Enfermedades infecciosas y microbiologia clinica · 2005
[Changes in the antimicrobial susceptibility of Escherichia coli isolates from nosocomial versus community-acquired urinary tract infections].
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Junquera Sonia, Loza Elena, Baquero Fernando
Аннотация
INTRODUCTION: We studied the variations in Escherichia coli sensitivity patterns to commonly used antimicrobial agents in urinary tract infections, by stratifying isolates according to year and source.
MATERIAL AND METHODS: Retrospective analysis of the sensitivity of 14,319 E. coli urine isolates to 14 antimicrobials during the period of 1994-2001. Sensitivity comparison by source of the isolate began in 1996, and included 13,263 isolates originating in the hospital and 2,350 originating in the community.
RESULTS: Penicillins were the least active antibiotic agents against the E. coli isolated (sensitivity 40.9%), followed by cotrimoxazole (66.4%), nalidixic acid (70.8%) and norfloxacin (76.1%). Sensitivities to the other antimicrobials tested remained near 95%. Sensitivity of E. coli isolates to most of the antimicrobials tested decreased gradually during the 8-year period, with a marked decrease for nalidixic acid and norfloxacin (76.0% down to 63.3% and 85.1% down to 66.6%, respectively). Nevertheless, sensitivity of E. coli to nitrofurantoin and ampicillin-sulbactam/amoxicillin-clavulanic acid increased; no significant differences were observed regarding cefazolin, gentamicin and fosfomycin. Sensitivity was higher in community E. coli isolates than in nosocomial isolates. The greatest differences corresponded to cephalosporins (OR = 2), nitrofurantoin (OR = 1.72), and ampicillin-sulbactam/ amoxicillin-clavulanic acid (OR = 1.57). Antimicrobials with significant differences in sensitivity between isolates of different sources decreased gradually from 6 (1996) to 1 (2001).
CONCLUSIONS: Penicillins, cotrimoxazole and quinolones can no longer be considered the antimicrobials of choice for empirical treatment of E. coli urinary tract infections. Along the study period, we observed a reduction in the initial susceptibility differences among hospital and community isolates.
MATERIAL AND METHODS: Retrospective analysis of the sensitivity of 14,319 E. coli urine isolates to 14 antimicrobials during the period of 1994-2001. Sensitivity comparison by source of the isolate began in 1996, and included 13,263 isolates originating in the hospital and 2,350 originating in the community.
RESULTS: Penicillins were the least active antibiotic agents against the E. coli isolated (sensitivity 40.9%), followed by cotrimoxazole (66.4%), nalidixic acid (70.8%) and norfloxacin (76.1%). Sensitivities to the other antimicrobials tested remained near 95%. Sensitivity of E. coli isolates to most of the antimicrobials tested decreased gradually during the 8-year period, with a marked decrease for nalidixic acid and norfloxacin (76.0% down to 63.3% and 85.1% down to 66.6%, respectively). Nevertheless, sensitivity of E. coli to nitrofurantoin and ampicillin-sulbactam/amoxicillin-clavulanic acid increased; no significant differences were observed regarding cefazolin, gentamicin and fosfomycin. Sensitivity was higher in community E. coli isolates than in nosocomial isolates. The greatest differences corresponded to cephalosporins (OR = 2), nitrofurantoin (OR = 1.72), and ampicillin-sulbactam/ amoxicillin-clavulanic acid (OR = 1.57). Antimicrobials with significant differences in sensitivity between isolates of different sources decreased gradually from 6 (1996) to 1 (2001).
CONCLUSIONS: Penicillins, cotrimoxazole and quinolones can no longer be considered the antimicrobials of choice for empirical treatment of E. coli urinary tract infections. Along the study period, we observed a reduction in the initial susceptibility differences among hospital and community isolates.