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定植于骨科植入物的15种次要葡萄球菌属菌种的流行情况及抗生素耐药性

Prevalence and antibiotic resistance of 15 minor staphylococcal species colonizing orthopedic implants.

作者信息

Arciola C R, Campoccia D, An Y H, Baldassarri L, Pirini V, Donati M E, Pegreffi F, Montanaro L

机构信息

Research Unit on Implant Infections, Rizzoli Orthopedic Institute, Bologna, Italy.

出版信息

Int J Artif Organs. 2006 Apr;29(4):395-401. doi: 10.1177/039139880602900409.

Abstract

Several species belonging to Staphylococcus genus (non Sau/ non Sep species) exhibit increasing abilities as opportunistic pathogens in colonisation of periprosthesis tissues. Here we report on antibiotic resistance of 193 strains, belonging to non Sau/ non Sep species, consecutively collected from orthopedic implant infections in a period of about 40 months. The 193 strains (representing 17% of all staphylococci isolated) were analysed for their antibiotic resistance to 16 different drugs. Five species turned out more prevalent, ranging from 1 to 5%: S. hominis (4.2%), S. haemolyticus (3.7%), S. capitis (2.7%), S. warneri (2.6%), and S. cohnii (1.6%). Among these, the prevalence of antibiotic resistance to penicillins was similar, ranging from 51% to 66%. Conversely, significant differences were observed for all the remaining antibiotics. For S. haemolyticus the resistances to oxacillin and imipenem, the four aminoglycosides and erythromycin were at least twice that of the other three species which were compared. S. warneri was on the contrary the species with the lowest occurrence of resistant strains. Ten species appeared only rarely at the infection sites: S. lugdunensis, S. caprae, S. equorum, S. intermedius, S. xylosus, S. simulans, S. saprophyticus, S. pasteuri, S. sciuri, and S. schleiferi. The behaviours of these species, often resistant to penicillins, were individually analysed. Differences in both the frequencies and the panels of antibiotic resistances observed among the non Sau/ non Sep species: i) suggest that horizontal spreading of resistance factors, if acting, was not sufficient per se to level their bio-diversities; ii) highlight and confirm the worrisome appearance within the Staphylococcus genus of emerging ""new pathogens"", not homogeneous for their virulence and antibiotic resistance prevalence, which deserve to be recognised and treated individually.

摘要

葡萄球菌属中的几种菌种(非金黄色葡萄球菌/非凝固酶阴性葡萄球菌菌种)作为假体周围组织定植中的机会性病原体,其致病能力日益增强。在此,我们报告了在约40个月的时间里,从骨科植入物感染中连续收集的193株属于非金黄色葡萄球菌/非凝固酶阴性葡萄球菌菌种的菌株的抗生素耐药性情况。对这193株菌株(占所有分离出的葡萄球菌的17%)进行了对16种不同药物的抗生素耐药性分析。结果发现有5种菌种更为常见,占比从1%到5%不等:人葡萄球菌(4.2%)、溶血葡萄球菌(3.7%)、头葡萄球菌(2.7%)、沃氏葡萄球菌(2.6%)和科氏葡萄球菌(1.6%)。其中,对青霉素的抗生素耐药率相似,在51%至66%之间。相反,对于所有其他抗生素,观察到了显著差异。对于溶血葡萄球菌,其对苯唑西林、亚胺培南、四种氨基糖苷类药物和红霉素的耐药率至少是与之比较的其他三种菌种的两倍。相反,沃氏葡萄球菌是耐药菌株出现率最低的菌种。有10种菌种在感染部位很少出现:路邓葡萄球菌、山羊葡萄球菌、马肠葡萄球菌、中间葡萄球菌、木糖葡萄球菌、模仿葡萄球菌、腐生葡萄球菌、巴斯德葡萄球菌、松鼠葡萄球菌和施氏葡萄球菌。对这些通常对青霉素耐药的菌种的行为进行了单独分析。在非金黄色葡萄球菌/非凝固酶阴性葡萄球菌菌种中观察到的抗生素耐药频率和耐药谱的差异:i)表明耐药因子的水平传播(如果起作用的话)本身不足以消除它们的生物多样性;ii)突出并证实了葡萄球菌属中令人担忧的新“病原体”的出现,这些新病原体的毒力和抗生素耐药率并不均匀,值得分别识别和治疗。

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