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墨西哥尤卡坦州一家三级医院重症监护病房中革兰氏阴性杆菌的抗生素耐药率很高。

High Prevalence of Antimicrobial Resistance Among Gram-Negative Isolated Bacilli in Intensive Care Units at a Tertiary-Care Hospital in Yucatán Mexico.

机构信息

Medical Research Unit-Yucatán, Medical Unity of High Specialty, Specialty Hospital 1, Mexican Social Security Institute, IMSS, Merida, Yucatán 97150, Mexico.

Internal Medicine Service, Regional General Hospital 1, Delegation Yucatán, Mexican Social Security Institute, IMSS, Merida, Yucatan 97150, Mexico.

出版信息

Medicina (Kaunas). 2019 Sep 13;55(9):588. doi: 10.3390/medicina55090588.

Abstract

: Antimicrobial resistance (AMR) is increasing worldwide and imposes significant life-threatening risks to several different populations, especially to those in intensive care units (ICU). The most commonly isolated organisms in ICU comprise gram-negative bacilli (GNB), and these represent a leading cause of serious infections. This study was conducted to describe the prevalence of resistance in GNB isolated from patients in adults, pediatric, and neonatal ICU in a tertiary-care hospital in Mérida, Mexico. : A retrospective study was done on samples collected in Neonatal (NICU), Pediatric (PICU) and Adult (AICU) ICU of Unidad Médica de Alta Especialidad, Instituto Mexicano del Seguro Social in Mérida, México. The identification of isolates and antimicrobial susceptibility testing were performed using an automated system. : A total of 517 GNB strains were isolated. The most common positive culture was bronchial secretions. was the prevalent pathogen in NICU and PICU, whereas was common in the AICU. Overall, GNB exhibited a high resistance rates for Ampicillin (95.85%), Cefuroxime (84.17%), Piperacillin (82.93%), Cefotaxime (78.07%), Ceftriaxone (77.41%), Aztreonam (75.23%), Cefazolin (75.00%), and Ceftazidime (73.19%). There are significant differences in the resistance rates of GNB from different ICUs for penicillins, cephalosporins, carbapenems and fluoroquinolones drugs. (multidrug-resistant [MDR] = 91.57%, highly resistant microorganisms [HRMO] = 90.36%) and (MDR = 86.79%, HRMO = 83.02%) exhibited the highest percentage of MDR and HRMO profiles. The prevalence of the extended-spectrum beta-lactamases (ESBL)-producing isolates was 83.13% in , 78.84% in , and 66.67% in , respectively. : The high resistance rates to drugs were exhibited by our GNB isolates. Continuous surveillance and control of the use of antimicrobials are urgently needed to reduce the emergence and spreading of MDR, HRMO, and/or ESBL-producing bacilli.

摘要

: 抗菌药物耐药性(AMR)在全球范围内不断加剧,对包括重症监护病房(ICU)在内的多个不同人群构成了重大生命威胁。ICU 中最常见的分离菌为革兰氏阴性杆菌(GNB),这些细菌是严重感染的主要原因。本研究旨在描述在墨西哥梅里达一家三级保健医院的成人、儿科和新生儿 ICU 患者中分离的 GNB 的耐药流行情况。 : 对墨西哥梅里达 Unidad Médica de Alta Especialidad,Instituto Mexicano del Seguro Social 新生儿(NICU)、儿科(PICU)和成人(AICU)ICU 中采集的样本进行了回顾性研究。使用自动化系统进行分离株的鉴定和抗菌药物敏感性试验。 : 共分离出 517 株 GNB 菌株。最常见的阳性培养物是支气管分泌物。 是 NICU 和 PICU 中流行的病原体,而 是 AICU 中的常见病原体。总体而言,GNB 对氨苄西林(95.85%)、头孢呋辛(84.17%)、哌拉西林(82.93%)、头孢噻肟(78.07%)、头孢曲松(77.41%)、氨曲南(75.23%)、头孢唑林(75.00%)和头孢他啶(73.19%)的耐药率较高。不同 ICU 的 GNB 对青霉素类、头孢菌素类、碳青霉烯类和氟喹诺酮类药物的耐药率存在显著差异。 (多重耐药 [MDR] = 91.57%,高度耐药微生物 [HRMO] = 90.36%)和 (MDR = 86.79%,HRMO = 83.02%)表现出最高的 MDR 和 HRMO 谱比例。产超广谱β-内酰胺酶(ESBL)分离株的检出率分别为 : 83.13%、78.84%和 66.67%。 : 我们的 GNB 分离株对药物表现出高耐药率。迫切需要进行持续监测和控制抗菌药物的使用,以减少 MDR、HRMO 和/或产 ESBL 杆菌的出现和传播。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/511d/6780114/ad6bb04d3d5e/medicina-55-00588-g001.jpg

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