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创伤病例中的耐万古霉素铜绿假单胞菌

Vancomycin-Resistant Pseudomonas Aeroginosa in the Cases of Trauma.

作者信息

Ahmadi Koorosh, Hashemian Amir Masoud, Bolvardi Ehsan, Hosseini Peyman Khadem

机构信息

Department of Emergency Medicine, Alborz University of Medical Sciences, Karaj, Iran.

Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Med Arch. 2016 Feb;70(1):57-60. doi: 10.5455/medarh.2016.70.57-60. Epub 2016 Jan 31.

Abstract

BACKGROUND

One of the main problems in the treatment of cases of P. aeruginosa especially in the orthopedic infections is the occurrence of high antibiotic resistance. The present study was carried out in order to investigate the prevalence of vancomycin-resistant P. aeruginosa in the cases of trauma in Iran.

METHODS

Two hundred and fifty swab samples were collected from the site of trauma from the patients who referred to the orthopedic wards of the Iranian health centers. Samples were cultured immediately and those that were P. aeruginosa-positive were analyzed by the disk diffusion method.

RESULTS

Of 250 swab samples collected, 43 were positive for P. aeruginosa (17.2%). The results of the culture technique were also confirmed by the PCR reaction. Of 43 P. aeruginosa isolates, 32 strains (74.41%) were resistant to vancomycin. Total prevalence of bacteria in Tehran and Mashhad hospitals were 18.46% and 15.83%, respectively. Statistically significant difference was seen for the prevalence of vancomycin-resistant P. aeruginosa between the samples collected from Tehran and Mashhad (P =0.027). More than 55 years old and less than 10 years old patients had the highest prevalence of P. aeruginosa. P. aeruginosa strains of male and more than 55 years old patients harbored the highest levels of resistance against vancomycin.

CONCLUSIONS

It is logical to primary identification of type of bacteria causing infection in the site of trauma and then using from the disk diffusion method to choose the best antimicrobial agent. Highest levels of health care should be performed for the patients less than 10 years and more than 55 years old patients.

摘要

背景

铜绿假单胞菌感染治疗中的主要问题之一,尤其是在骨科感染中,是高抗生素耐药性的出现。本研究旨在调查伊朗创伤病例中耐万古霉素铜绿假单胞菌的流行情况。

方法

从转诊至伊朗健康中心骨科病房的患者创伤部位采集250份拭子样本。样本立即进行培养,对铜绿假单胞菌阳性的样本采用纸片扩散法进行分析。

结果

在采集的250份拭子样本中,43份铜绿假单胞菌呈阳性(17.2%)。培养技术的结果也通过聚合酶链反应得到证实。在43株铜绿假单胞菌分离株中,32株(74.41%)对万古霉素耐药。德黑兰和马什哈德医院的细菌总流行率分别为18.46%和15.83%。从德黑兰和马什哈德采集的样本中,耐万古霉素铜绿假单胞菌的流行率存在统计学显著差异(P = 0.027)。55岁以上和10岁以下的患者铜绿假单胞菌的流行率最高。男性和55岁以上患者的铜绿假单胞菌菌株对万古霉素的耐药水平最高。

结论

首先鉴定创伤部位引起感染的细菌类型,然后采用纸片扩散法选择最佳抗菌药物是合理的。应对10岁以下和55岁以上的患者提供最高水平的医疗护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f26f/4779343/c2882c03e2f5/MA-70-57-g002.jpg

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