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伊朗癌症住院患者中多重耐药肠杆菌科细菌的抗菌药物耐药模式及谱

Antimicrobial Resistance Pattern and Spectrum of Multiple-drug-resistant Enterobacteriaceae in Iranian Hospitalized Patients with Cancer.

作者信息

Fazeli Hossein, Moghim Sharareh, Zare Donya

机构信息

Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Adv Biomed Res. 2018 Apr 24;7:69. doi: 10.4103/abr.abr_164_17. eCollection 2018.

Abstract

BACKGROUND

Nosocomial infections are one of the most leading causes of morbidity and mortality in patients with cancer. The emergence of multiple-drug-resistant (MDR) strains of Gram-negative bacteria causing nosocomial infection has become a serious concern in cancer patients. Therefore, the present study aimed to determine the spectrum and antibiotic resistance pattern of Gram-negative bacteria related nosocomial infections among Iranian cancer patients.

MATERIALS AND METHODS

This descriptive cross-sectional study was conducted during the 6 months from December 2015 to May 2016 in two tertiary care centers located in Isfahan and Arak Province. Gram-negative bacteria obtained from different clinical specimens from hospitalized patients with cancer and were identified using standard microbiological methods. Antibiotic susceptibility pattern was determined by the disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) recommendation.

RESULTS

Of totally 259 culture positive cases, showed the highest isolation rate (60.6%) followed by (26.6%) and spp (11.2%). The rate of MDR isolates were 91.5% (237/259). Overall, the most frequent source of bacterial isolation was urinary tract infection (65.6%) followed by skin and soft-tissue infection (23.6%). The antibiotic susceptibility results showed meropenem (MEN) and ceftazidime as the most effective antibiotics for , , and spp. isolates. Moreover, MEN was the most effective antibiotic against MDR isolates.

CONCLUSION

The study findings showed a significant distribution of MDR Gram-negative bacteria which may increase the burden of healthcare-associated infections in cancer patients. Although, carbapenem can be considered as effective agents toward MDR strains for empirical antibiotic therapy in our region.

摘要

背景

医院感染是癌症患者发病和死亡的主要原因之一。导致医院感染的革兰氏阴性菌多重耐药(MDR)菌株的出现已成为癌症患者的严重问题。因此,本研究旨在确定伊朗癌症患者中与医院感染相关的革兰氏阴性菌的种类及抗生素耐药模式。

材料与方法

本描述性横断面研究于2015年12月至2016年5月的6个月期间在位于伊斯法罕和阿拉克省的两个三级医疗中心进行。从癌症住院患者的不同临床标本中获取革兰氏阴性菌,并使用标准微生物学方法进行鉴定。根据临床和实验室标准研究所(CLSI)的建议,采用纸片扩散法确定抗生素敏感性模式。

结果

在总共259例培养阳性病例中,[具体细菌名称1]的分离率最高(60.6%),其次是[具体细菌名称2](26.6%)和[具体细菌名称3]属(11.2%)。多重耐药菌株的比例为91.5%(237/259)。总体而言,最常见的细菌分离来源是尿路感染(65.6%),其次是皮肤和软组织感染(23.6%)。抗生素敏感性结果显示,美罗培南(MEN)和头孢他啶是对[具体细菌名称1]、[具体细菌名称2]和[具体细菌名称3]属分离株最有效的抗生素。此外,美罗培南是对抗多重耐药分离株最有效的抗生素。

结论

研究结果表明多重耐药革兰氏阴性菌分布显著,这可能会增加癌症患者医疗相关感染的负担。尽管如此,碳青霉烯类药物可被视为在我们地区针对多重耐药菌株进行经验性抗生素治疗的有效药物。

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