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比较一家三级教学医院新生儿和成人重症监护病房的抗菌药物耐药性。

Comparison of antimicrobial resistance in neonatal and adult intensive care units in a tertiary teaching hospital.

机构信息

Department of Pediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia.

出版信息

Am J Infect Control. 2012 Aug;40(6):572-5. doi: 10.1016/j.ajic.2012.02.032.

Abstract

Intrahospital variations in antimicrobial profiles may be related to many factors. This study compared causative agents of nosocomial bloodstream infections between a neonatal intensive care unit (NICU) that adopted a ward-tailored antibiotic policy and adult intensive care units (ICUs). Data on organisms from blood cultures obtained from the respective wards between 2005 and 2009 were analyzed. Compared with the adult ICUs, the NICU had a higher frequency of Enterobacteriacae and lower frequencies of typical hospital-acquired pathogens (eg, Klebsiella pneumoniae, 17.4% vs 10.0% [P < .001]; Acinetobacter baumannii, 3.9% vs 11.6% [P < .001]). Antibiotic resistance of gram-negative organisms was also significantly lower in the NICU, including resistance to imipenem (5.7% vs 32.1%; P < .001), amikacin (8.8% vs 30.3%), and ceftriaxone (36.1% vs 74.6%; P < .001). This could possibly be due to the ward-tailored antibiotic policy adopted by the NICU but not by the other ICUs.

摘要

医院内抗菌药物谱的差异可能与多种因素有关。本研究比较了采用病房定制抗生素策略的新生儿重症监护病房(NICU)与成人重症监护病房(ICU)的医院获得性血流感染的病原体。对 2005 年至 2009 年间各病房血培养中分离的病原体数据进行了分析。与成人 ICU 相比,NICU 肠杆菌科的检出率更高,而典型医院获得性病原体(如肺炎克雷伯菌,17.4%比 10.0%[P<.001];鲍曼不动杆菌,3.9%比 11.6%[P<.001])的检出率较低。NICU 革兰氏阴性菌的抗生素耐药率也显著降低,包括对亚胺培南(5.7%比 32.1%;P<.001)、阿米卡星(8.8%比 30.3%)和头孢曲松(36.1%比 74.6%;P<.001)的耐药性。这可能是由于 NICU 采用了病房定制的抗生素策略,而其他 ICU 则没有。

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