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Vaxandi lyfjaónæmi við þvagfærasýkingar?

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Authors
Magnús Ólafsson
Jóhann Ág. Sigurðsson
Issue Date
1996-01-01

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Increased antimicrobial resistance in urinary tract infections?
Citation
Læknablaðið 1996, 82(1):66-70
Abstract
Increased resistance to antimicrobial agents is an increasing problem. More selective or broadspectrum drugs are needed to treat even simple infections such as urinary tract infections. Objectives: To investigate what microorganisms cause urinary tract infections in the community outside hospitals and their sensitivity/patterns to commonly used antimicrobial drugs. Setting: Akureyri District in Northern Iceland with on average 17300 inhabitants. Material and methods: During three years (1992-1994), a total of 1996 urine specimens were analysed, 996 were confirmed as positive (≥1O*5 cfu/ml of urine for all species except Staphylococcus saprophyticus, where the definition 5= 104 was used). Results: The most common cause of urinary tract infections outside hospitals was E. coli causing 82% of infections and S. saprophyticus causing 4%. For infections caused by E. coli, intermediate sensitivity to ampicillin was 2% and resistant 36%, with corresponding figures for sulfafurasol beeing 8% and 29%; cephalothin 22% and 22%; trimethoprim 1% and 13% and mecillinam 5% and 11%. Only 1% of the strains were resistant to nitrofurantoin. Conclusions: Antimicrobial resistance or decreased sensitivity is a considerable problem in urinary tract infections in the community. E. coli was only fully sensitive to nitrofurantoin among commonly used agents. These results can be helpful in the choice of antimicrobial drugs for empirical therapy in suspected or documented urinary tract infections.
Þvagfærasýkingar eru vandamál sem oft koma til kasta heilsugæslunnar. Ekki eru fyrir hendi birtar rannsóknir um helstu orsakir þvagfærasýkinga hjá sjúklingum í heilsugæslunni hér á landi og hvernig sýklalyfjanæmi utan sjúkrahúsa er háttað. Þessi rannsókn nær til þriggja ára, 1992-1994 á þjónustusvæði Heilsugæslustöðvarinnar á Akureyri. Á tímabilinu voru gerðar 1996 þvagræktanir, þar af voru 966 jákvæðar (≥1O*5 þyrpingar/ml þvags fyrir alla sýkla nema Staphylococcus saprophyticus, þar sem miðað var við 5=104/ml). Eschercichia coli var algengasta orsök þvagfærasýkingar utan sjúkrahúsa og greindist í 82% tilvika og S. saprophyticus í 4% tilvika. Skert næmi eða ónæmi E. coli fyrir algengum sýklalyfjum var umtalsvert og meira en áður hefur verið sýnt fram á. Fyrir ampicillin mældist skert næmi í 2% tilvika og ónæmi í 36%. Samsvarandi hlutföll fyrir súlfafúrasól voru 8% og 29%; cefalótín 22% og 22%, trímetóprím 1% og 13%, mecillinam 5% og 11% og loks nitrofurantoin með skert næmi 12% og ónæmi í 1% tilvika. Ekki kom fram munur á tíðni ónæmis á milli ára gagnvart ampicillíni á þessu þriggja ára tímabili.
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