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对氨基糖苷类抗生素的耐药性:德意志联邦共和国的情况

Resistance to aminoglycosides: the situation in the Federal Republic of Germany.

作者信息

Naber K G, Grimm H, Rosenthal E J, Shah P M, Wiedemann B

机构信息

Urological Clinic, Elisabeth Hospital, Straubling, FRG.

出版信息

J Int Med Res. 1990;18 Suppl 4:6D-26D.

PMID:2178099
Abstract

The susceptibility of important pathogens to aminoglycosides was analysed using data from five studies encompassing different patient groups. Enterobacteria were generally sensitive to all modern aminoglycosides without marked differences. The frequency of resistance of Pseudomonas aeruginosa and other non-fermenters to gentamicin was 5-15% and to amikacin was 0-3%, and similar values applied for staphylococci. A higher rate of resistance was observed in pathogens isolated from urological patients: for non-fermenters resistance to gentamicin, tobramycin and netilmicin was 24-28%, whereas resistance to amikacin was 12%; and for staphylococci resistance was 33% for gentamicin, 48% for tobramycin and 9% for netilmicin. It is concluded that resistance to aminoglycosides is not an important problem in the Federal Republic of Germany, probably because aminoglycosides are used in combination with beta-lactam antibiotics, except in the case of urinary tract infections. Aminoglycosides are still important antibiotics, thus their rational use and constant surveillance are necessary to preserve their efficacy.

摘要

利用涵盖不同患者群体的五项研究的数据,分析了重要病原体对氨基糖苷类药物的敏感性。肠杆菌通常对所有现代氨基糖苷类药物敏感,无明显差异。铜绿假单胞菌和其他非发酵菌对庆大霉素的耐药率为5%-15%,对阿米卡星的耐药率为0%-3%,葡萄球菌的情况类似。从泌尿科患者分离出的病原体耐药率较高:非发酵菌对庆大霉素、妥布霉素和奈替米星的耐药率为24%-28%,而对阿米卡星的耐药率为12%;葡萄球菌对庆大霉素的耐药率为33%,对妥布霉素的耐药率为48%,对奈替米星的耐药率为9%。得出的结论是,在德意志联邦共和国,对氨基糖苷类药物的耐药性不是一个重要问题,这可能是因为除尿路感染外,氨基糖苷类药物与β-内酰胺类抗生素联合使用。氨基糖苷类药物仍然是重要的抗生素,因此有必要合理使用并持续监测以保持其疗效。

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