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产超广谱β-内酰胺酶大肠埃希菌和克雷伯菌属的流行情况及其对抗菌药物的共同耐药模式。

Prevalence of ESBL producing Escherichia Coli and Klebsiella species with their co-resistance pattern to antimicrobials.

作者信息

Biswas T, Das M, Mondal R, Raj H J, Mondal S

机构信息

Department of Microbiology, Burdwan Medical College, Burdwan, West Bengal, India.

出版信息

Mymensingh Med J. 2013 Apr;22(2):377-84.

Abstract

Extended spectrum β-lactamase producing bacteria are potential emerging pathogens and continue to be a major challenge in clinical setup worldwide. In the present study an attempt was made to study the prevalence of extended spectrum β-lactamase producing Escherichia coli and Klebsiella species from clinical isolates in a rural tertiary care hospital in West Bengal, India with their antimicrobial susceptibility as well as co-resistance pattern to different antimicrobials. A total of 179 Escherichia coli and 62 Klebsiella isolates recovered from various clinical samples of urine, pus, aural swabs and respiratory secretions (including sputum) for a period of six months were subjected to routine antimicrobial susceptibility testing and also tested for extended spectrum β-lactamase production as per NCCLS recommendations. Extended spectrum β-lactamase was detected in 32.40% of Escherichia coli and 40.32% of Klebsiella species isolates. Urine, pus and respiratory samples were common source of extended spectrum β-lactamase producers and resistance rate of these organisms to third generation cephalosporins were more than 30 to 40%. Co-resistance pattern of these extended spectrum β-lactamase producers to other commonly used antimicrobials were also statistically significant (p≤0.05). From the study it is concluded that indiscriminate use of third generation cephalosporins may be responsible for the selection of extended spectrum β-lactamase producing multidrug resistant strains in hospital setup and amikacin is a reliable drug against them.

摘要

产超广谱β-内酰胺酶细菌是潜在的新兴病原体,在全球临床环境中仍然是一个重大挑战。在本研究中,我们试图研究印度西孟加拉邦一家农村三级护理医院临床分离株中产超广谱β-内酰胺酶的大肠杆菌和克雷伯菌属的流行情况,以及它们对不同抗菌药物的药敏性和共同耐药模式。从尿液、脓液、耳拭子和呼吸道分泌物(包括痰液)等各种临床样本中,在六个月的时间里共分离出179株大肠杆菌和62株克雷伯菌,对其进行常规抗菌药敏试验,并按照美国国家临床实验室标准化委员会(NCCLS)的建议检测超广谱β-内酰胺酶的产生情况。在32.40%的大肠杆菌和40.32%的克雷伯菌属分离株中检测到超广谱β-内酰胺酶。尿液、脓液和呼吸道样本是产超广谱β-内酰胺酶细菌的常见来源,这些细菌对第三代头孢菌素的耐药率超过30%至40%。这些产超广谱β-内酰胺酶细菌对其他常用抗菌药物的共同耐药模式也具有统计学意义(p≤0.05)。从研究中可以得出结论,在医院环境中,第三代头孢菌素的滥用可能是导致产超广谱β-内酰胺酶的多重耐药菌株产生的原因,而阿米卡星是对抗这些菌株的可靠药物。

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