Jung R, Fish D N, Obritsch M D, MacLaren R
Antimicrobial Research Laboratory, Department of Clinical Pharmacy, School of Pharmacy, University of Colorado Health Sciences Center, 4200 East Ninth Avenue, Campus Box C-238 Denver, CO 80262, USA.
J Hosp Infect. 2004 Jun;57(2):105-11. doi: 10.1016/j.jhin.2004.03.001.
Antimicrobial resistance in Pseudomonas aeruginosa is a serious clinical problem. To determine the incidence of multi-drug resistant P. aeruginosa, resistance rates of P. aeruginosa clinical isolates against commonly used antibiotics were evaluated for the period 1998 to 2002. Multi-drug resistance was defined as resistance to at least three of the four drugs, ceftazidime, imipenem, ciprofloxacin, and tobramycin. Resistance to most anti-pseudomonal agents has increased by >20% over the five-year period, with dramatic increases observed with fluoroquinolones, tobramycin, and imipenem (resistance increased by 34-37%). In 1998, 78% of isolates were susceptible to all four anti-pseudomonal agents and no isolate was considered multi-drug resistant. However, in 2002, only 27% of isolates were sensitive to all four of the drugs and 32% were considered multi-drug resistant. Multi-drug resistance in individual institutions may be significantly higher than rates reported in nationwide surveillance studies and may more accurately reflect the true magnitude of local resistance problems. On-going surveillance within individual institutions is critical for the selection of appropriate empiric antimicrobial therapy.
铜绿假单胞菌的抗菌耐药性是一个严重的临床问题。为了确定多重耐药铜绿假单胞菌的发生率，我们评估了1998年至2002年期间铜绿假单胞菌临床分离株对常用抗生素的耐药率。多重耐药被定义为对头孢他啶、亚胺培南、环丙沙星和妥布霉素这四种药物中的至少三种耐药。在这五年期间，对大多数抗铜绿假单胞菌药物的耐药性增加了20%以上，氟喹诺酮类、妥布霉素和亚胺培南的耐药性显著增加（耐药性增加了34%-37%）。1998年，78%的分离株对所有四种抗铜绿假单胞菌药物敏感，没有分离株被认为是多重耐药的。然而，在2002年，只有27%的分离株对所有四种药物敏感，32%被认为是多重耐药的。个别机构的多重耐药率可能显著高于全国监测研究报告的率，并且可能更准确地反映当地耐药问题的真实严重程度。在个别机构内持续进行监测对于选择合适的经验性抗菌治疗至关重要。
