Wroblewska Marta M, Rudnicka Jolanta, Marchel Halina, Luczak Miroslaw
Department of Medical Microbiology, Medical University of Warsaw, 5 Chalubinskiego Street, 02-004 Warsaw, Poland.
Int J Antimicrob Agents. 2006 Apr;27(4):285-9. doi: 10.1016/j.ijantimicag.2005.11.015. Epub 2006 Mar 20.
Surveys of the prevalence and susceptibility patterns of bacterial isolates are important in determining optimum empirical therapy for infections in critically ill patients. The aim of this study was to determine possible differences in the patterns of bacterial resistance in two Intensive Care Units (ICUs) depending on the patient profile. There was a high percentage of non-fermenting Gram-negative rods (NFGNR) among the bacterial isolates from both wards. NFGNR comprised 43.8% of all isolates from ICU-B and 38.9% from ICU-A. Extended-spectrum beta-lactamase production was detected in 40.0% of Gram-negative rods cultured from ICU-A compared with 26.7% from ICU-B; whilst imipenem-resistant strains of Acinetobacter baumannii constituted 17.1% of isolates from ICU-A and 9.6% from ICU-B. Emergence of A. baumannii strains resistant to imipenem was recorded, particularly among blood isolates. In both wards, multidrug-resistant (MDR) strains of Gram-negative bacilli were more prevalent among blood isolates than among strains cultured from other specimens. Longer stay in ICU-A promoted selection of MDR Gram-negative rods.
对细菌分离株的流行率和药敏模式进行调查，对于确定重症患者感染的最佳经验性治疗至关重要。本研究的目的是根据患者情况，确定两个重症监护病房（ICU）中细菌耐药模式的可能差异。两个病房的细菌分离株中，非发酵革兰氏阴性杆菌（NFGNR）的比例都很高。NFGNR在ICU - B的所有分离株中占43.8%，在ICU - A中占38.9%。在从ICU - A培养的革兰氏阴性杆菌中，检测到40.0%产生超广谱β-内酰胺酶，而从ICU - B培养的此类杆菌中这一比例为26.7%；耐亚胺培南的鲍曼不动杆菌菌株在ICU - A的分离株中占17.1%，在ICU - B中占9.6%。记录到出现了对亚胺培南耐药的鲍曼不动杆菌菌株，尤其是在血液分离株中。在两个病房中，革兰氏阴性杆菌的多重耐药（MDR）菌株在血液分离株中比在从其他标本培养的菌株中更普遍。在ICU - A停留时间较长促进了MDR革兰氏阴性杆菌的选择。
