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首页> 外文期刊>Antibiotics >Uncomplicated Urinary Tract Infections and Antibiotic Resistance—Epidemiological and Mechanistic Aspects
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Uncomplicated Urinary Tract Infections and Antibiotic Resistance—Epidemiological and Mechanistic Aspects

机译：单纯性尿路感染和抗生素耐药性的流行病学和机理研究

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摘要

Uncomplicated urinary tract infections are typically monobacterial and are predominantly caused by Escherichia coli. Although several effective treatment options are available, the rates of antibiotic resistance in urinary isolates of E. coli have increased during the last decade. Knowledge of the actual local rates of antibiotic resistant pathogens as well as the underlying mechanisms are important factors in addition to the geographical location and the health state of the patient for choosing the most effective antibiotic treatment. Recommended treatment options include trimethoprim alone or in combination with sulfamethoxazol, fluoroquinolones, β-lactams, fosfomycin-trometamol, and nitrofurantoin. Three basic mechanisms of resistance to all antibiotics are known, i.e., target alteration, reduced drug concentration and inactivation of the drug. These mechanisms—alone or in combination—contribute to resistance against the different antibiotic classes. With increasing prevalence, combinations of resistance mechanisms leading to multiple drug resistant (mdr) pathogens are being detected and have been associated with reduced fitness under in vitro situations. However, mdr clones among clinical isolates such as E. coli sequence type 131 (ST131) have successfully adapted in fitness and growth rate and are rapidly spreading as a worldwide predominating clone of extraintestinal pathogenic E. coli.
机译：简单的泌尿道感染通常是单细菌的，主要由大肠杆菌引起。尽管有几种有效的治疗方法可供选择，但在过去的十年中，大肠杆菌的尿分离株对抗生素的耐药率有所提高。除了选择最有效的抗生素治疗方法的地理位置和患者的健康状况外，了解抗生素耐药性病原体的实际局部发生率以及潜在机制也是重要因素。推荐的治疗选择包括单独使用甲氧苄啶或与磺胺甲恶唑，氟喹诺酮类，β-内酰胺类，磷霉素-曲美莫尔和呋喃妥因合用。已知对所有抗生素具有抗性的三种基本机制，即靶标改变，药物浓度降低和药物失活。这些机制（单独或组合使用）有助于抵抗不同的抗生素类别。随着患病率的增加，正在检测导致多种耐药（mdr）病原体的耐药机制组合，并与体外情况下的适应性降低相关。但是，临床分离株如大肠杆菌131型序列（ST131）中的mdr克隆在适应性和生长速度方面已经成功地适应了，并且作为肠外致病性大肠杆菌的全球主要克隆而迅速传播。

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