Hanulík Vojtěch, Suchánková Hana, Urbánek Karel, Imwensi Peter, Htoutou Sedláková Miroslava, Vojtová Vladimírá, Kolář Milan
Department of Microbiogy, Palacký University, Olomouc, Czech Republic.
Klin Mikrobiol Infekc Lek. 2013 Jun;19(2):52-5.
Recently, there has been a renaissance of the use of the antibiotic colistin resulting from increasing resistance of bacterial pathogens, particularly in intensive care patients. The study aimed at assessing the impact of colistin consumption on the prevalence of colistin-resistant bacteria in the University Hospital Olomouc (UHO).
A laboratory database was retrospectively searched to identify all clinically significant colistin-resistant bacterial strains isolated between 2007 and 2011. These data were compared with colistin consumption over the same period and the results were statistically processed.
Over the study period, a total of 6 338 clinically significant colistin-resistant strains were detected in the UHO (Acinetobacter spp., Burkholderia cepacia complex, Citrobacter spp., Enterobacter spp., Escherichia coli, Klebsiella spp., Morganella morganii, Proteus spp., Providencia spp., Pseudomonas spp., Serratia marcesces and Stenotrophomonas maltophilia). Over the same period, the consumption of colistin increased nearly 10-fold. With the increasing colistin consumption, the numbers of colistin-resistant strains of Pseudomonas aeruginosa and Acinetobacter spp. decreased over that period of time. By contrast, there was an increase in the rates of naturally Burkholderia cepacia complex strains naturally resistant to colistin. An alarming finding is that the prevalence of colistin-resistant strains of Klebsiella pneumoniae increased in the last years of the study period, especially in intensive care patients.
In the UHO, higher consumption of colistin was accompanied by increased numbers of colistin-resistant strains. There was a marked increase of Burkholderia cepacia complex strains and, recently, a statistically insignificant but alarming increase in colistin-resistant Klebsiella pneumoniae strains.
近年来，由于细菌病原体耐药性增加，尤其是在重症监护患者中，抗生素黏菌素的使用再度兴起。本研究旨在评估黏菌素消耗量对奥洛穆茨大学医院（UHO）中耐黏菌素细菌流行率的影响。
对实验室数据库进行回顾性检索，以识别2007年至2011年间分离出的所有具有临床意义的耐黏菌素细菌菌株。将这些数据与同期黏菌素的消耗量进行比较，并对结果进行统计学处理。
在研究期间，UHO共检测到6338株具有临床意义的耐黏菌素菌株（不动杆菌属、洋葱伯克霍尔德菌复合体、柠檬酸杆菌属、肠杆菌属、大肠埃希菌、克雷伯菌属、摩根摩根菌、变形杆菌属、普罗威登斯菌属、假单胞菌属、黏质沙雷菌和嗜麦芽窄食单胞菌）。同期，黏菌素的消耗量增加了近10倍。随着黏菌素消耗量的增加，铜绿假单胞菌和不动杆菌属的耐黏菌素菌株数量在该时间段内有所下降。相比之下，天然耐黏菌素的洋葱伯克霍尔德菌复合体菌株的比例有所增加。一个令人担忧的发现是，在研究期的最后几年，耐黏菌素肺炎克雷伯菌菌株的流行率有所上升，尤其是在重症监护患者中。
在UHO，黏菌素的高消耗量伴随着耐黏菌素菌株数量的增加。洋葱伯克霍尔德菌复合体菌株显著增加，最近，耐黏菌素肺炎克雷伯菌菌株虽无统计学意义但令人担忧地增加。
