Rajkumari Nonika, John Nibu Varghese, Mathur Purva, Misra Mahesh Chandra
Department of Laboratory Medicine, Microbiology Division, All India Institute of Medical Sciences, New Delhi, India.
Hospital Infection Control Unit, All India Institute of Medical Sciences, New Delhi, India.
J Glob Infect Dis. 2014 Oct;6(4):182-5. doi: 10.4103/0974-777X.145250.
Drug resistance to Pseudomonas sp. has spread to such a level irrespective of the type of patients, that its pattern of distribution and antibiotic resistance needs to be studied in detail, especially in trauma patients and hence the study. A 6 year study was carried out among trauma patients to see the trend and type of resistance prevalent in the apex hospital for trauma care in India among nonduplicate isolates where multidrug-resistance (MDR), cross-resistance and pan-drug resistance in Pseudomonas sp. were analyzed. Of the total 2,269 isolates obtained, the species, which was maximally isolated was Pseudomonas aeruginosa (2,224, 98%). The highest level of resistance was seen in tetracycline (2,166, 95.5%, P < 0.001) and chloramphenicol (2,160, 95.2%, P < 0.001) and least in meropenem (1,739, 76.7%, P < 0.003). Of the total, 1,692 (74.6%) isolates were MDR in which P. aeruginosa (75%) were maximum. MDR Pseudomonas is slowing increasing since the beginning of the study period. Of 1,797 imipenem-resistant P. aeruginosa isolated during the study period, 1,763 (98%) showed resistance to ciprofloxacin or levofloxacin, suggesting that cross-resistance may have developed for imipenem due to prior use of fluoroquinolones. Antibiotic resistance in Pseudomonas sp. is fast becoming a problem in trauma patients, especially in those who requires prolong hospital stay, which calls for proper antimicrobial stewardship.
对假单胞菌属的耐药性已蔓延到无论患者类型的何种程度，以至于其分布模式和抗生素耐药性需要进行详细研究，尤其是在创伤患者中，因此开展了这项研究。在印度一家创伤护理顶级医院对创伤患者进行了为期6年的研究，以观察非重复分离株中假单胞菌属的耐药趋势和类型，分析其中的多重耐药（MDR）、交叉耐药和泛耐药情况。在总共获得的2269株分离株中，分离最多的菌种是铜绿假单胞菌（2224株，98%）。四环素（2166株，95.5%，P<0.001）和氯霉素（2160株，95.2%，P<0.001）的耐药水平最高，美罗培南的耐药水平最低（1739株，76.7%，P<0.003）。总共1692株（74.6%）分离株为多重耐药，其中铜绿假单胞菌（75%）最多。自研究开始以来，多重耐药假单胞菌呈缓慢增加趋势。在研究期间分离出的1797株对亚胺培南耐药的铜绿假单胞菌中，1763株（98%）对环丙沙星或左氧氟沙星耐药，这表明由于先前使用氟喹诺酮类药物，可能已对亚胺培南产生了交叉耐药。假单胞菌属的抗生素耐药性在创伤患者中正迅速成为一个问题，尤其是在那些需要延长住院时间的患者中，这需要进行适当的抗菌管理。
