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[墨西哥一家医院儿科人群抗菌药物耐药性的现状]

[Current status of antimicrobial resistance in pediatric population in a Mexican hospital].

作者信息

Sánchez-Álvarez Blanca Patricia, Rincón-Zuno Joaquín, Mejía-Caballero Laura, Hernández-Castellanos Claudia Alix, Diaz-Conde Marcelo, Magaña-Matienzo Ixchel, Terrazas-Peraza Alberto Antonio

机构信息

Instituto Materno Infantil del Estado de México, Hospital para el Niño, Servicio de Infectología Pediátrica. Toluca, Estado de México, México.

Secretaría de Salud, Hospital General Dr. Manuel Gea González, Servicio de Terapia Intensiva. Ciudad de México, México.

出版信息

Rev Med Inst Mex Seguro Soc. 2022 Jul 4;60(4):371-378.

Abstract

BACKGROUND

Today bacterial resistance is a global problem, it is estimated that in 2050 it could reach 10 million deaths per year. Bacterial resistance can be caused by different mechanisms, in the case of beta-lactams they include the production of flow pumps, the modification or reduction of porin production, alteration of penicillin-binding proteins and production of an enzyme capable of inactivating the antibiotic.

OBJECTIVE

To describe the main bacterial agents reported in the Hospital para el Niño de Toluca and their sensitivity pattern.

MATERIAL AND METHODS

This is an observational, descriptive, retrospective cohort study, evaluated from January 1, 2018 to December 31, 2020, in hospitalized patients under 18 years of age, with confirmed infections from blood culture specimens, urine culture, fluid cerebrospinal and secretions.

RESULTS

599 patients with positive cultures were reported. The five most frequently isolated agents were Staphylococci aureus, Escherichia coli, Klebsiella sp, Candida sp and Enterococci sp, Pseudomonas third in frequency in 2019 and fifth in 2020. The main isolated gram positive coconut was S. epidermidis with 52.3% in 2020 , while the BGN report an increase in positive ESBL organisms by 21.5% for 2020.

CONCLUSIONS

S aureus, E coli, Klebsiella, Candida, and pseudomonas remain the main causative agents of infection. The GNBs showed an increase in frequency up to 21.5%, showing high resistance in fourth grade cephalosporins, gentamicin, ciprofloxacin and meropenem.

摘要

背景

如今细菌耐药是一个全球性问题,据估计到2050年每年可能导致1000万人死亡。细菌耐药可由不同机制引起,就β-内酰胺类而言,这些机制包括产生流出泵、孔蛋白产生的改变或减少、青霉素结合蛋白的改变以及产生一种能够使抗生素失活的酶。

目的

描述托卢卡儿童医院报告的主要细菌病原体及其药敏模式。

材料与方法

这是一项观察性、描述性、回顾性队列研究,对2018年1月1日至2020年12月31日期间18岁以下住院患者进行评估,这些患者的血培养标本、尿培养、脑脊液和分泌物感染确诊。

结果

报告了599例培养阳性患者。五种最常分离出的病原体是金黄色葡萄球菌、大肠杆菌、克雷伯菌属、念珠菌属和肠球菌属,铜绿假单胞菌在2019年分离频率排第三,在2020年排第五。2020年分离出的主要革兰氏阳性菌是表皮葡萄球菌,占52.3%,而2020年超广谱β-内酰胺酶阳性菌的报告增加了21.5%。

结论

金黄色葡萄球菌、大肠杆菌、克雷伯菌属、念珠菌属和铜绿假单胞菌仍然是主要的感染病原体。革兰氏阴性菌的频率增加了21.5%,在四代头孢菌素、庆大霉素、环丙沙星和美罗培南方面显示出高耐药性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba89/10396037/b5f644f829be/04435117-60-4-371-f001.jpg

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