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首页> 外文期刊>American Journal of Infection Control >Resistance trends and risk factors of extended spectrum β-lactamases in Escherichia coli infections in Aleppo, Syria
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Resistance trends and risk factors of extended spectrum β-lactamases in Escherichia coli infections in Aleppo, Syria

机译：叙利亚阿勒颇地区大肠埃希菌感染的耐药性趋势和广谱β-内酰胺酶的危险因素

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Background: Recently, there has been a notable surge in urinary tract infections (UTIs) by extended spectrum β-lactamase (ESBL)-producing Escherichia coli, which considerably limits treatment options. This study aimed to determine prevalence, phenotypic patterns, and ESBL-production status of E coli in isolates from UTI patients along with uncovering locally relevant risk factors for contracting ESBL-producing E coli infections. Methods: One hundred four nonrepetitive urine samples were collected from 3 major hospitals in Aleppo, Syria. Antibiotic susceptibility and ESBL production were studied by disc diffusion and double disk synergy tests according to Clinical Laboratory Standards Institute guidelines. Epidemiologic analysis was done using χ2 and multivariate logistic regression tests. Results: This study revealed high prevalence of multidrug-resistant (MDR) E coli reaching 63%, whereas ESBL-producing E coli exceeded 52%. The latter exhibited alarmingly elevated levels of coresistance to non-β-lactam antibiotics leading to vast increase in MDR rates in comparison with non-ESBL-producing E coli (83.6% vs 12.2%, respectively). Conclusion: We found previous exposure to third-generation cephalosporins and fluoroquinolones to be a significant risk factor for ESBL-producing E coli infections, in addition to other known factors such as hospitalization and catheterization. Tigecycline and carbapenems demonstrated near perfect efficacy against tested E coli, so they rank high among treatment options.
机译：背景：最近，产生超广谱β-内酰胺酶（ESBL）的大肠杆菌引起的尿路感染（UTI）激增，这大大限制了治疗选择。这项研究旨在确定UTI患者分离株中大肠杆菌的患病率，表型和ESBL产生状况，以及发现本地相关的导致ESBL产生大肠杆菌感染的危险因素。方法：从叙利亚阿勒颇的三家主要医院收集了一百零四份非重复尿液样本。根据临床实验室标准协会指南，通过椎间盘扩散和双椎间协同试验研究了抗生素的敏感性和ESBL的产生。流行病学分析使用χ2和多元logistic回归检验进行。结果：这项研究表明，多药耐药性（MDR）大肠杆菌的流行率高达63％，而产生ESBL的大肠杆菌超过52％。与非β-内酰胺类抗生素相比，后者对非β-内酰胺类抗生素的抗药性水平令人震惊地提高，从而导致耐多药率大大增加（分别为83.6％和12.2％）。结论：除其他已知因素（如住院和导管插入）外，我们发现先前接触第三代头孢菌素和氟喹诺酮类药物是产生ESBL的大肠杆菌感染的重要危险因素。替加环素和碳青霉烯类药物对测试的大肠杆菌表现出近乎完美的功效，因此在治疗选择中排名很高。

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