Khan Mubashir A, Faiz Aftab
Professor Mubashir Ahmad Khan, Umm Al Qura University, Laboratory Medicine, PO Box 7607 Makkah 2195, Saudi Arabia, T: 0509010825, F: 012-5270000-4227,
Ann Saudi Med. 2016 Jan-Feb;36(1):23-8. doi: 10.5144/0256-4947.2016.23.
The clinical significance of Pseudomonas aeruginosa has greatly increased due to its ability to rapidly develop resistance to major groups of antibiotics.
Our objective was to determine the pattern of antimicrobial resistance of P aeruginosa.
Prospective, descriptive study.
Four tertiary care hospitals in Makkah and Jeddah.
Clinical isolates of P aeruginosa were processed following standard microbiological procedures. A Microscan Walk Away system was used for the identification and antibiotic susceptibility of P aeruginosa isolates.
Percentage of resistance of P aeruginosa to antibiotics.
The overall drug resistance among 121 strains of P aeruginosa was low to moderate to commonly used anti-pseudomonal drugs (4.9% to 30.6%). Significantly less resistance was exhibited by piperacillin tazobactam (4.9%; P < .05) and meropenem showed significantly high resistance (30.6%; P < .05) as compared to other antibiotics, followed by ticarcillin (22.3%) and imipenem (19%), irrespective of the site of infection. The antibiotics with < 10% resistance were cefepime (8.3%), amikacin (7.4%) and piperacillin-tazobactam, which showed lowest resistance (4.9%). Although, data varied between hospitals, meropenem and ticarcillin had the highest drug resistance in all hospitals. Multidrug resistance was 10.7%.
Low-to-moderate rates of drug resistance among P aeruginosa isolates were observed. Meropenem resistance was high irrespective of the site of infection. This pattern of resistance indicates probable overuse of broad-spectrum antibiotics like carbapenems. Overuse needs to be addressed by each institution, and consideration given to regulating use of broad-spectrum antibiotics.
Results cannot be generalized as the study did not include all tertiary hospitals in these cities.
铜绿假单胞菌对主要抗生素类别迅速产生耐药性的能力使其临床意义大幅增加。
我们的目的是确定铜绿假单胞菌的抗菌耐药模式。
前瞻性描述性研究。
麦加和吉达的四家三级护理医院。
按照标准微生物学程序处理铜绿假单胞菌的临床分离株。使用Microscan Walk Away系统对铜绿假单胞菌分离株进行鉴定和抗生素敏感性检测。
铜绿假单胞菌对各抗生素的耐药百分比。
121株铜绿假单胞菌对常用抗假单胞菌药物的总体耐药率为低到中度（4.9%至30.6%）。与其他抗生素相比，哌拉西林他唑巴坦的耐药率显著较低（4.9%；P <.05），美罗培南的耐药率显著较高（30.6%；P <.05），其次是替卡西林（22.3%）和亚胺培南（19%），与感染部位无关。耐药率低于10%的抗生素有头孢吡肟（8.3%）、阿米卡星（7.4%）和哌拉西林-他唑巴坦，后者耐药率最低（4.9%）。尽管各医院数据有所不同，但美罗培南和替卡西林在所有医院的耐药率最高。多重耐药率为10.7%。
观察到铜绿假单胞菌分离株的耐药率为低到中度。无论感染部位如何，美罗培南的耐药率都很高。这种耐药模式表明碳青霉烯类等广谱抗生素可能存在过度使用的情况。各机构需要解决过度使用的问题，并考虑对广谱抗生素的使用进行规范。
由于该研究未涵盖这些城市的所有三级医院，结果不能一概而论。
