[医院革兰氏阴性病原菌的抗菌药敏模式：哈杰泰佩大学成人医院MYSTIC研究结果（2000 - 2004年）]
[Antimicrobial susceptibility pattern of nosocomial gram negative pathogens: results from MYSTIC study in Hacettepe University Adult Hospital (2000-2004)].
作者信息
Zarakolu Pinar, Hasçelik Gülşen, Unal Serhat
机构信息
Hacettepe Universitesi Tip Fakültesi, iç Hastaliklan Anabilim Dali, Infeksiyon Hastaliklari Unitesi, Ankara.
出版信息
Mikrobiyol Bul. 2006 Jul;40(3):147-54.
Antimicrobial susceptibility patterns of Gram negative pathogens (n: 699) isolated from nosocomial infections in Hacettepe University Adult Hospital included in MYSTIC programme between 2000-2004 were determined by Etest (AB BIODISK, Solna, Sweden) using CLSI criteria. Of the total Escherichia coli (n: 179), Klebsiella pneumoniae (n: 168), Pseudomonas aeruginosa (n: 179) and Acinetobacter baumannii (n: 173) isolates, 55% were from patients in inpatient clinics and 45% were from patients in intensive care units. The extended-spectrum beta-lactamase (ESBL) production rate of E. coli and K. pneumoniae isolates were 28% and 47%, respectively. All E. coli and K. pneumoniae isolates were found susceptible to carbapenems. The susceptibility of ESBL positive E. coli isolates to piperacillin+tazobactam was 76% and 65% to cefepime, 63% to ceftazidime, 56% to tobramycin, 24% to ciprofloxacin. For ESBL negative E. coli isolates, the susceptibility rates were found 95%, 92%, 84% and 58% for ceftazidime and tobramycin, cefepime, piperacillin+tazobactam and ciprofloxacin, respectively. The susceptibility rates of ESBL positive K. pneumoniae isolates to piperacillin+tazobactam was 55% and 51% to cefepime, 49% to ciprofloxacin, 45% to tobramycin, 42% to ceftazidime. For ESBL negative K. pneumoniae isolates, the susceptibility rates were determined as follows; 92% for cefepime, 87% for tobramycin, 70% for piperacillin+tazobactam, 62% for ceftazidime and 60% for ciprofloxacin. Of the P. aeruginosa isolates, 77% were multi-drug resistant with susceptibility rates to piperacillin+tazobactam, ciprofloxacin, meropenem and imipenem as 55%, 53%, 51% and 49%, respectively. The susceptibilities of P. aeruginosa isolates were 48% to ceftazidime, 41% to cefepime and 35% to tobramycin. Of the A.baumannii isolates, 67% were multi-drug resistant with higher susceptibility rates to meropenem (53%), imipenem (48%) and tobramycin (44%) compared to other antimicrobials cefepime (37%), ciprofloxacin (29%), piperacillin+tazobactam (26%) and ceftazidime (22%).
2000年至2004年纳入MYSTIC项目的、从哈杰泰佩大学成人医院医院感染中分离出的699株革兰氏阴性病原菌的药敏模式，采用Etest（AB BIODISK，瑞典索尔纳）并依据CLSI标准进行测定。在总共分离出的大肠杆菌（179株）、肺炎克雷伯菌（168株）、铜绿假单胞菌（179株）和鲍曼不动杆菌（173株）中，55%来自住院病房患者，45%来自重症监护病房患者。大肠杆菌和肺炎克雷伯菌分离株的超广谱β-内酰胺酶（ESBL）产生率分别为28%和47%。所有大肠杆菌和肺炎克雷伯菌分离株均对碳青霉烯类敏感。ESBL阳性大肠杆菌分离株对哌拉西林+他唑巴坦的药敏率为76%，对头孢吡肟为65%，对头孢他啶为63%，对妥布霉素为56%，对环丙沙星为24%。对于ESBL阴性大肠杆菌分离株，头孢他啶、妥布霉素、头孢吡肟、哌拉西林+他唑巴坦和环丙沙星的药敏率分别为95%、92%、84%和58%。ESBL阳性肺炎克雷伯菌分离株对哌拉西林+他唑巴坦的药敏率为55%，对头孢吡肟为51%，对环丙沙星为49%，对妥布霉素为45%，对头孢他啶为42%。对于ESBL阴性肺炎克雷伯菌分离株，药敏率如下：头孢吡肟为92%，妥布霉素为87%，哌拉西林+他唑巴坦为70%，头孢他啶为62%，环丙沙星为60%。在铜绿假单胞菌分离株中，77%对多种药物耐药，对哌拉西林+他唑巴坦、环丙沙星、美罗培南和亚胺培南的药敏率分别为55%、53%、51%和49%。铜绿假单胞菌分离株对头孢他啶的药敏率为48%，对头孢吡肟为41%，对妥布霉素为35%。在鲍曼不动杆菌分离株中，67%对多种药物耐药，与其他抗菌药物头孢吡肟（37%）、环丙沙星（29%）、哌拉西林+他唑巴坦（26%）和头孢他啶（22%）相比，对美罗培南（53%）、亚胺培南（48%）和妥布霉素（44%）的药敏率更高。
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