Thabet Lamia, Messadi Amen allah, Mbarek Mondher, Turki Amel, Meddeb Balkis, Ben Redjeb Saida
Laboratoire de résistance aux antibiotiques, Faculté de Médecine de Tunis.
Tunis Med. 2008 Nov;86(11):992-5.
Controlling antibiotic resistance of bacteria is a priority for public healthcare.
This study concerned the frequency of multidrug resistant bacteria (MDRB) in a Tunisian Hospital with the aim of establishing guidelines for MDRB prevention.
The study was conducted during two years (1 January 2005-31 December 2006). Samples collected for the clinical diagnostic were included. The MDRB concerned were: methicillin resistant Staphylococcus aureus(MRSA), Enterobacteriacae resistant to of third generation cephalosporin (ER3GC), Acinetobacter baumannii resistant to both imipenem and ceftazidime, Pseudomonas aeruginosa resistant to both imipenem and ceftazidime.
During the study period, 2475 bacteria were tested by disk diffusion. 597 MDRB were collected, the rate of MBR was 24.1%. These MDRB were mainly recovered in burn unit (82.6%). ER3GC (47%) and MRSA (29,2%) were the most frequent MDRB. A. baumannii and P. aeruginosa multiresistant concerned 14,8% and 9% of MDRB. MDRB were isolated mainly from blood cultures (45%). The rate of MRSA was 46.4% among 375 strains of S. aureus. ER3GC represented 25,6% among 1096 isolates. Concerning A. baumannii and P. aeruginosa, 51.7% and 20.5% were resistant to both imipenem and ceftazidime among 170 and 264 isolates. Antibiotic resistance evolution showed a decrease of resistance in 2006 versus 2005. This decrease should be explained by the improvement of hygiene measure especially hand washing with the introduction of hydro- alcoholic solutions, a better targeted antibiotherapy promoted by a close cooperation between microbiologists and clinicians.
The MDRB were frequent in our hospital. They were mainly isolated from the burn department. The measures of prevention already implemented are effective and must be strengthened with the continuous surveillance of MDRB.
控制细菌的抗生素耐药性是公共卫生保健的首要任务。
本研究关注突尼斯一家医院中多重耐药菌（MDRB）的出现频率，旨在制定预防MDRB的指南。
该研究为期两年（2005年1月1日至2006年12月31日）。纳入为临床诊断而采集的样本。所涉及的MDRB包括：耐甲氧西林金黄色葡萄球菌（MRSA）、对第三代头孢菌素耐药的肠杆菌科细菌（ER3GC）、对亚胺培南和头孢他啶均耐药的鲍曼不动杆菌、对亚胺培南和头孢他啶均耐药的铜绿假单胞菌。
在研究期间，通过纸片扩散法检测了2475株细菌。共收集到597株MDRB，MBR发生率为24.1%。这些MDRB主要在烧伤病房检出（82.6%）。ER3GC（47%）和MRSA（29.2%）是最常见的MDRB。鲍曼不动杆菌和多重耐药铜绿假单胞菌分别占MDRB的14.8%和9%。MDRB主要从血培养中分离得到（45%）。在375株金黄色葡萄球菌菌株中，MRSA的发生率为46.4%。在1096株分离株中，ER3GC占25.6%。在170株和264株分离株中，分别有51.7%的鲍曼不动杆菌和20.5%的铜绿假单胞菌对亚胺培南和头孢他啶均耐药。抗生素耐药性演变显示，与2005年相比，2006年耐药性有所下降。这种下降应归因于卫生措施的改善，特别是引入含酒精洗手液后的洗手情况，以及微生物学家与临床医生密切合作推动的更具针对性的抗菌治疗。
MDRB在我院较为常见。它们主要从烧伤科分离得到。已实施的预防措施是有效的，必须通过对MDRB的持续监测加以强化。
