Picazo Juan J, Betriu Carmen, Rodríguez-Avial Iciar, Azahares Enrique, Ali Sánchez Blas
Servicio de Microbiología Clínica. Hospital Clínico San Carlos. Madrid. España.
Enferm Infecc Microbiol Clin. 2002 Dec;20(10):503-10. doi: 10.1016/s0213-005x(02)72853-x.
Resistance to antimicrobial drugs has increased in recent years. The aim of this multicenter study was to determine the current situation in Spain regarding the resistance patterns of the most common infectious agents to antimicrobial drugs.
A total 1,475 strains isolated in 38 hospitals in October 2001 were studied. These included 294 methicillin-resistant Staphylococcus aureus (MRSA), 149 clinically significant coagulase-negative staphylococci (CNS), 96 Enterococcus faecium, 1 ampicillin-resistant Enterococcus faecalis, 204 penicillin-resistant Streptococcus pneumoniae, 100 ampicillin-resistant Haemophilus influenzae, 361 ciprofloxacin-resistant Escherichia coli, 160 Pseudomonas aeruginosa, and 110 Acinetobacter baumannii. Sensitivity to various antibiotics was studied by a broth microdilution method. Additionally, an epidemiologic survey was conducted in the participating hospitals to determine the incidence of these multi-drug resistant microorganisms.
Overall incidence of ciprofloxacin-resistant E. coli and MRSA strains was 24% in both cases. The pneumococci were resistant to several antibiotics. Telithromycin showed excellent activity against all the pneumococci, including those resistant to macrolides. Most MRSA isolates were resistant to quinolones and macrolides. All the staphylococci were susceptible to linezolid and quinupristin-dalfopristin. Only 50% of A. baumannii strains were susceptible to imipenem.
The results of this study evidence increasing multi-drug resistance among various microorganisms, such as MRSA, CNS, ampicillin-resistant enterococci, and penicillin-resistant pneumococci, and underline the need for surveillance programs to gain information on this significant therapeutic problem.
近年来，对抗菌药物的耐药性有所增加。这项多中心研究的目的是确定西班牙目前最常见的感染病原体对抗菌药物的耐药模式。
对2001年10月在38家医院分离出的总共1475株菌株进行了研究。这些菌株包括294株耐甲氧西林金黄色葡萄球菌（MRSA）、149株具有临床意义的凝固酶阴性葡萄球菌（CNS）、96株粪肠球菌、1株耐氨苄西林粪肠球菌、204株耐青霉素肺炎链球菌、100株耐氨苄西林流感嗜血杆菌、361株耐环丙沙星大肠杆菌、160株铜绿假单胞菌和110株鲍曼不动杆菌。通过肉汤微量稀释法研究了对各种抗生素的敏感性。此外，在参与研究的医院进行了一项流行病学调查，以确定这些多重耐药微生物的发生率。
耐环丙沙星大肠杆菌和MRSA菌株的总体发生率均为24%。肺炎球菌对几种抗生素耐药。泰利霉素对所有肺炎球菌，包括对大环内酯类耐药的肺炎球菌，均表现出优异的活性。大多数MRSA分离株对喹诺酮类和大环内酯类耐药。所有葡萄球菌对利奈唑胺和奎奴普丁-达福普汀敏感。只有50%的鲍曼不动杆菌菌株对亚胺培南敏感。
本研究结果证明了各种微生物，如MRSA、CNS、耐氨苄西林肠球菌和耐青霉素肺炎球菌的多重耐药性不断增加，并强调了需要开展监测计划，以获取有关这一重大治疗问题的信息。
