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[对从重症监护病房和住院诊所患者中分离出的铜绿假单胞菌和鲍曼不动杆菌菌株的抗生素敏感性率进行四年监测]

[Four years of monitoring of antibiotic sensitivity rates of Pseudomonas aeruginosa and Acinetobacter baumannii strains isolated from patients in intensive care unit and inpatient clinics].

作者信息

Alişkan Hikmet, Colakoğlu Sule, Turunç Tuba, Demiroğlu Yusuf Ziya, Erdoğan Ferit, Akin Sule, Arslan Hande

机构信息

Başkent Universitesi Tip Fakültesi, Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dali, Ankara.

出版信息

Mikrobiyol Bul. 2008 Apr;42(2):321-9.

Abstract

Pseudomonas aeruginosa and Acinetobacter baumannii which are usually multiply antibiotic resistant, are the most important agents causing infections in intensive care units (ICUs). The aim of this study was to determine the antibiotic sensitivity patterns of P. aeruginosa and A.baumannii that cause infections in ICUs and hospital service units and to follow the variation in resistance between the years of 2003 to 2006. P. aeruginosa (n:1071) and A.baumannii (n:587) strains were isolated from blood, urine, wound, sterile body fluid, sputum and tracheal aspirate cultures of patients who were diagnosed to have infections in ICUs and hospital service units. Conventional methods were used for the identification of the bacteria, and antibiotic sensitivies of the isolates were investigated by disk diffusion method. The most effective antibiotics in 2003 were piperacillin-tazobactam (84%), ciprofloxacin (79%), imipenem (77.5%), and meropenem (69%) for P. aeruginosa strains isolated from ICUs. Decreasing sensitivities to imipenem (51%), meropenem (45%), cefepime (51%), piperacillin (38.5%), ciprofloxacin (72%), cefoperazone/sulbactam (44%) and piperacillin/tazobactam (67%) for P. aeruginosa were found statistically significant in 2006 (p < 0.05). The most effective antibiotics were meropenem (98%) imipenem (94%) and ampicillin/sulbactam (72%) for A.baumannii strains isolated from ICUs in 2003. Decreasing sensitivities to imipenem (60.5%), meropenem (69%), cefepime (24%), ciprofloxacin (14%), gentamicin (13%), and amikacin (19%) for A.baumannii were statistically significant in 2006 (p < 0.05). Our data have indicated that P. aeruginosa and A.baumannii strains isolated in ICUs at our hospital showed multi-drug resistance in 2006, with significant increases since 2003 against certain antimicrobial agents. In conclusion there is an urgent need for effective strategies to control the use of antibiotics in our hospital.

摘要

铜绿假单胞菌和鲍曼不动杆菌通常对多种抗生素耐药,是重症监护病房(ICU)中引起感染的最重要病原体。本研究的目的是确定在ICU和医院服务科室引起感染的铜绿假单胞菌和鲍曼不动杆菌的抗生素敏感性模式,并追踪2003年至2006年间耐药性的变化。从诊断为在ICU和医院服务科室感染的患者的血液、尿液、伤口、无菌体液、痰液和气管吸出物培养物中分离出铜绿假单胞菌(n = 1071)和鲍曼不动杆菌(n = 587)菌株。采用常规方法鉴定细菌,并用纸片扩散法研究分离株的抗生素敏感性。2003年,对于从ICU分离出的铜绿假单胞菌菌株,最有效的抗生素是哌拉西林 - 他唑巴坦(84%)、环丙沙星(79%)、亚胺培南(77.5%)和美罗培南(69%)。2006年,铜绿假单胞菌对亚胺培南(51%)、美罗培南(45%)、头孢吡肟(51%)、哌拉西林(38.5%)、环丙沙星(72%)、头孢哌酮/舒巴坦(44%)和哌拉西林/他唑巴坦(67%)的敏感性下降具有统计学意义(p < 0.05)。2003年,对于从ICU分离出的鲍曼不动杆菌菌株,最有效的抗生素是美罗培南(98%)、亚胺培南(94%)和氨苄西林/舒巴坦(72%)。2006年,鲍曼不动杆菌对亚胺培南(60.5%)、美罗培南(69%)、头孢吡肟(24%)、环丙沙星(14%)、庆大霉素(13%)和阿米卡星(19%)的敏感性下降具有统计学意义(p < 0.05)。我们的数据表明,2006年在我院ICU分离出的铜绿假单胞菌和鲍曼不动杆菌菌株呈现多重耐药性,自2003年以来对某些抗菌药物的耐药性显著增加。总之,我院迫切需要有效的策略来控制抗生素的使用。

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