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目的:调查我国近5年临床尿路感染病原菌对头孢曲松的耐药情况。方法:利用中国期刊全文数据库检索公开发表的关于尿路感染病原菌对头孢曲松耐药性监测的全部文献,分层计算尿路感染病原菌对头孢曲松的耐药率、敏感率,计算肯德尔相关系数(τ)。结果:共筛选出文献36篇,经统计,尿液中检出病原菌主要为大肠埃希菌(占64%)和肺炎克雷伯菌(占18%)。除奇异变形杆菌外,检出细菌对头孢曲松的耐药率均超过50%,而阴沟肠杆菌、鲍曼不动杆菌超过75%。根据肯德尔相关系数(τ)大小判断,大肠埃希菌和肺炎克雷伯菌对头孢噻肟和头孢曲松耐药呈高度相关,但不完全一致,菌株产ESBLs与头孢曲松耐药呈高度相关。结论:尿路感染分离革兰阴性菌对头孢曲松呈现出较高的耐药性,耐药机制以ESBLs为主,对于头孢曲松耐药菌感染选用头孢曲松酶抑制剂复方或许具有更好的针对性。
Objective: To investigate the resistance of clinical pathogenic bacteria to ceftriaxone in China in recent 5 years. Methods: The published literature about the surveillance of ceftriaxone in urinary tract infection pathogens was retrieved from the Chinese Journal Full-text Database, and the drug resistance rate and susceptibility to ceftriaxone of the urinary tract infection pathogens were calculated by stratified calculation. Correlation coefficient (τ). Results: Thirty-six articles were screened out. According to statistics, the main pathogens detected in urine were Escherichia coli (64%) and Klebsiella pneumoniae (18%). In addition to Proteus mirabilis, the detection rate of bacterial resistance to ceftriaxone are more than 50%, and Enterobacter cloacae, Acinetobacter baumanni more than 75%. According to the Kendall correlation coefficient (τ), Escherichia coli and Klebsiella pneumoniae were highly related to the drug resistance to cefotaxime and ceftriaxone but not identical, and the ESBLs-producing strains were resistant to ceftriaxone Highly correlated. CONCLUSION: Gram-negative bacteria isolated from urinary tract infection showed high resistance to ceftriaxone, with ESBLs-predominant resistance mechanisms, ceftriaxone-resistant compound may be more effective for ceftriaxone-resistant bacterial infections Good targeting.