Raymond Josette, Nordmann Patrice, Doit Catherine, Vu Thien Hoang, Guibert Michèle, Ferroni Agnès, Aujard Yannick
Service de Bactériologie, Hôpital Cochin-Saint Vincent de Paul, 27 rue du faubourg Saint-Jacques, 75679 Paris Cedex 14, France.
Pediatrics. 2007 Apr;119(4):e798-803. doi: 10.1542/peds.2006-1384.
The objective of this study was to determine the incidence of multidrug-resistant bacteria in hospitalized children.
This multicenter study was conducted in 5 hospitals in the Paris area from 1999 to 2003. We recorded all isolations of multidrug-resistant bacteria from clinical samples that were obtained from hospitalized children. Strains that were isolated during systematic screening for carriers were excluded.
The mean incidences were 0.9 per 1000 hospitalization-days for methicillin-resistant Staphylococcus aureus, 0.45 for extended-spectrum beta-lactamase-producing Klebsiella pneumoniae, 0.32 for extended-spectrum beta-lactamase-producing Enterobacteriaceae other than Klebsiella pneumoniae, 0.40 for Enterobacter species with derepressed cephalosporinase, and 0.01 for vancomycin-resistant Enterococcus. The incidences per 1000 hospitalization-days of methicillin-resistant Staphylococcus aureus, extended-spectrum beta-lactamase-producing Klebsiella pneumoniae, extended-spectrum beta-lactamase-producing Enterobacteriaceae other than Klebsiella pneumoniae, and Enterobacter species with derepressed cephalosporinase decreased significantly from 1999 to 2003, whereas the incidence of vancomycin-resistant Enterococcus remained very low. The proportion of resistant strains within the species did not vary significantly for methicillin-resistant Staphylococcus aureus (11% to 9.6%), extended-spectrum beta-lactamase-producing Enterobacteriaceae other than Klebsiella pneumoniae (1.1%), and vancomycin-resistant Enterococcus (0.03% to 0.023%). In contrast, the frequency of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae decreased from 31.6% to 7.4%, and that of Enterobacter species with derepressed cephalosporinase decreased from 38.8% to 18.5%.
We report significant decreases in the incidence of methicillin-resistant Staphylococcus aureus, extended-spectrum beta-lactamase-producing Klebsiella pneumoniae, extended-spectrum beta-lactamase-producing Enterobacteriaceae other than Klebsiella pneumoniae, and Enterobacter species with derepressed cephalosporinase in hospitalized children during a 5-year period.
本研究的目的是确定住院儿童中多重耐药菌的发生率。
这项多中心研究于1999年至2003年在巴黎地区的5家医院进行。我们记录了从住院儿童临床样本中分离出的所有多重耐药菌。排除在携带者系统筛查期间分离出的菌株。
耐甲氧西林金黄色葡萄球菌的平均发生率为每1000住院日0.9例，产超广谱β-内酰胺酶的肺炎克雷伯菌为0.45例，产超广谱β-内酰胺酶的非肺炎克雷伯菌肠杆菌科细菌为0.32例，头孢菌素酶去抑制的肠杆菌属为0.40例，耐万古霉素肠球菌为0.01例。1999年至2003年，耐甲氧西林金黄色葡萄球菌、产超广谱β-内酰胺酶的肺炎克雷伯菌、产超广谱β-内酰胺酶的非肺炎克雷伯菌肠杆菌科细菌以及头孢菌素酶去抑制的肠杆菌属每1000住院日的发生率显著下降，而耐万古霉素肠球菌的发生率仍然很低。耐甲氧西林金黄色葡萄球菌（11%至9.6%）、产超广谱β-内酰胺酶的非肺炎克雷伯菌肠杆菌科细菌（1.1%）和耐万古霉素肠球菌（0.03%至0.023%）在菌种内的耐药菌株比例没有显著变化。相比之下，产超广谱β-内酰胺酶的肺炎克雷伯菌的频率从31.6%降至7.4%，头孢菌素酶去抑制的肠杆菌属的频率从38.8%降至18.5%。
我们报告了在5年期间住院儿童中耐甲氧西林金黄色葡萄球菌、产超广谱β-内酰胺酶的肺炎克雷伯菌、产超广谱β-内酰胺酶的非肺炎克雷伯菌肠杆菌科细菌以及头孢菌素酶去抑制的肠杆菌属的发生率显著下降。
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