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印度住院患者中多重耐药性尿路致病性细菌的监测

Surveillance of multidrug resistant uropathogenic bacteria in hospitalized patients in Indian.

作者信息

Mishra Monali Priyadarsini, Debata Nagen Kumar, Padhy Rabindra Nath

机构信息

Department of Microbiology, IMS & Sum Hospital, Siksha 'O' Anusandhan University, Kalinga Nagar, Bhubaneswar, 751003, Odisha, India.

出版信息

Asian Pac J Trop Biomed. 2013 Apr;3(4):315-24. doi: 10.1016/S2221-1691(13)60071-4.

Abstract

OBJECTIVE

To record surveillance, antibiotic resistance of uropathogens of hospitalized patients over a period of 18 months.

METHODS

Urine samples from wards and cabins were used for isolating urinary tract infection (UTI)-causing bacteria that were cultured on suitable selective media and identified by biochemical tests; and their antibiograms were ascertained by Kirby-Bauer's disc diffusion method, in each 6-month interval of the study period, using 18 antibiotics of five different classes.

RESULTS

From wards and cabins, 1 245 samples were collected, from which 996 strains of bacteria belonging to 11 species were isolated, during April 2011 to September 2012. Two Gram-positive, Staphylococcus aureus (S. aureus) and Enterococcus faecalis (E. faecalis), and nine Gram-negative bacteria, Acinetobacter baumannii, Citrobacter sp., Escherichia coli, Enterobacter aerogenes, Klebsiella pneumoniae, Klebsiella oxytoca, Proteus mirabilis, Proteus vulgaris and Pseudomonas aeruginosa were isolated. Both S. aureus and E. faecalis were vancomycin resistant, and resistant-strains of all pathogens increased in each 6-month period of study. Particularly, all Gram-negatives were resistant to nitrofurantoin and co-trimoxazole, the most preferred antibiotics of empiric therapy for UTI.

CONCLUSIONS

Antibiograms of 11 UTI-causing bacteria recorded in this study indicated moderately higher numbers of strains resistant to each antibiotic studied, generating the fear of precipitating fervent episodes in public health particularly with bacteria, Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae and S. aureus. Moreover, vancomycin resistance in strains of S. aureus and E. faecalis is a matter of concern.

摘要

目的

记录18个月期间住院患者尿路病原体的监测情况及抗生素耐药性。

方法

采集病房和小隔间的尿液样本,用于分离引起尿路感染(UTI)的细菌,这些细菌在合适的选择性培养基上培养,并通过生化试验进行鉴定;在研究期间的每6个月间隔内,使用五类18种抗生素,通过 Kirby-Bauer 纸片扩散法确定其抗菌谱。

结果

在2011年4月至2012年9月期间,从病房和小隔间收集了1245份样本,从中分离出996株属于11个菌种的细菌。分离出两种革兰氏阳性菌,即金黄色葡萄球菌(S. aureus)和粪肠球菌(E. faecalis),以及九种革兰氏阴性菌,即鲍曼不动杆菌、柠檬酸杆菌属、大肠杆菌、产气肠杆菌、肺炎克雷伯菌、产酸克雷伯菌、奇异变形杆菌、普通变形杆菌和铜绿假单胞菌。金黄色葡萄球菌和粪肠球菌均对万古霉素耐药,并且在研究的每6个月期间,所有病原体的耐药菌株数量都有所增加。特别是,所有革兰氏阴性菌均对呋喃妥因和复方新诺明耐药,而这两种药物是UTI经验性治疗中最常用的抗生素。

结论

本研究记录的11种引起UTI的细菌的抗菌谱表明,对所研究的每种抗生素耐药的菌株数量适度增加,这引发了对公共卫生中出现严重感染事件的担忧,尤其是对于鲍曼不动杆菌、大肠杆菌、肺炎克雷伯菌和金黄色葡萄球菌等细菌。此外,金黄色葡萄球菌和粪肠球菌菌株中的万古霉素耐药性令人担忧。

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