Division of Infectious Diseases, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
J Microbiol Immunol Infect. 2009 Aug;42(4):317-23.
The Study for Monitoring Antimicrobial Resistance Trends (SMART) was initiated to monitor the in vitro antimicrobial susceptibility of aerobic and facultative anaerobic Gram-negative bacilli (GNB) isolated from patients with intra-abdominal infections (IAI). This report summarizes the SMART data from 1 of the study centers from 2002 to 2006.
492 Gram-negative isolates were collected from 482 patients with IAI. Susceptibilities of these isolates to 12 antimicrobial agents were determined using the broth microdilution method.
Enterobacteriaceae comprised 68.3% of the isolates (n = 336). The 4 main species were Klebsiella spp. (n = 129; 26.2%), Escherichia coli (n = 122; 24.8%), Enterobacter spp. (n = 36; 7.3%), and Aeromonas hydrophila (n = 35; 7.1%). The commonest glucose non-fermentative GNB were Acinetobacter baumannii (n = 46; 9.3%) and Pseudomonas aeruginosa (n = 35; 7.1%). Extended-spectrum beta-lactamase (ESBL) production was detected in 70 Enterobacteriaceae isolates (70/336; 21%). The ESBL phenotype was exhibited by 23% of Klebsiella pneumoniae, 26% of E. coli, and 19% of Enterobacter spp. The highest rate of ESBL production was found in 2005 for E. coli (38%) and in 2003 for Klebsiella spp. (38%) and Enterobacter spp. (40%). The incidence of ESBL-producing isolates declined in 2005 and 2006. Low susceptibility rates of E. coli isolates to ciprofloxacin (58%) and levofloxacin (64%) were noted. Ertapenem (99%), imipenem (99%), and amikacin (94%) were the most potent agents against Enterobacteriaceae spp.
Continuous surveillance is crucial to monitor the trend of antimicrobial resistance patterns among GNB isolated from IAI.
监测抗菌药物耐药趋势的研究（SMART）旨在监测从腹腔内感染（IAI）患者中分离的需氧和兼性厌氧革兰氏阴性杆菌（GNB）的体外抗菌药物敏感性。本报告总结了 2002 年至 2006 年期间该研究中心之一的 SMART 数据。
从 482 例 IAI 患者中采集了 492 株革兰氏阴性菌分离株。采用肉汤微量稀释法测定这些分离株对 12 种抗菌药物的敏感性。
肠杆菌科占分离株的 68.3%（n = 336）。主要的 4 个种是肺炎克雷伯菌（n = 129；26.2%）、大肠埃希菌（n = 122；24.8%）、肠杆菌属（n = 36；7.3%）和嗜水气单胞菌（n = 35；7.1%）。最常见的非发酵葡萄糖革兰氏阴性杆菌是鲍曼不动杆菌（n = 46；9.3%）和铜绿假单胞菌（n = 35；7.1%）。在 70 株肠杆菌科分离株中检测到产超广谱β-内酰胺酶（ESBL）（70/336；21%）。ESBL 表型在肺炎克雷伯菌中占 23%，大肠埃希菌中占 26%，肠杆菌属中占 19%。产 ESBL 率最高的是 2005 年的大肠埃希菌（38%）和 2003 年的肺炎克雷伯菌（38%）和肠杆菌属（40%）。2005 年和 2006 年产 ESBL 分离株的发生率下降。大肠埃希菌分离株对环丙沙星（58%）和左氧氟沙星（64%）的敏感性较低。厄他培南（99%）、亚胺培南（99%）和阿米卡星（94%）是肠杆菌科最有效的药物。
连续监测对于监测 IAI 患者分离的 GNB 抗菌药物耐药趋势至关重要。
