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[新生儿化脓性败血症感染病原体耐药性的微生物学控制]

[Microbiological control of drug resistance of causative agents in suppurative-septic infections in newborn infants].

作者信息

Belokrysenko S S, Parfeniuk R L

出版信息

Antibiot Khimioter. 1990 May;35(5):21-4.

PMID:2200371
Abstract

Resistance of the main causative agents of purulent septic infections such as pneumonia, meningitis, sepsis, etc. to 11 chemotherapeutic drugs was studied. The pathogens were isolated from autopsies of 203 newborns who died within 1981 to 1987. Among 2978 isolates belonging to Enterobacteriaceae (2466 strains) and Pseudomonadaceae (512 strains) which constituted 88% of all the isolates, strains with multiple resistance predominated: 90% of the strains resistant to 4 or more antibiotics, 77% of the strains resistant to 6 or more antibiotics and 48% of the strains resistant to 8 or more antibiotics. The highest number of the isolates were resistant to 8 and 9 chemotherapeutics (19 and 20%, respectively). 84% of all the isolates belonged to 4 genera: Klebsiella (34%), Escherichia (21%), Serratia (14%) and Pseudomonas (15%). They were characterized by the highest resistance spectra. In all the cases massive colonization of the intestine by the strains with multiple resistance which caused purulent septic infections was observed. The most frequent variants of the drug resistance combination were determined. In the total frequency of the isolate with multiple resistance no significant differences were detected in 1981 and thereafter. In 1986-1987 the frequency of S. marcescens strains increased 3-5 times with simultaneous broadening of their drug resistance spectra. Strains of S. marcescens and K. pneumoniae with multiple drug resistance endemic for definite hospitals were detected.

摘要

对肺炎、脑膜炎、败血症等化脓性败血症感染的主要病原体对11种化疗药物的耐药性进行了研究。病原体取自1981年至1987年间死亡的203例新生儿的尸检样本。在所有分离菌株中占88%的2978株肠杆菌科(2466株)和假单胞菌科(512株)中,多重耐药菌株占主导:90%的菌株对4种或更多抗生素耐药,77%的菌株对6种或更多抗生素耐药,48%的菌株对8种或更多抗生素耐药。分离菌株数量最多的是对8种和9种化疗药物耐药(分别为19%和20%)。所有分离菌株的84%属于4个属:克雷伯菌属(34%)、大肠杆菌属(21%)、沙雷菌属(14%)和假单胞菌属(15%)。它们具有最高的耐药谱。在所有病例中均观察到导致化脓性败血症感染的多重耐药菌株在肠道大量定植。确定了最常见的耐药组合变体。在1981年及之后,多重耐药分离株的总频率未检测到显著差异。1986 - 1987年,黏质沙雷菌菌株的频率增加了3 - 5倍,同时其耐药谱也变宽。检测到某些医院特有的多重耐药黏质沙雷菌和肺炎克雷伯菌菌株。

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