Department of Medical Microbiology, Maastricht University Medical Centre, Maastricht, The Netherlands.
J Antimicrob Chemother. 2009 Nov;64(5):1029-34. doi: 10.1093/jac/dkp337. Epub 2009 Sep 22.
To determine the usefulness of flucloxacillin as empirical therapy for putative Staphylococcus aureus infections in intensive care unit (ICU) patients in the Netherlands, the antibiotic resistance of S. aureus isolates from ICUs over a 13 year period was investigated.
From 1996 to 2008, 1146 consecutive S. aureus isolates from ICU patients in 14 large referral hospitals were collected. The susceptibility to relevant antibiotics was determined by microbroth dilution according to CLSI guidelines.
Resistance to flucloxacillin was only found in 12 isolates (1%). The resistance to clarithromycin, ciprofloxacin and moxifloxacin showed a significant trend over time, from 4.2% to 10.3%, from 1.0% to approximately 10% and from 0.0% to approximately 5.0%, respectively (P < 0.05). The resistance to penicillin, clindamycin and doxycycline increased over time, from 74% to 75%, from approximately 3.0% in 1996 to 3.2% in 2008 and from 2.2% in 1996 to 8.2% in 2008, respectively (P > 0.05). Resistance to cephalosporins, carbapenems, rifampicin and gentamicin was sporadically observed. No resistance was found to vancomycin, teicoplanin and linezolid.
The empirical choice of flucloxacillin in the case of putative S. aureus infections in patients admitted to ICUs in the Netherlands is still justified.
为了确定氟氯西林在荷兰重症监护病房（ICU）疑似金黄色葡萄球菌感染患者中作为经验性治疗的有效性，我们对 ICU 中分离的金黄色葡萄球菌在 13 年期间的抗生素耐药性进行了研究。
1996 年至 2008 年，从 14 家大型转诊医院的 ICU 患者中连续收集了 1146 株金黄色葡萄球菌。根据 CLSI 指南，采用微量肉汤稀释法测定相关抗生素的敏感性。
仅在 12 株（1%）分离株中发现对氟氯西林的耐药性。克拉霉素、环丙沙星和莫西沙星的耐药性呈显著趋势，分别从 4.2%增加到 10.3%，从 1.0%增加到约 10%，从 0.0%增加到约 5.0%（P < 0.05）。青霉素、克林霉素和强力霉素的耐药性随时间而增加，分别从 74%增加到 75%，从 1996 年的约 3.0%增加到 2008 年的 3.2%，从 1996 年的 2.2%增加到 2008 年的 8.2%（P > 0.05）。头孢菌素、碳青霉烯类、利福平、庆大霉素的耐药性呈散在发生。未发现万古霉素、替考拉宁和利奈唑胺耐药。
在荷兰 ICU 住院患者中，疑似金黄色葡萄球菌感染时，氟氯西林作为经验性选择仍然是合理的。
