2011 - 2019年东安纳托利亚老年门诊患者广谱β -内酰胺酶产生大肠杆菌相关尿路感染的抗菌素耐药率和危险因素

IF 0.5 4区 医学 Q4 MICROBIOLOGY Jundishapur Journal of Microbiology Pub Date : 2023-05-15 DOI:10.5812/jjm-132890
S. Şahin, O. Karaşahin, P. Tasar
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引用次数: 0

摘要

背景:社区获得性尿路感染是老年人最常见的感染之一。无论年龄大小,最常检测到的致病微生物是大肠杆菌。随着抗生素使用的增加,社区获得性广谱β -内酰胺酶产生大肠杆菌(ESBL-E)的频率也在增加。大肠杆菌)已达到临界水平。经验性抗生素治疗的使用是通过评估基于患者的危险因素来确定的。因此,了解抗菌素耐药的危险因素和频率可以指导治疗,制定治疗方案。目的:本研究旨在确定ESBL-E的风险和耐药频率,以指导经验治疗方案的选择。老年患者结肠炎相关尿路感染(UTI)。方法:本研究为回顾性队列研究。该研究于2011年至2019年进行。815例65岁及以上门诊患者尿液培养物中大肠杆菌生长≥105菌落形成单位(cfu)/mL。结果:260例(31.9%)患者有ESBL-E。杆菌。在ESBL-E。大肠杆菌对青霉素+ β-内酰胺酶抑制剂的耐药率最高(100%)。碳青霉烯类、氨基糖苷类、膦酸和呋喃妥英类的耐药率最低。测定产esbl细菌的危险因素。其中良性前列腺肥大、近3个月使用抗生素、近1年尿路感染史、近1年导尿管使用情况、男性、近1年住院情况(P < 0.05)。唯一的独立危险因素是去年有尿路感染史,使ESBL的风险增加了2.8倍。结论:在经验性抗生素治疗中,尤其在过去一年有尿路感染史的患者中,碳青霉烯类药物可作为外注射选择,磷酸和呋喃妥因可作为口服选择。
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Antimicrobial Resistance Rates and Risk Factors for Extended-spectrum beta-Lactamase-producing Escherichia coli-associated Urinary Tract Infections in Older Outpatients in East Anatolia from 2011 - 2019
Background: Community-acquired urinary tract infection is among the most common infections in older adults. Regardless of age, the most frequently detected causative microorganism is Escherichia coli. In parallel with the increase in antibiotic use, the frequency of community-acquired extended-spectrum beta-lactamase-producing E. coli (ESBL-E. coli) has reached critical levels. The use of empirical antibiotic therapy is determined by assessing patient-based risk factors. Therefore, knowing the risk factors and the frequency of antimicrobial resistance can guide the treatment to shape the treatment. Objectives: This study aimed to determine the risks and resistance frequencies to guide the empirical treatment selection for ESBL-E. coli-associated urinary tract infection (UTI) in elderly patients. Methods: This study is a retrospective cohort study. It was carried out between 2011 - 2019. Escherichia coli growth of ≥ 105 colony-forming units (cfu)/mL in urine culture was included in 815 patients aged 65 and over who applied to outpatient clinics. Results: Two hundred and sixty (31.9%) of the patients had ESBL-E. coli. In ESBL-E. coli, antimicrobial resistance rates were highest (100%) for penicillins + β-lactamase inhibitors. The lowest resistance rates were determined for carbapenems, aminoglycosides, phosphonic acid, and nitrofurantoins. Risk factors for ESBL-producing bacteria were determined. These were the presence of benign prostatic hypertrophy, antibiotic use in the last three months, history of UTI in the last year, urinary catheter uses in the last year, male gender, and hospitalization in the last year (P < 0.05). The only independent risk factor was a history of UTI in the last year, which increased the risk of ESBL by 2.8 times. Conclusions: Carbapenems can be chosen as parenteral options, and phosphonic acids and nitrofurantoin as oral options for empirical antibiotic treatment, especially in patients with a history of UTI in the past year.
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来源期刊
CiteScore
1.30
自引率
0.00%
发文量
56
审稿时长
6-12 weeks
期刊介绍: Jundishapur Journal of Microbiology, (JJM) is the official scientific Monthly publication of Ahvaz Jundishapur University of Medical Sciences. JJM is dedicated to the publication of manuscripts on topics concerning all aspects of microbiology. The topics include medical, veterinary and environmental microbiology, molecular investigations and infectious diseases. Aspects of immunology and epidemiology of infectious diseases are also considered.
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