加，萘啶酸耐药性变得越来越重要。与其他测试药物相比，更多的病原体对环丙沙星敏感，几乎没有耐药性增加的迹象。
