Ruiz M, Sirvent E, Hernández C, Rodríguez J C, Royo G
Sección de Microbiología, Hospital General Universitario de Elche, Universidad Miguel Hernández, Elche (Alicante).
Rev Esp Quimioter. 1999 Dec;12(4):366-8.
Salmonella enterica is mainly associated with acute gastroenteritis; however, it is also associated with other more severe disease processes, for which quinolones are the treatment of choice. We retrospectively studied the evolution of resistance to nalidixic acid and ciprofloxacin of all the clinical isolates of S. enterica from 1992 to 1998 in our hospital environment. A total of 848 strains from feces, blood and other locations were studied. We detected an increase in the resistance to nalidixic acid from 12% in 1992 to 21.3% in 1998, especially in the Enteritidis and Hadar serotypes. We did not detect resistance to ciprofloxacin, but there was in increase in the MIC in the nalidixic acid-resistant strains. Although this is interpreted as sensitive according the the NCCLS criteria, if we apply the cutoff points established by MENSURA, 89.46% of the strains do not fit into this category (S <0.12 mg/l). This puts into question the utility of quinolones in the long-term treatment of severe disease processes produced by this type of strain.
肠炎沙门氏菌主要与急性肠胃炎相关;然而,它也与其他更严重的疾病进程有关,对此喹诺酮类药物是治疗的首选。我们回顾性研究了1992年至1998年我院环境中所有肠炎沙门氏菌临床分离株对萘啶酸和环丙沙星的耐药性演变。共研究了来自粪便、血液和其他部位的848株菌株。我们检测到对萘啶酸的耐药性从1992年的12%增加到1998年的21.3%,尤其是在肠炎血清型和哈达尔血清型中。我们未检测到对环丙沙星的耐药性,但耐萘啶酸菌株的最低抑菌浓度有所增加。尽管根据美国国家临床实验室标准委员会(NCCLS)标准这被解释为敏感,但如果我们应用MENSURA制定的临界值,89.46%的菌株不符合这一类别(S<0.12mg/l)。这使喹诺酮类药物在长期治疗此类菌株引起的严重疾病进程中的效用受到质疑。