Cornejo-Juárez Patricia, Velásquez-Acosta Consuelo, Díaz-González Adriana, Volkow-Fernández Patricia
Departamento de Infectología, Instituto Nacional de Cancerología, Tlalpan, México, DF México.
Salud Publica Mex. 2005 Jul-Aug;47(4):288-93. doi: 10.1590/s0036-36342005000400006.
To describe the patterns of antimicrobial resistance organisms isolated in blood cultures from patients detected in a tertiary level of care, teaching oncological hospital.
All strains obtained from blood cultures from 1998 to 2003 were included and processed using the Bactec and Microscan system to determinate isolates and susceptibility to antimicrobials. The percent difference (increase or decrease) was obtained by comparing the frequency of resistance at baseline and at the end of the study.
A total of 2071 positive blood cultures were obtained; 59.7% of isolates were Gram negative bacteria, 35.7% Gram-positive bacteria and 4.6% were yeasts. E. coli was the most frequent isolated (18.6%), followed by. Staphylococcus epidermidis (12.7%) and Klebsiella spp (9%). Throughout the study the susceptibility of Gram negative bacteria was stable and over 88% for most of the antimicrobials tested (except for Pseudomonas aeruginosa). Ciprofloxacin susceptibility for Escherichia coli stayed around 50%. Susceptibility to amikacin was higher than that to gentamicin. Staphylococcus aureus susceptibility for oxacillin was 96% and that for vancomycin 100%. S. epidermidis susceptibility for oxacillin was 14% and for vancomycin was 98.6%. No strains of vancomycin-resistant enterococci were found. All Streptococcus pneumoniae strains were penicillin susceptible.
The drug-resistance found in this hospital is the result of the control in the use of antimicrobials, the hospital nosocomial infection program and the use of drug combination in all patients with bacteremia.
描述在一家三级护理教学肿瘤医院中，从患者血培养中分离出的抗菌药物耐药菌的模式。
纳入1998年至2003年从血培养中获得的所有菌株，并使用Bactec和Microscan系统进行处理，以确定分离株及对抗菌药物的敏感性。通过比较基线和研究结束时的耐药频率，得出百分比差异（增加或减少）。
共获得2071份阳性血培养结果；59.7%的分离株为革兰氏阴性菌，35.7%为革兰氏阳性菌，4.6%为酵母菌。大肠杆菌是最常见的分离菌（18.6%），其次是表皮葡萄球菌（12.7%）和克雷伯菌属（9%）。在整个研究过程中，革兰氏阴性菌的敏感性保持稳定，对于大多数测试抗菌药物而言，敏感性超过88%（铜绿假单胞菌除外）。大肠杆菌对环丙沙星的敏感性维持在50%左右。对阿米卡星的敏感性高于庆大霉素。金黄色葡萄球菌对苯唑西林的敏感性为96%，对万古霉素的敏感性为100%。表皮葡萄球菌对苯唑西林的敏感性为14%，对万古霉素的敏感性为98.6%。未发现耐万古霉素肠球菌菌株。所有肺炎链球菌菌株对青霉素敏感。
该医院发现的耐药性是抗菌药物使用控制、医院院内感染防控计划以及所有菌血症患者联合用药的结果。
