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[阿根廷布宜诺斯艾利斯一家医院社区获得性腹腔内感染革兰氏阴性杆菌的药敏情况]

[Antimicrobial susceptibility of Gram-negative bacilli of community acquired intra-abdominal infections in a hospital at Buenos Aires, Argentina].

作者信息

Morganti L, Córdova E, Cassini E, Gómez N, López Moral L, Badía M, Rodríguez C

机构信息

Laura Morganti, Hospital General de Agudos Cosme Argerich. Pi y Margall 750, Ciudad Autónoma de Buenos Aires. Argentina.

出版信息

Rev Esp Quimioter. 2016 Aug;29(4):202-5. Epub 2016 Jun 17.

Abstract

OBJECTIVE

Community acquired complicated intra-abdominal infections (cIAI) are a common condition. Few data are available about the level of antimicrobial resistance of Gram-negative bacteria isolated from community acquired cIAIs in Argentina.

METHODS

Retrospective-prospective observational study (March 2010 to February 2012). Gram-negative bacteria antimicrobial susceptibility of isolates from community acquired cIAIs were evaluated.

RESULTS

During this period, a total of 85 patients were included and 138 pathogens were collected. Male sex: 58%. Median age: 33. Monomicrobial cultures were obtained in 49% of the cases. Ninety (65%) corresponded to Gram-negative organisms, and 48 (38%) to Gram-positive cocci. Gram-negative organisms most frequently observed were: Escherichia coli 76%, Klebsiella pneumoniae 8%, Pseudomonas aeruginosa 7% and Enterobacter spp. 6%. E. coli and K. pneumoniae showed a high percentage of strains resistance to ciprofloxacin of 37% and 29%, respectively. Similarly, resistance to ampicillin/sulbactam was observed in a 16% of the E. coli isolates. The prevalence of multiresistant Gram-negative organisms was 38%.

CONCLUSIONS

A high level of resistance to antimicrobials was observed in community acquired cIAIs, mainly to ciprofloxacin and ampicillin/sulbactam two of the most used antimicrobial for empirically treatment of cIAIs in our country. In addition a significant proportion of multiresistant Gram-negative organisms were identified.

摘要

目的

社区获得性复杂性腹腔内感染(cIAI)是一种常见病症。关于从阿根廷社区获得性cIAI中分离出的革兰氏阴性菌的抗菌药物耐药水平,可用数据很少。

方法

回顾性-前瞻性观察性研究(2010年3月至2012年2月)。评估了社区获得性cIAI分离株的革兰氏阴性菌抗菌药物敏感性。

结果

在此期间,共纳入85例患者,收集到138种病原体。男性占58%。中位年龄为33岁。49%的病例获得了单一微生物培养物。90株(65%)为革兰氏阴性菌,48株(38%)为革兰氏阳性球菌。最常观察到的革兰氏阴性菌为:大肠杆菌76%、肺炎克雷伯菌8%、铜绿假单胞菌7%和肠杆菌属6%。大肠杆菌和肺炎克雷伯菌对环丙沙星的耐药菌株比例分别高达37%和29%。同样,16%的大肠杆菌分离株对氨苄西林/舒巴坦耐药。多重耐药革兰氏阴性菌的患病率为38%。

结论

在社区获得性cIAI中观察到对抗菌药物的高耐药水平,主要是对环丙沙星和氨苄西林/舒巴坦这两种我国用于cIAI经验性治疗最常用的抗菌药物。此外,还鉴定出相当比例的多重耐药革兰氏阴性菌。

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