Tsukayama D T, van Loon H J, Cartwright C, Chmielewski B, Fluit A C, van der Werken Chr, Verhoef J
Department of Medicine, Hennepin County Medical Center, 701 Park Avenue, Minneapolis, MN 55415, USA.
Int J Antimicrob Agents. 2004 Oct;24(4):339-45. doi: 10.1016/j.ijantimicag.2004.04.011.
Bacterial spread between patients may contribute to the high prevalence of antibiotic-resistant pathogens within ICUs. The aim of this study was to evaluate the fate of Pseudomonas aeruginosa during the different antibiotic regimens. Susceptibility patterns and genotyping were performed to determine whether there was a predominant clone and to track the spread of resistant strains within the unit. Twenty-eight different ribotypes were found among 82 Pseudomonas isolates. Four ribotypes accounted for 42 (51%) isolates and were designated the "major clones" occurring throughout multiple cycles. The ribotypes with multiple occurrences were more resistant to antibiotics than ribotypes that appeared only once. The correlation of antibiotic use with antibiotic resistance and the finding of a large number of ribotypes suggested that de novo development of antibiotic resistance is a likely event in P. aeruginosa. In addition, ribotypes associated with antibiotic resistance appeared to have a survival advantage and can become frequent colonizers in the ICU.
患者之间的细菌传播可能导致重症监护病房（ICU）内耐抗生素病原体的高流行率。本研究的目的是评估铜绿假单胞菌在不同抗生素治疗方案下的转归。进行药敏模式和基因分型以确定是否存在优势克隆，并追踪耐药菌株在病房内的传播。在82株铜绿假单胞菌分离株中发现了28种不同的核糖型。四种核糖型占42株（51%）分离株，被指定为在多个周期中出现的“主要克隆”。多次出现的核糖型比仅出现一次的核糖型对抗生素更具耐药性。抗生素使用与抗生素耐药性的相关性以及大量核糖型的发现表明，铜绿假单胞菌中抗生素耐药性的从头发展可能是一个常见事件。此外，与抗生素耐药性相关的核糖型似乎具有生存优势，并且可能成为ICU中常见的定植菌。
