重新认识呋喃妥因在治疗非复杂性尿路感染中的重要地位

摘要

目的 从大肠埃希菌株对抗菌药物的耐药性评估呋喃妥因在治疗非复杂性尿路感染的地位.方法 收集2004-2012年中国15个省20家三级医院尿样本分离大肠埃希菌对各种抗菌药物的敏感率和2005-2014年CHINET对大肠埃希菌耐药性监测;分析长江流域6个城市样本医院2011-2015年呋喃妥因用药量.结果 大肠埃希菌对不同种类的抗菌药物的敏感性各有不同,10年间大肠埃希菌对头孢类药物、氟喹诺酮类药物的耐药率高(>50%),但对呋喃妥因的耐药率低(<10%).结论 呋喃妥因是治疗泌尿系感染的一个老药,具有广谱的抗菌活性,特别是对产超广谱β-内酰胺酶(ESBLs)大肠埃希菌株或非产ESBLs大肠埃希菌株具有高度敏感性.呋喃妥因治疗女性非复杂性尿路感染具有高效、安全、经济的特点,各级医院应加强合理应用.%Objective To estimate the value of nitrofuratoin in uncomplicated urinary tract infection by examining antimicrobial resistance of Escherichia coli (E.coli) strains isolated from the patients.Methods The antimicrobial susceptibility information was collected from two projects: an antimicrobial survey of clinical urine specimens in 20 hospitals in 15 provinces during 2004-2012 and CHINET Antimicrobial Resistance Surveillance Program during 2005-2014.Then the clinical consumption of nitrofuratoin was analyzed according to the data of sample hospitals from 6 cities of Yangtze River system between 2011 and 2015.Results The antimicrobial susceptibility of E.coli strains showed that the resistance rate to cephalosporins and fluoroquinolones were above 50% during the last decade.Meanwhile,the resistance rate to nitrofuratoin was below 10%.Conclusion Nitrofuratoin,which is an old drug in the treatment of urinary tract infection,is famous for its broad-spectrum antimicrobial activity and high sensitivity to ESBLs producing or non-ESBLs producing strains of E.coli.It is efficacious,safe and cost-effective in the treatment to uncomplicated urinary tract infection in women.Therefore,it is highly recommend that rational use of nitrofuratoin in the clinical practice.