Nica Maria, Biolan Tatiana, Dascălu Amalia, Mozes Elena, Toderan Andreea, Calistru Petre, Ceauşu Emanoil
Spitalul Clinic de Boli Infecţioase şi Tropicale Dr. V. Babeş-Bucureşti.
Bacteriol Virusol Parazitol Epidemiol. 2010 Apr-Jun;55(2):161-8.
Testing antibiotic resistance of bacterial strains (compulsor, reported for EARSS surveillance) isolated from patients hospitalised for systemic infection in the "Dr. V. Babe" Hospital for Infectious and Tropical Diseases during 01.01.2005-11.11.2009, for a dynamic evaluation and for the surveillance of resistance emergence for certain classes of antibiotics.
Bacterial isolation: BacT/ALERT system; strain identification in classic and automated system (ATB Expression. VITEK 2C): antibioresistance: disk-difussion method (NCCLS 2005--CLSI 2009), MIC (E-Test, ATB/ Expression, VITEK 2C). Screening of ESBL-producing strains performed with double disk-difussion method (DDD). Reference strains used: S. aureus ATCC 25923, S. pneumoniae ATCC 49619, E. coli A TCC 25922, Enterococcus fiecalis ATCC 29212.
During the studied period, 245 bacterial strains have been isolated, identified and tested (Staphylococcus aureus / 70, Streptococcus pneumoniae / 61, Enterococcus faecalis / 18, Enterococcus faecium / 5, Neisseria meningitidis / 18, E. coli / 73). out of 166 hemocultures and 79 cerebrospinal fluids / CSF. The average incidence of MRSA strains in systemic infections was 34.28%. 44.28% of the S. aureus strains were resistant to erythromycin, 17.14% to cyprofloxacyne, 15.71% to rifampicine, 14.49% to gentamycine. No strain resistant to vancomycine and linezolide. Streptococcus pneumoniae presented an average high resistance to penicillin G of 11.47%. and a 1.63% resistance to third generation cephalosporines. 0% resistance to vancomycine and rifampicine. 7/ 18 Enterococcus faecalis strains and 4/5 Enterococcus faecium strains presented high level resistance to gentamycine (CN 120 microg/disk) and no strain was resistant to vancomycine, teicoplanin or linezolid. The 18 Neisseria meningitidis strains were all sensitive to beta-lactams, macrolides, fluoroquinolones and cloramphenicol. For the 73 Escherichia coli strains, the average incidence of ESBL-producing isolates was 10.95%, the average resistance to ampicillin was 58.90%, to gentamycine--13.88% and to cyprofloxacin--20.83%. No strain resistant to carbapenemes and amikacine.
For the systematic surveillance of antibiotic resistance there is a need for a harmonised protocol of data gathering and strain selection and the rigurous implementation of correct evaluating methods for antibiotic resistance in the microbiology laboratory. Carbapenemes. glycopeptides and oxazolidinones still present a major effectiveness in the first intention treatment of systemic infections.
检测2005年1月1日至2009年11月11日期间在“V. Babe博士”传染病与热带病医院因全身感染住院的患者所分离出的细菌菌株（强制要求，上报至欧洲抗菌药物耐药性监测系统）的抗生素耐药性，以便进行动态评估并监测某些类抗生素耐药性的出现情况。
细菌分离：采用BacT/ALERT系统；在传统和自动化系统（ATB Expression、VITEK 2C）中进行菌株鉴定；抗生素耐药性检测：纸片扩散法（依据美国国家临床实验室标准化委员会2005年标准——临床和实验室标准协会2009年标准）、最低抑菌浓度（E试验、ATB/Expression、VITEK 2C）。采用双纸片扩散法（DDD）筛选产超广谱β-内酰胺酶（ESBL）菌株。使用的参考菌株：金黄色葡萄球菌ATCC 25923、肺炎链球菌ATCC 49619、大肠埃希菌ATCC 25922、粪肠球菌ATCC 29212。
在研究期间，共分离、鉴定并检测了245株细菌菌株（金黄色葡萄球菌70株、肺炎链球菌61株、粪肠球菌l株、屎肠球菌5株、脑膜炎奈瑟菌18株、大肠埃希菌73株），分别来自166份血培养标本和79份脑脊液标本。全身感染中耐甲氧西林金黄色葡萄球菌（MRSA）菌株的平均发生率为34.28%。44.28%的金黄色葡萄球菌菌株对红霉素耐药，17.14%对环丙沙星耐药，15.71%对利福平耐药，14.49%对庆大霉素耐药。无菌株对万古霉素和利奈唑胺耐药。肺炎链球菌对青霉素G的平均耐药率较高，为11.47%，对第三代头孢菌素的耐药率为1.63%。对万古霉素和利福平的耐药率为0%。18株粪肠球菌中的7株和5株屎肠球菌中的4株对庆大霉素（CN 120μg/纸片）呈现高水平耐药，无菌株对万古霉素、替考拉宁或利奈唑胺耐药。18株脑膜炎奈瑟菌菌株对β-内酰胺类、大环内酯类、氟喹诺酮类和氯霉素均敏感。对于73株大肠埃希菌菌株，产ESBL分离株的平均发生率为10.95%，对氨苄西林的平均耐药率为58.90%，对庆大霉素为13.88%，对环丙沙星为20.83%。无菌株对碳青霉烯类和阿米卡星耐药。
为了系统监测抗生素耐药性，需要一个统一的数据收集和菌株选择方案，并在微生物实验室严格实施正确的抗生素耐药性评估方法。碳青霉烯类、糖肽类和恶唑烷酮类在全身感染的初始治疗中仍具有主要疗效。
