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[肿瘤中心尿液培养的细菌耐药性:长达10年的随访]

[Bacterial resistance from urine cultures at an oncological center: follow-up to 10 years].

作者信息

Velázquez-Acosta Consuelo, Cornejo-Juárez Patricia, Volkow-Fernández Patricia

出版信息

Salud Publica Mex. 2016 Aug;58(4):446-52.

Abstract

OBJECTIVE

To describe the incidence and patterns of bacterial resistance in urine samples from a tertiary care oncology hospital in Mexico, from 2004 to 2013.

MATERIALS AND METHODS

We included the strains obtained from urine cultures, describing separately multidrug-resistant (MDR) bacteria. We analyzed the susceptibility to different antibiotics.

RESULTS

51 202 urine cultures were processed during the study; 14 480 (28.3%) cultures were positive. In 11 427 samples Gram negative (79%) were isolated, 2 080 Gram positive (14.4%), and 973 yeasts (6.6%). Escherichia coli was the most frequent bacteria identified (56.1%); 24% of the community strains and 65.7% of the nosocomial were extended-spectrum beta-lactamase producers (ESBL). Klebsiella pneumoniae was isolated in 705 samples (4.8%); 115 were ESBL (16%), 13.1% from community and 29.8% from nosocomial source. Pseudomonas aeruginosa was identified in 593 cultures (4.1%): 9% from community and 51% nosocomial.

CONCLUSIONS

MDR bacteria were more frequent in nosocomial isolates. It should be a priority to intensify the rational use of antimicrobials in the community and antibiotic stewardship in the hospital.

摘要

目的

描述2004年至2013年墨西哥一家三级肿瘤专科医院尿液样本中细菌耐药的发生率及模式。

材料与方法

我们纳入了从尿培养中获得的菌株,分别描述多重耐药(MDR)细菌。我们分析了对不同抗生素的敏感性。

结果

研究期间共处理了51202份尿培养;14480份(28.3%)培养结果为阳性。在11427份样本中分离出革兰阴性菌(79%),2080份革兰阳性菌(14.4%),973份酵母菌(6.6%)。大肠埃希菌是最常见的鉴定细菌(56.1%);24%的社区菌株和65.7%的医院菌株是超广谱β-内酰胺酶产生菌(ESBL)。肺炎克雷伯菌在705份样本中分离得到(4.8%);115份是ESBL(16%),其中13.1%来自社区,29.8%来自医院来源。铜绿假单胞菌在593份培养物中鉴定得到(4.1%):9%来自社区,51%来自医院。

结论

MDR细菌在医院分离株中更为常见。加强社区抗菌药物的合理使用和医院的抗生素管理应成为优先事项。

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