Najmi Amirreza, Karimi Fateme, Kunhikatta Vijayanarayan, Varma Muralidhar, Nair Sreedharan
Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Department of Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Open Access Maced J Med Sci. 2019 Apr 14;7(7):1119-1123. doi: 10.3889/oamjms.2019.223. eCollection 2019 Apr 15.
Incidence of bacteraemia and driving concerns about antibiotic resistance is increasing globally. Risk factors for developing antimicrobial resistance are antibiotic overuse, incorrect dosing and extended duration of administration.
This study was conducted to examine the prescription and susceptibility pattern of antibiotics in bacteraemia patients with ESBL producing and Non-ESBL-producing and their correlation with mortality.
Data were collected from medical records of the patients aged 18 years and above, diagnosed with E. coli bacteremia from January 2013 through July 2017. Institutional ethics committee approval was obtained before the study (IEC 483/2017). Cumulative sensitivity/resistance pattern of isolated microorganisms and DDD/100 bed days of prescribed antibiotics were obtained.
182 cases of bacteraemia were reviewed. 59.9% (n = 109) were male with an age range of 20-90 years. The mortality rate was 24.9% (n = 44). 55.5% (n = 101) of the isolated organisms were ESBL-producing. A high percentage of resistance to cephalosporins and fluoroquinolones were observed among the patients, and most of the identified isolates were sensitive to the aminoglycosides, carbapenems and β-lactam and β-lactamase inhibitor combinations (BLBLIs).
Frequent utilisation of the high-end antibiotics and increase in microorganism's resistance to different antibiotics can lead to a worrisome level. Local antibiotic resistance data and consumption policy are essential to prevent and slow down this process. We observed a descending resistance trend for amoxicillin-clavulanic acid combination in our setting to both the ESBL producing and non-producing.
全球范围内，菌血症的发病率以及对抗生素耐药性的担忧日益增加。产生抗菌药物耐药性的风险因素包括抗生素的过度使用、剂量不正确以及给药时间延长。
本研究旨在调查产超广谱β-内酰胺酶（ESBL）和非产ESBL菌血症患者抗生素的处方和药敏模式及其与死亡率的相关性。
收集2013年1月至2017年7月期间诊断为大肠杆菌菌血症的18岁及以上患者的病历数据。研究前获得了机构伦理委员会的批准（IEC 483/2017）。获取分离微生物的累积敏感/耐药模式以及处方抗生素的限定日剂量（DDD）/100床日。
回顾了182例菌血症病例。59.9%（n = 109）为男性，年龄范围为20 - 90岁。死亡率为24.9%（n = 44）。55.5%（n = 101）的分离菌为产ESBL菌。患者中观察到对头孢菌素和氟喹诺酮类药物的耐药率较高，大多数鉴定出的分离菌对氨基糖苷类、碳青霉烯类以及β-内酰胺类和β-内酰胺酶抑制剂联合制剂（BLBLIs）敏感。
频繁使用高端抗生素以及微生物对不同抗生素耐药性的增加可能导致令人担忧的程度。当地的抗生素耐药数据和使用政策对于预防和减缓这一过程至关重要。在我们的研究环境中，观察到阿莫西林 - 克拉维酸联合制剂对产ESBL和非产ESBL菌的耐药趋势呈下降。
