Bastopcu Ayse, Yazgi Halil, Uyanik M Hamidullah, Ayyildiz Ahmet
Atatürk University, School of Medicine, Department of Microbiology and Clinical Microbiology, Erzurum, Turkey.
Eurasian J Med. 2008 Aug;40(2):58-61.
Gram negative bacilli are among the most important microbial agents involved in both hospital- and community-acquired infections. The quinolones are preferred antibacterial agents for the treatment of both community- and hospital-acquired urinary tract infections caused by gram negative bacilli because of their strong antibacterial effects, and because they can be administered both orally and parenterally. In this study, it was aimed to determine the sensitivity of gram negative bacteria isolated from both hospital- and community-acquired infections, to quinolones.
Bacterial strains used in this study were isolated from pathologic samples of patients who were treated in different clinics or who were admitted to the polyclinics of Atatürk University Research Hospitals. Susceptibility to ciprofloxacin, levofloxacin, ofloxacin and norfloxacin was assessed for all strains included in the study via the Kirby-Bauer disk diffusion method according to CLSI criteria.
Of the 205 strains tested, 116 (56.5%) were from community-acquired infections, and 89 (43.5%) were from hospital-acquired infections. Resistance rates of community-origin strains against ciprofloxacin, ofloxacin and levofloxacin were 25%, whereas they were 26.7% against norfloxacin. Ciprofloxacin was the most effective quinolone (65.2%) against hospital-origin strains. E. coli was the most commonly isolated etiological agent from both community- and hospital-acquired infections.
In this study, resistance to quinolones was observed for gram negative bacilli isolated from both hospital- and community-acquired infections, with the exception of community-acquired Salmonella and Shigella. Thus, these drugs should not be used empirically in the treatment of infections caused by gram negative bacilli, and susceptibility test results should be considered when planning therapy.
革兰氏阴性杆菌是医院获得性感染和社区获得性感染中最重要的微生物病原体之一。喹诺酮类药物因其强大的抗菌作用，且可口服和注射给药，是治疗由革兰氏阴性杆菌引起的社区获得性和医院获得性尿路感染的首选抗菌药物。本研究旨在确定从医院获得性感染和社区获得性感染中分离出的革兰氏阴性菌对喹诺酮类药物的敏感性。
本研究中使用的细菌菌株是从在不同诊所接受治疗或入住阿塔图尔克大学研究医院门诊的患者的病理样本中分离出来的。根据CLSI标准，通过 Kirby-Bauer 纸片扩散法对研究中纳入的所有菌株进行环丙沙星、左氧氟沙星、氧氟沙星和诺氟沙星的敏感性评估。
在测试的205株菌株中，116株（56.5%）来自社区获得性感染，89株（43.5%）来自医院获得性感染。社区来源菌株对环丙沙星、氧氟沙星和左氧氟沙星的耐药率为25%，而对诺氟沙星的耐药率为26.7%。环丙沙星是对医院来源菌株最有效的喹诺酮类药物（65.2%）。大肠杆菌是社区获得性感染和医院获得性感染中最常分离出的病原体。
在本研究中，除社区获得性沙门氏菌和志贺氏菌外，从医院获得性感染和社区获得性感染中分离出的革兰氏阴性杆菌对喹诺酮类药物存在耐药性。因此，这些药物不应凭经验用于治疗由革兰氏阴性杆菌引起的感染，在制定治疗方案时应考虑药敏试验结果。
