从伊朗德黑兰儿童医学中心败血症患者中分离出的革兰氏阴性菌的抗菌药敏模式。
Antimicrobial susceptibility patterns of the gram-negative bacteria isolated from septicemia in Children's Medical Center, Tehran, Iran.
作者信息
Rabirad N, Mohammadpoor M, Lari A Rastegar, Shojaie A, Bayat R, Alebouyeh M
出版信息
J Prev Med Hyg. 2014 Mar;55(1):23-6.
INTRODUCTION
The choice of antimicrobial treatment for septicemia is often empirical and based on the knowledge of local anti-microbial activity patterns of the most common bacteria causing such bloodstream infections. The current study aimed to study the prevalence of bacterial pathogens causing septicemia and their antimicrobial resistant profiles in hospital admitted patients.
METHODS
This cross sectional study done at Children's Medical Center, Tehran, Iran. We examined 168 bacterial strains isolated from 186 clinically diagnosed septicemia cases refereed at Children's Medical Center, Tehran, Iran. Over a period of twelve months from July 2010 to 2011 July. 11446 blood samples from patients of clinically suggestive septicemia were evaluated.
RESULTS
Bacterial strains were isolated from 910 (7.95%) of blood cultures. Gram-negative bacteria identified were Pseudomonas species (20.5%), Pseudomonas aeruginosa (1.86%), Salmonella spp (1.09%), Acinetobacter naumannii (8.13%), Escherichia coli (4.06%), Klebsiella spp (5.16%). Gram-negative pathogens were more than gram positive in bloodstream infections. Antimicrobial susceptibility testing was done according to Clinical and Laboratory Standards Institute (CLSI, USA) guidelines against: amikacin ampicillin, amoxicillin, amoxiclav, cefuroxime, cefotaxime, ceftazidime, cefoperazone tetracycline, chloramphenicol, ciprofloxacin, gentamicin. Resistanc to different antibiotics in the most important isolated bacteria were: 32.1%, 10.8%, 87.8%, 96%, 39.1%, 35.2, 49.4%, 69%, 80.02%, 22%, 59%, 30.1% respectively, for Pseudomonas spp, 32%, 3.7%, 84.2%, 83.2%, 80.1%, 75.4%, 44.8%, 45.2%, 33.3%, 19%, 34.1, 11.5% respectively for Acinetobacter species.
DISCUSSION
Resistant to majority of the antimicrobial agents for several pathogens implicated in bloodstream infections, particularly in Gram-negative bacteria, can make complication in treatment of infection cause by them.
引言
败血症抗菌治疗的选择通常是经验性的，基于对引起此类血流感染的最常见细菌的当地抗菌活性模式的了解。本研究旨在调查医院收治患者中引起败血症的细菌病原体的流行情况及其抗菌耐药谱。
方法
本横断面研究在伊朗德黑兰儿童医学中心进行。我们检查了从伊朗德黑兰儿童医学中心转诊的186例临床诊断为败血症的病例中分离出的168株细菌菌株。在2010年7月至2011年7月的十二个月期间，对11446份临床疑似败血症患者的血样进行了评估。
结果
从910份（7.95%）血培养中分离出细菌菌株。鉴定出的革兰氏阴性菌有假单胞菌属（20.5%）、铜绿假单胞菌（1.86%）、沙门氏菌属（1.09%）、鲍曼不动杆菌（8.13%）、大肠杆菌（4.06%）、克雷伯菌属（5.16%）。血流感染中革兰氏阴性病原体多于革兰氏阳性病原体。根据美国临床和实验室标准协会（CLSI）指南对以下抗菌药物进行药敏试验：阿米卡星、氨苄西林、阿莫西林、阿莫西林克拉维酸、头孢呋辛、头孢噻肟、头孢他啶、头孢哌酮、四环素、氯霉素、环丙沙星、庆大霉素。最重要的分离细菌对不同抗生素的耐药率分别为：假单胞菌属对上述抗生素的耐药率分别为32.1%、10.8%、87.8%、96%、39.1%、35.2%、49.4%、69%、80.02%、22%、59%、30.1%；不动杆菌属对上述抗生素的耐药率分别为32%、3.7%、84.2%、83.2%、80.1%、75.4%、44.8%、45.2%、33.3%、19%、34.1%、11.5%。
讨论
血流感染中涉及的几种病原体，尤其是革兰氏阴性菌，对大多数抗菌药物耐药，这可能会导致由它们引起的感染治疗出现并发症。
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