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尿液样本中耐甲氧西林金黄色葡萄球菌意外的多重耐药性:一项单中心研究

Unexpected Multidrug Resistance of Methicillin-Resistant Staphylococcus aureus in Urine Samples: A Single-Center Study.

作者信息

Lunacek Andreas, Koenig Uwe, Mrstik Christof, Radmayr Christian, Horninger Wolfgang, Plas Eugen

机构信息

Department of Urology, Hanusch Krankenhaus, Vienna, Austria.

Department of Pathology, Hanusch Krankenhaus, Vienna, Austria.

出版信息

Korean J Urol. 2014 May;55(5):349-53. doi: 10.4111/kju.2014.55.5.349. Epub 2014 May 12.

Abstract

PURPOSE

Infections of methicillin-resistant Staphylococcus aureus (MRSA) are becoming an increasingly concerning clinical problem. The aim of this study was to assess the development of MRSA in urine cultures in a major public university-affiliated hospital and the therapeutical and hygiene-related possibilities for reducing resistance.

MATERIALS AND METHODS

This study included 243 samples from patients diagnosed with MRSA infection over a period of 6 years. An agar diffusion test measured the effects of antimicrobial agents against bacteria grown in culture. The analyses were based on the guidelines of the Clinical and Laboratory Standards Institute.

RESULTS

A regression analysis was performed, which showed 100% resistance to the following antibiotics throughout the entire testing period: carbapenem, cephalosporin (1st-4th generation), penicillin G, aminopenicillin, β-lactamase, and isoxazolyl penicillin. However, a significant decrease in resistance was found for amikacin, gentamicin, clindamycin, levofloxacin, erythromycin, and mupirocin.

CONCLUSIONS

MRSA showed a decreasing trend of antimicrobial resistance, except against carbapenem, cephalosporin (1st-4th generation), penicillin G, aminopenicillin, β-lactamase, and isoxazolyl penicillin, for which complete resistance was observed.

摘要

目的

耐甲氧西林金黄色葡萄球菌(MRSA)感染正成为一个日益令人担忧的临床问题。本研究的目的是评估一所大型公立大学附属医院尿培养中MRSA的发展情况以及降低耐药性的治疗和卫生相关可能性。

材料与方法

本研究纳入了6年间243例被诊断为MRSA感染患者的样本。琼脂扩散试验测定了抗菌药物对培养物中生长细菌的作用。分析基于临床和实验室标准协会的指南。

结果

进行了回归分析,结果显示在整个测试期间对以下抗生素的耐药率为100%:碳青霉烯类、头孢菌素(第一代至第四代)、青霉素G、氨基青霉素、β-内酰胺酶和异恶唑青霉素。然而,发现阿米卡星、庆大霉素、克林霉素、左氧氟沙星、红霉素和莫匹罗星的耐药性显著下降。

结论

除对碳青霉烯类、头孢菌素(第一代至第四代)、青霉素G、氨基青霉素、β-内酰胺酶和异恶唑青霉素观察到完全耐药外,MRSA的抗菌耐药性呈下降趋势。

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