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多重耐药菌引起的伤口感染

Wound infections with multi-drug resistant bacteria.

作者信息

Pîrvănescu H, Bălăşoiu M, Ciurea M E, Bălăşoiu A T, Mănescu R

出版信息

Chirurgia (Bucur). 2014 Jan-Feb;109(1):73-9.

Abstract

INTRODUCTION

Wound infections remain a public health problem, despite the progress made on improving surgical techniques and antibiotic prophylaxis application. Misuse of antibiotics to prevent bacterial infections leads to increased bacterial resistance and their dissemination.

MATERIAL AND METHODS

The study refers to 470 samples taken from wound infections of which only multi-drug resistant strains were selected for study, using two special culture mediums (Metistaph-2 for methicillin-resistant staphylococci and ESBLs-Agar for extended-spectrum betalactamases secreting bacteria). Sensitivity of these strains was tested using the diffusion method.

RESULTS

Of all studied samples, a rate of 27.6 bacterial strains showed multi-drug resistance. Among them stood primarily Staphylococcus aureus; both MRSA strains and ESBL Gram negative bacteria studied showed high resistance to aminoglycosides, quinolones, third generation cephalosporins and low to fourth generation cephalosporins. No vancomycin resitant nor vancomycin-intermediate Staphylococcus aureus strains were isolated.

CONCLUSIONS

Knowing the antibiotic resistance is very useful in antibiotic "cycling"application, avoiding this way the emergence of increased resistant strains.

摘要

引言

尽管在改进手术技术和应用抗生素预防方面取得了进展,但伤口感染仍然是一个公共卫生问题。滥用抗生素预防细菌感染会导致细菌耐药性增加及其传播。

材料与方法

该研究涉及从伤口感染中采集的470份样本,仅选择多重耐药菌株进行研究,使用两种特殊培养基(用于耐甲氧西林葡萄球菌的Metistaph-2和用于分泌超广谱β-内酰胺酶细菌的ESBLs-琼脂)。使用扩散法检测这些菌株的敏感性。

结果

在所有研究样本中,27.6%的菌株表现出多重耐药性。其中主要是金黄色葡萄球菌;所研究的耐甲氧西林金黄色葡萄球菌菌株和产超广谱β-内酰胺酶革兰氏阴性菌对氨基糖苷类、喹诺酮类、第三代头孢菌素耐药性高,对第四代头孢菌素耐药性低。未分离出耐万古霉素或万古霉素中介的金黄色葡萄球菌菌株。

结论

了解抗生素耐药性对抗生素“轮换”应用非常有用,通过这种方式避免出现耐药性增加的菌株。

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