尿路感染細菌抗藥性趨勢與相關因子
柯明中1、李文凱1、鄭惠升1、楊智凱1、劉志光1、邱文祥1,2
1臺北市立聯合醫院泌尿科
2國立陽明大學醫學院
Factors associated with and trend of resistance to antibiotics among uropathogens
Ming-Chung Ko1, Wen-Kai Lee1, Huey-Sheng Jeng1, Chih-Kai Yang1, Chih-Kuang Liu1,
Allen Wen-Hsiang Chiu1,2
1Department of Urology, Taipei City Hospital, Taipei, Taiwan.
2National Yang-Ming University, School of Medicine, Taipei, Taiwan.
Purpose
To investigate bacterial profile and trend of and factors associated with resistance to antibiotics among uropathogens
Materials and Methods
This is a cross sectional study using reports of urine culture form a regional hospital in Taipei city from year 2006 to 2012. Only the report of the first urine culture for each individual was used for analysis. We analyze bacterial profile and rates as well as trend of resistance to commonly prescribed antibiotics among uropathogens. We used logistic regression to identifying independent risk factors, including sex, age, diabetes, indwelling urethral catheterization, urolithiasis, and urinary tract surgery, of resistance to ciprofloxacin for Escherichia coli
Results
Escherichia coli was the most common uropathogen followed by Non-E. coli Enterobacteriaceae, Pseudomonas spp., and Enterococcus spp. The percentage of Escherichia coli declined from year 2000 to 2007 although not statistically significant. The percentage of Enterococcus spp. Increased significantly during study period. The resistance rates of Escherichia coli to SXT ranged from 42.1% to 47.6% during study period. The resistance rates of Escherichia coli to cefazoline, amoxicillin+clavulanic acid, ciprofloxacin, gentamicin, amikacin, ceftazidime, and imipenem were 33.1-62.3%, 33.5-37.4%, 28.9-34.9%, 29.6%-23.9%, 2.0-3.1%, 6.9-21.7%, and 0.1%-0.1%, respectively. The resistance rates of Escherichia coli to cefazoline and ciprofloxacin increased significantly during study period. The resistance rates of Non-E. coli Enterobacteriaceae to cefazoline and ciprofloxacin increased significantly during study period. The resistance rates of Enterococcus spp. To ampicillin and penicillin increased significantly during study period. Male sex, aged more than 64 years, indwelling urine catheterization, urolithiasis, and urotract surgery are independent risk factors associated with resistance of Escherichia coli to ciprofloxacin.
Conclusion
Understanding the profile of uropathogens and their resistance pattern to commonly prescribed antibiotics is important in treating urinary tract infection.