Gailiene Greta, Pavilonis Alvydas, Kareiviene Violeta
Department of Microbiology, Kaunas University of Medicine, Eiveniu 4, 50009 Kaunas, Lithuania.
Medicina (Kaunas). 2007;43(1):36-42.
Pseudomonas aeruginosa is one of the most common nonfermenting aerobic gram-negative microorganisms identified in clinical specimens of hospitalized patients. The emergence of multidrug-resistant (MDR) Pseudomonas aeruginosa strains is a growing concern in hospital-acquired infections. Typing of strains is important for identifying the sources of infection as well as prevention of cross-infections and monitoring of the efficacy of antimicrobial therapy. The aim of this study was to evaluate the antimicrobial resistance and prevalence of Pseudomonas aeruginosa serogroups isolated at Kaunas University of Medicine Hospital, Lithuania.
Minimum inhibitory concentrations of piperacillin, cefoperazone, ceftazidime, cefotaxime, cefepime, imipenem, meropenem, gentamicin, amikacin, tobramycin, and ciprofloxacin for 609 Pseudomonas aeruginosa strains isolated from various clinical specimens between November 2001 and November 2002 were determined by the microdilution method in Mueller-Hinton agar using interpretative guidelines of National Committee for Clinical Laboratory Standards. Serogroups of Pseudomonas aeruginosa strains were identified using serums of Seiken Co. Ltd (Tokyo, Japan), containing antibodies against antigens of Pseudomonas aeruginosa O-group.
Pseudomonas aeruginosa strains were the most sensitive to ceftazidime (78.9%), imipenem (73.6%), meropenem (70.9%) and the most resistant to gentamicin (54.1%) and ciprofloxacin (52.5%). Multidrug-resistant strains made up 9.85% of all Pseudomonas aeruginosa strains investigated. Multidrug-resistant Pseudomonas aeruginosa strains were 1.5-3.5 times more resistant to antibiotics compared to non-multidrug-resistant strains, except to amikacin: multidrug-resistant strains were more sensitive (81.7%) than non-multidrug-resistant Pseudomonas aeruginosa strains (61.0%). Pseudomonas aeruginosa serogroups O:E and O:B were the most common serogroups (34.7% and 29.0%, respectively) followed by serogroups O:I (11.4%) and O:A (10.1%). Pseudomonas aeruginosa serogroup O:E strains were the most prevalent among multidrug-resistant strains (48.3%).
The results of our study show that serogroup O:E was the most prevalent serogroup of Pseudomonas aeruginosa in our hospital, and its resistance to antibiotics was the highest.
铜绿假单胞菌是在住院患者临床标本中鉴定出的最常见的非发酵需氧革兰氏阴性微生物之一。多重耐药(MDR)铜绿假单胞菌菌株的出现是医院获得性感染中日益受到关注的问题。菌株分型对于确定感染源、预防交叉感染以及监测抗菌治疗效果很重要。本研究的目的是评估立陶宛考纳斯医科大学医院分离出的铜绿假单胞菌血清型的抗菌耐药性和流行情况。
采用微量稀释法,在穆勒-欣顿琼脂中,依据美国国家临床实验室标准委员会的解释性指南,测定了2001年11月至2002年11月期间从各种临床标本中分离出的609株铜绿假单胞菌对哌拉西林、头孢哌酮、头孢他啶、头孢噻肟、头孢吡肟、亚胺培南、美罗培南、庆大霉素、阿米卡星、妥布霉素和环丙沙星的最低抑菌浓度。使用日本东京Seiken有限公司的血清鉴定铜绿假单胞菌菌株的血清型,该血清含有针对铜绿假单胞菌O群抗原的抗体。
铜绿假单胞菌菌株对头孢他啶(78.9%)、亚胺培南(73.6%)、美罗培南(70.9%)最敏感,对庆大霉素(54.1%)和环丙沙星(52.5%)最耐药。多重耐药菌株占所有调查的铜绿假单胞菌菌株的9.85%。除阿米卡星外,多重耐药铜绿假单胞菌菌株对抗生素的耐药性是非多重耐药菌株的1.5至3.5倍:多重耐药菌株比非多重耐药铜绿假单胞菌菌株更敏感(81.7%),而非多重耐药菌株的敏感率为61.0%。铜绿假单胞菌血清型O:E和O:B是最常见的血清型(分别为34.7%和29.0%),其次是血清型O:I(11.4%)和O:A(10.1%)。铜绿假单胞菌血清型O:E菌株在多重耐药菌株中最为普遍(48.3%)。
我们的研究结果表明,血清型O:E是我院铜绿假单胞菌最普遍的血清型,其对抗生素的耐药性最高。