摘要
目的研究产超广谱β-内酰胺酶(ESBLs)大肠埃希菌致社会获得性尿路感染患者的耐药情况,旨在为合理选择抗生素提供参考。方法132例社会获得性尿路感染患者,采集并统计其中段尿样的培养结果,根据尿培养结果分为ESBLs组(65例)和非ESBLs组(67例)。比较两组耐药情况及导致尿路感染的临床指标。结果ESBLs组对氨苄西林、氨曲南、环丙沙星、头孢曲松、左氧氟沙星及妥布霉素的耐药率分别为100.0%、38.5%、66.2%、95.4%、67.7%、23.1%,均高于非ESBLs组的83.6%、17.9%、46.3%、31.3%、40.3%、7.5%,差异具有统计学意义(P<0.05)。ESBLs组尿路梗阻、近3个月入住医疗机构、3个月内抗生素的应用、置入双J管的比例分别为46.2%、53.8%、27.7%、20.0%,均高于非ESBLs组的26.9%、31.3%、9.0%、4.5%,差异具有统计学意义(P<0.05)。结论患有尿路梗阻、近3个月入住医疗机构、3个月内应用抗生素、置入双J管史的患者较容易出现产ESBLs大肠埃希菌导致的尿路感染,所以应该对出现以上情况的尿路感染患者给予密切监控,并尽快进行治疗,选取适当的抗生素,以防加重病情。
Objective To study the drug resistance in patients with community-acquired urinary tract infection caused by extended-spectrumβ-lactamase(ESBLs)-producing Escherichia coli,so as to provide reference for rational selection of antibiotics.Methods 132 patients with community-acquired urinary tract infection were selected,and the culture results of the middle urine samples were collected and counted.According to the culture results,they were divided into ESBLs group(65 cases)and non-ESBLs group(67 cases).The drug resistance and clinical indexes of urinary tract infection were compared between the two groups.Results The rates of resistance to ampicillin,aztreonam,ciprofloxacin,ceftriaxone,levofloxacin and tobramycin in the ESBLs group were 100.0%,38.5%,66.2%,95.4%,67.7%and 23.1%,which were higher than 83.6%,17.9%,46.3%,31.3%,40.3%and 7.5%in the non-ESBLs group,and the differences were statistically significant(P<0.05).The proportions of urinary tract obstruction,admission to medical institutions in the last 3 months,application of antibiotics within 3 months,and placement of double-J tube were 46.2%,53.8%,27.7%,and 20.0%in the ESBLs group,which were higher than 26.9%,31.3%,9.0%,and 4.5%in the non-ESBLs group,and the differences were statistically significant(P<0.05).Conclusion Patients with urinary tract obstruction and a history of admission to a medical facility in the last 3 months,application of antibiotics within 3 months,and placement of a double J-tube are more likely to develop urinary tract infections caused by ESBLs-producing Escherichia coli,so patients with these conditions should be closely monitored and treated as soon as possible with appropriate antibiotics selected to prevent aggravation.
作者
王卉怡
肖冬梅
WANG Hui-yi;XIAO Dong-mei(Department of Microbiological Laboratory,Tiexi District Center for Disease Control and Prevention,Shenyang 110000,China)
出处
《中国现代药物应用》
2023年第5期73-76,共4页
Chinese Journal of Modern Drug Application
关键词
产超广谱Β-内酰胺酶
大肠埃希菌
社区来源
尿路感染
Extended-spectrumβ-lactamase
Escherichia coli
Community source
Urinary tract infection
