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铜绿假单胞菌医院感染药敏模式的多中心监测

Multicentre surveillance of Pseudomonas aeruginosa susceptibility patterns in nosocomial infections.

作者信息

Van Eldere J

机构信息

Rega Institute and Laboratory of Microbiology, University Hospital Gasthuisberg, Catholic University of Leuven, Leuven, Belgium.

出版信息

J Antimicrob Chemother. 2003 Feb;51(2):347-52. doi: 10.1093/jac/dkg102.

Abstract

OBJECTIVES

To determine susceptibility rates and patterns in Pseudomonas aeruginosa strains isolated from nosocomial infections.

METHODS

Seven hundred and sixteen P. aeruginosa isolates from 40 different hospitals in Belgium and the Grand Duchy of Luxembourg were collected in 1999.

RESULTS

Resistance rates varied significantly between hospitals. Of the fluoroquinolones, ciprofloxacin showed least resistance (24%), levofloxacin showed 27.5% resistance and ofloxacin 37.5%. Of the aminoglycosides, amikacin was the most potent antibiotic (10.5% resistance), followed by isepamicin (12%), tobramycin (19.5%) and gentamicin (23.5%). Of the beta-lactam antibiotics, meropenem was the most active (9.5% resistance); piperacillin and piperacillin/tazobactam had, respectively, 24% and 17.5% resistance, ceftazidime 28.5%, cefepime 29.5%, ticarcillin/clavulanic acid 37% and aztreonam 55.5%. MIC distribution curves show the presence of significant subpopulations, with MICs just below breakpoint for many antibiotics.

CONCLUSION

Resistance of P. aeruginosa to penicillins, cephalosporins, fluoroquinolones and aminoglycosides varies between hospitals, but is increasing.

摘要

目的

确定从医院感染中分离出的铜绿假单胞菌菌株的药敏率及药敏模式。

方法

1999年收集了来自比利时和卢森堡大公国40家不同医院的716株铜绿假单胞菌分离株。

结果

各医院之间的耐药率差异显著。在氟喹诺酮类药物中,环丙沙星的耐药率最低(24%),左氧氟沙星为27.5%,氧氟沙星为37.5%。在氨基糖苷类药物中,阿米卡星是最有效的抗生素(耐药率为10.5%),其次是异帕米星(12%)、妥布霉素(19.5%)和庆大霉素(23.5%)。在β-内酰胺类抗生素中,美罗培南活性最强(耐药率为9.5%);哌拉西林和哌拉西林/他唑巴坦的耐药率分别为24%和17.5%,头孢他啶为28.5%,头孢吡肟为29.5%,替卡西林/克拉维酸为37%,氨曲南为55.5%。最低抑菌浓度(MIC)分布曲线显示存在显著的亚群,许多抗生素的MIC值略低于断点。

结论

铜绿假单胞菌对青霉素、头孢菌素、氟喹诺酮类和氨基糖苷类药物的耐药性在各医院之间有所不同,但呈上升趋势。

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