[2010 - 2012年期间在拉曼恰中心综合医院分离出的最常见细菌病原体的药敏趋势]

[Trend in the susceptibility of the most frequent bacterial pathogens isolated at Hospital General La Mancha Centro over 2010-2012 period].

作者信息

Asencio María Ángeles, Huertas María, Carranza Rafael, Franco María, Castellanos Jesús, Barberá José Ramón, Conde María del Carmen, Tenías José María

机构信息

María Ángeles Asencio Egea, Laboratorio de Microbiología, Hospital General La Mancha Centro, Avenida Constitución 3. - 13600, Alcázar de San Juan, Ciudad Real, Spain.

出版信息

Rev Esp Quimioter. 2014 Dec;27(4):261-8.

PMID:25536430

Abstract

Introduction. Our objective was to determine the trend of the antimicrobial susceptibility of the most common bacterial pathogens isolated in La Mancha Centro Hospital (MCH) between 2010-2012. Material and methods. Isolates of Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa from patients admitted to MCH were studied. These data and their antibiotic susceptibility were obtained from the database OBSERVA (BioMérieux). Results. The percentages of susceptibility for S. aureus were: 50% methicillin-resistant-S. aureus (MRSA) (higher co-resistance to erythromycin and levofloxacin), 46% erythromycin, 73% clindamycin, 45% levofloxacin, 99% rifampin and 100% cotrimoxazole, glycopeptides, linezolid and daptomycin. Increased resistance in ICU was observed (63% MRSA), with 50% of S. aureus (susceptible and methicillin-resistant strains) with vancomycin MIC values ≥ 0.5 mg/L. E. coli susceptibility: 62% amoxicillin-clavulanate, 55% ciprofloxacin, 60% cotrimoxazole, 84% gentamicin and 95% fosfomycin. K. pneumoniae susceptibility: 74% amoxicillin-clavulanate, 71% ciprofloxacin, 78% cotrimoxazole, 94% gentamicin and 87% fosfomycin. The percentage of BLEE strains was 17% and 21% for E. coli and K. pneumoniae, respectively, without detection of resistance to carbapenems. P. aeruginosa susceptibility: 80% ceftazidime and carbapenems, 63% ciprofloxacin and higher than 90% aminoglycosides. A decreasing trend of susceptibility to ceftazidime and carbapenems was observed in ICU and increasing trend to ciprofloxacin. Conclusions. Resistance percentages were higher in ICU than in the rest of the hospital, highlighting 63% of MRSA strains. Our percentage of BLEE and MRSA strains were higher than the Spanish media. Rifampicin and cotrimoxazole maintain good susceptibility to S. aureus, fosfomycin and aminoglycosides to Enterobacteriaceae and carbapenems to P. aeruginosa.

摘要

引言。我们的目标是确定2010 - 2012年期间在拉曼恰中心医院（MCH）分离出的最常见细菌病原体的抗菌药敏趋势。材料与方法。对MCH收治患者的金黄色葡萄球菌、大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌分离株进行了研究。这些数据及其抗生素敏感性来自OBSERVA数据库（生物梅里埃公司）。结果。金黄色葡萄球菌的药敏百分比为：耐甲氧西林金黄色葡萄球菌（MRSA）占50%（对红霉素和左氧氟沙星的共耐药性较高），红霉素占46%，克林霉素占73%，左氧氟沙星占45%，利福平占99%，复方新诺明、糖肽类、利奈唑胺和达托霉素占100%。在重症监护病房（ICU）观察到耐药性增加（MRSA占63%），50%的金黄色葡萄球菌（敏感和耐甲氧西林菌株）万古霉素MIC值≥0.5mg/L。大肠埃希菌药敏情况：阿莫西林 - 克拉维酸占62%，环丙沙星占55%，复方新诺明占60%，庆大霉素占84%，磷霉素占95%。肺炎克雷伯菌药敏情况：阿莫西林 - 克拉维酸占74%，环丙沙星占71%，复方新诺明占78%，庆大霉素占94%，磷霉素占87%。大肠埃希菌和肺炎克雷伯菌的产超广谱β - 内酰胺酶（BLEE）菌株百分比分别为17%和21%，未检测到对碳青霉烯类的耐药性。铜绿假单胞菌药敏情况：头孢他啶和碳青霉烯类占80%，环丙沙星占63%，氨基糖苷类高于90%。在ICU中观察到对头孢他啶和碳青霉烯类的药敏呈下降趋势，对环丙沙星呈上升趋势。结论。ICU中的耐药百分比高于医院其他科室，突出表现为63%的MRSA菌株。我们的BLEE和MRSA菌株百分比高于西班牙平均水平。利福平、复方新诺明对金黄色葡萄球菌保持良好的敏感性，磷霉素、氨基糖苷类对肠杆菌科细菌，碳青霉烯类对铜绿假单胞菌保持良好的敏感性。