【摘要】 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。更多还原

【Abstract】 Objective: To investigate drug resistance of pathogens causing urinary tract infection to ceftriaxone in the recent five years. Methods: the references related to drug resistance of pathogens causing urinary tract infection to ceftriaxone were retrieved through CNKI database. The resistance rates and sensibility rates of different types of bacteria were classified,calculated,and analyzed. And the Kendall correlation coefficient was also calculated. Results: 36 references were screened out,and statistical analysis showed that the main pathogen detected in the urine was Escherichia coli( 64%),followed by Klebsiella pneumoniae( 18%). In addition to Proteus mirabilis,the drug resistance rate of detected bacterias was over 50% to ceftriaxone,while the drug resistance rates of Enterobacter cloacae,Acinetobacter baumannii and Pseudomonas aeruginosa were more than 75%. According to the Kendall correlation coefficient( τ),the resistance rates of Escherichia coli and Klebsiella pneumoniae to cefotaxime and ceftriaxone were highly correlated,especially that from the ESBLs-producing Escherichia coli and Klebsiella pneumonia. Conclusion: The resistance rates of pathogens causing urinary tract infection to ceftriaxone displayed an upward tendency. The mechanism of resistance to strains was mainly involved in producing ESBLs. Which indicated that ceftriaxone and β-lactamase compound preparations may become the best choice for the treatment of the infection of ceftriaxone drug-resistant strains.更多还原