对喀麦隆雅温得中心医院革兰氏阴性杆菌的抗菌活性。
Antimicrobial activity against gram negative bacilli from Yaounde Central Hospital, Cameroon.
作者信息
Gangoue-Pieboji Joseph, Koulla-Shiro Sinata, Ngassam Pierre, Adiogo Dieudonne, Ndumbe Peter
机构信息
Institute of Medical Research and Medicinal Plants studies, Yaounde, Cameroon.
出版信息
Afr Health Sci. 2006 Dec;6(4):232-5. doi: 10.5555/afhs.2006.6.4.232.
BACKGROUND
Antimicrobial resistance among bacteria pathogens is a world-wide issue. The antimicrobial susceptibility patterns of common pathogenic bacteria are essential to guide empirical and pathogen-specific therapy; unfortunately, these data are scarse in Cameroon.
OBJECTIVE
To determine the antimicrobial susceptibility patterns of Gram-negative bacilli isolated in Yaounde Central Hospital Laboratory of Bacteriology.
METHODS
Gram-negative bacilli isolates (n = 505), obtained from a wide range of clinical specimens (urine, pus and blood) in Yaoundé Central Hospital Laboratory of Bacteriology between March 1995 and April 1998, were evaluated for resistance to antibiotics (amoxicillin, amoxicillin/clavulanate, piperacillin, cefazolin, cefoxitin, cefotaxime, ceftazidime, aztreonam, imipenem, gentamicin, tobramicin, ofloxacin and trimethoprim/sulfamethoxazole) by the Kirby-Bauer disk diffusion method.
RESULTS
High rates of resistance were found in most of the bacteria studied. Resistance to all isolates was mostly observed for amoxicillin (87%), piperacillin (74%) and trimethoprim/sulfamethoxazole (73%). Susceptibilities to third generation cephalosporins (cefotaxime, ceftazidime) and monobactame (aztreonam) were = 91% for Escherichia coli, = 71% for Klebsiella spp., = 98% for Proteus mirabilis, = 50% for Enterobacter spp. and Citrobacter spp. Pseudomonas aeruginosa was less susceptible to cefotaxime (2%) and aztreonam (33%), and highly susceptible to ceftazidime (72%) whereas Acinetobacter baumannii was highly resistant to aztreonam (100%), to cefotaxime (96%) and cetazidime (62%). Imipenem (98%) was the most active antibiotic followed by the ofloxacine (88%). Susceptibility of all isolates to gentamicin was 67%.
CONCLUSION
These results indicate that surveillance to antimicrobial resistance in Cameroon is necessary to monitor microbial trends, antimicrobial resistance pattern, and provide information for choosing empirical or direct therapy to physicians.
背景
细菌病原体中的抗菌药物耐药性是一个全球性问题。常见病原菌的抗菌药物敏感性模式对于指导经验性治疗和针对病原体的治疗至关重要；不幸的是，这些数据在喀麦隆很匮乏。
目的
确定在雅温得中心医院细菌学实验室分离出的革兰氏阴性杆菌的抗菌药物敏感性模式。
方法
对1995年3月至1998年4月期间在雅温得中心医院细菌学实验室从各种临床标本（尿液、脓液和血液）中获得的革兰氏阴性杆菌分离株（n = 505），采用 Kirby-Bauer 纸片扩散法评估其对抗生素（阿莫西林、阿莫西林/克拉维酸、哌拉西林、头孢唑林、头孢西丁、头孢噻肟、头孢他啶、氨曲南、亚胺培南、庆大霉素、妥布霉素、氧氟沙星和甲氧苄啶/磺胺甲恶唑）的耐药性。
结果
在大多数研究的细菌中发现了高耐药率。对所有分离株的耐药性在阿莫西林（87%）、哌拉西林（74%）和甲氧苄啶/磺胺甲恶唑（73%）中最为常见。对第三代头孢菌素（头孢噻肟、头孢他啶）和单环β-内酰胺类（氨曲南）的敏感性：大肠杆菌为≥91%，克雷伯菌属为71%，奇异变形杆菌为98%，肠杆菌属和柠檬酸杆菌属为50%。铜绿假单胞菌对头孢噻肟（2%）和氨曲南（33%）的敏感性较低，对头孢他啶（72%）高度敏感，而鲍曼不动杆菌对氨曲南（100%）、头孢噻肟（96%）和头孢他啶（62%）高度耐药。亚胺培南（98%）是最有效的抗生素，其次是氧氟沙星（88%）。所有分离株对庆大霉素的敏感性为67%。
结论
这些结果表明，喀麦隆有必要对抗菌药物耐药性进行监测，以监测微生物趋势、抗菌药物耐药模式，并为医生选择经验性或直接治疗提供信息。
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