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韩国某单一医院近 10 年不同年龄组的抗菌药物敏感性趋势。

Antimicrobial Susceptibility Trends of by Age Groups Over Recent 10 Years in a Single Hospital in South Korea.

机构信息

Department of Internal Medicine, Jeju National University Hospital, Jeju, Korea.

Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.

出版信息

Yonsei Med J. 2021 Apr;62(4):306-314. doi: 10.3349/ymj.2021.62.4.306.

Abstract

PURPOSE

() causes respiratory tract infections. Its non-vaccine serotypes and multidrug-resistant pneumococcal diseases have increased during the post-pneumococcal vaccination era. Therefore, it is important to understand the regional and age-related antimicrobial susceptibility of to select appropriate empirical antimicrobials.

MATERIALS AND METHODS

We retrospectively studied trends in the antimicrobial resistance of to commonly prescribed antibiotics in patient groups of various ages at a single teaching hospital in Jeju Island from 2009 to 2018.

RESULTS

In total, 1460 isolates were obtained during the study period. The overall antimicrobial resistance rates of to penicillin, erythromycin, ceftriaxone, levofloxacin, and vancomycin were 16.2%, 84.7%, 25.9%, 3.3%, and 0.0%, respectively, and the MDR rate was 6.7%. Erythromycin and ceftriaxone resistance rates increased by years; however, they were significantly reduced in adult groups. Levofloxacin resistance and MDR rates were also higher in adult groups. Overall, the MDR rate significantly increased during the recent 10 years, as well as in patients with a history of hospitalization within 90 days [odds ratio (OR)=3.58, 95% confidence interval (CI)=1.91-6.71] and sinusitis (OR=4.98, 95% CI=2.07-11.96).

CONCLUSION

Erythromycin and ceftriaxone resistance rates and the MDR rate of significantly increased during the recent 10 years; the trends in individual antimicrobial resistance rates significantly differed between the age groups. This study indicates the need for caution when using ceftriaxone as an empirical antimicrobial against pneumococcal infections.

摘要

目的

()引起呼吸道感染。在肺炎球菌疫苗接种后时代,其非疫苗血清型和多药耐药性肺炎球菌病有所增加。因此,了解地区和年龄相关的对选择合适的经验性抗菌药物具有重要意义。

材料和方法

我们在济州岛的一家教学医院对不同年龄段的患者群体进行了回顾性研究,研究了 2009 年至 2018 年期间常见抗生素对的抗生素耐药趋势。

结果

在研究期间共获得了 1460 株分离株。对青霉素、红霉素、头孢曲松、左氧氟沙星和万古霉素的总体抗生素耐药率分别为 16.2%、84.7%、25.9%、3.3%和 0.0%,MDR 率为 6.7%。红霉素和头孢曲松的耐药率逐年上升;然而,在成年组中显著降低。左氧氟沙星耐药率和 MDR 率在成年组中也较高。总体而言,最近 10 年 MDR 率以及在 90 天内有住院史的患者(比值比[OR]=3.58,95%置信区间[CI]=1.91-6.71)和鼻窦炎(OR=4.98,95%CI=2.07-11.96)的 MDR 率显著增加。

结论

最近 10 年,肺炎链球菌对红霉素和头孢曲松的耐药率和 MDR 率显著增加;各年龄组之间个体抗生素耐药率的趋势明显不同。本研究表明,在使用头孢曲松作为治疗肺炎链球菌感染的经验性抗菌药物时应谨慎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da3e/8007430/94be85a4f918/ymj-62-306-g001.jpg

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