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从囊性纤维化患者痰液中分离出的微生物的患病率及抗菌药敏性

Prevalence and antimicrobial susceptibility of microorganisms isolated from sputa of patients with cystic fibrosis.

作者信息

Valenza Giuseppe, Tappe Dennis, Turnwald Doris, Frosch Matthias, König Corinne, Hebestreit Helge, Abele-Horn Marianne

机构信息

Institute of Hygiene and Microbiology, University of Würzburg, Germany.

出版信息

J Cyst Fibros. 2008 Mar;7(2):123-7. doi: 10.1016/j.jcf.2007.06.006. Epub 2007 Aug 13.

Abstract

BACKGROUND

New emerging pathogens and associated antimicrobial resistance mechanisms have been observed in the respiratory tract of patients suffering from cystic fibrosis (CF) in the last years. Amongst others, the rate of metallo-beta-lactamase (MBL)-producing Pseudomonas aeruginosa strains is growing. However, there are no published data on the prevalence of MBL-producing P. aeruginosa in CF patients to our knowledge.

METHODS

In this study, 271 sputum samples of 60 CF patients were collected during a 12-months period. Microbiological cultures and antimicrobial susceptibility tests of the most frequently isolated bacteria were performed.

RESULTS

464 bacterial and 414 fungal strains were isolated and characterized. 63.3% of the patients harbored Staphylococcus aureus, 50% P. aeruginosa, 16.6% Haemophilus influenzae, 15% Stenotrophomonas maltophilia and 13.3% non tuberculous Mycobacteria (NTM). Methicillin resistant S. aureus (MRSA) and MBL-producing P. aeruginosa were detected in 3 (5%) and 5 (8.3%) patients respectively. Among the fungi, Aspergillus fumigatus and Candida albicans showed the highest prevalence.

CONCLUSIONS

The detection of MBL-producing P. aeruginosa and MRSA in CF patients confirms that antimicrobial resistance patterns should be always kept under surveillance. Moreover hygiene regulations in CF clinics should prevent a further spread of resistant bacterial strains.

摘要

背景

近年来,在患有囊性纤维化(CF)的患者呼吸道中观察到了新出现的病原体及相关的抗菌耐药机制。其中,产金属β-内酰胺酶(MBL)的铜绿假单胞菌菌株比例正在上升。然而,据我们所知,尚无关于CF患者中产MBL铜绿假单胞菌患病率的公开数据。

方法

在本研究中,在12个月期间收集了60例CF患者的271份痰标本。对最常分离出的细菌进行了微生物培养和药敏试验。

结果

分离并鉴定出464株细菌和414株真菌。63.3%的患者携带金黄色葡萄球菌,50%携带铜绿假单胞菌,16.6%携带流感嗜血杆菌,15%携带嗜麦芽窄食单胞菌,13.3%携带非结核分枝杆菌(NTM)。分别在3例(5%)和5例(8.3%)患者中检测到耐甲氧西林金黄色葡萄球菌(MRSA)和产MBL的铜绿假单胞菌。在真菌中,烟曲霉和白色念珠菌的患病率最高。

结论

在CF患者中检测到产MBL的铜绿假单胞菌和MRSA,证实应始终监测抗菌耐药模式。此外,CF诊所的卫生规定应防止耐药菌株的进一步传播。

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