Ben Hassen A, Chourou O, Fendri C, Kammoun A, Ben Redjeb S
Laboratoire de Microbiologie, Hôpital Charles Nicolle de Tunis.
Bull Soc Pathol Exot. 1991;84(2):145-53.
Beta-lactams and aminoglycosides are widely used in the therapy of serious Gram negative infections in pediatrics. In order to survey acquired resistance, the phenotype of resistance to beta-lactams and aminoglycosides were characterized for 260 strains of enterobacteriaceae among the mainly isolated species in pediatrics. These phenotypes were established according to the results of the disk susceptibility tests for beta-lactams respectively ampicillin, ticarcillin, cefaloridin and cefotaxim, and aminoglycosides, streptomycin (S), gentamicin (G), tobryamycin (T), amikacin (A), and netilmicin (N). 49% of E. coli and 73% of P. mirabilis strains were resistant to 3 beta-lactams (RRRS). 72% of Salmonella spp. strains were resistant to 4 beta-lactams (RRRR). For the majority of strains, the mainly observed resistance phenotype to aminoglycosides was streptomycin resistance excepted for Salmonella spp., which was S + KGTNA. The high level of acquired resistance to beta-lactams and aminoglycosides among Enterobacteriaceae with the selection of multiresistant strains would be explained by the wild use of cefotaxim and amikacin in pediatrics.
β-内酰胺类抗生素和氨基糖苷类抗生素广泛应用于儿科严重革兰氏阴性菌感染的治疗。为了调查获得性耐药情况，对儿科主要分离菌种中的260株肠杆菌科细菌的β-内酰胺类抗生素和氨基糖苷类抗生素耐药表型进行了鉴定。这些表型分别根据氨苄西林、替卡西林、头孢噻啶和头孢噻肟等β-内酰胺类抗生素以及链霉素（S）、庆大霉素（G）、妥布霉素（T）、阿米卡星（A）和奈替米星（N）等氨基糖苷类抗生素的纸片扩散药敏试验结果确定。49%的大肠杆菌菌株和73%的奇异变形杆菌菌株对3种β-内酰胺类抗生素耐药（RRRS）。72%的沙门氏菌属菌株对4种β-内酰胺类抗生素耐药（RRRR）。对于大多数菌株，除沙门氏菌属表现为S+KGTNA外，观察到的主要氨基糖苷类抗生素耐药表型是对链霉素耐药。儿科中头孢噻肟和阿米卡星的滥用可能解释了肠杆菌科细菌中对β-内酰胺类抗生素和氨基糖苷类抗生素获得性耐药水平较高以及多重耐药菌株的出现。
