Diwane Dnyaneshwar, Rajhans Prasad A, Jog Sameer A, Dalvi Mousami
Department of Critical Care Medicine, Deenanath Mangeshkar Hospital & Research Center, Pune, Maharashtra, India.
Department of Microbiology, Deenanath Mangeshkar Hospital & Research Center, Pune, Maharashtra, India.
Indian J Crit Care Med. 2024 Mar;28(3):286-289. doi: 10.5005/jp-journals-10071-24658.
Intensive care units have become hotspots for antimicrobial resistance, particularly concerning colistin resistance, posing a threat of untreatable infections.
This study aims to analyze the epidemiological and clinical aspects of patients carrying colistin-resistant organisms. It focuses on identifying risk factors, the microbiological profile, susceptibility patterns, and treatment outcomes.
Isolates with colistin MIC >2 µg/mL, identified via BD PHOENIX, were subjected to colistin broth disc elution testing (as per CLSI guidelines) in our Microbiology Department between January and December 2022.
Among the 30 patients, colistin-resistant gram-negative isolates were found predominantly in blood cultures (50%), followed by ET/TT cultures (23.3%), urine cultures (10%), and other sites (16.7%). was the most common organism (80%), showing the highest sensitivity to Ceftazidime-avibactam + Aztreonam (CAZ-AVI + ATM) (76.7%). Of these patients, 66.7% recovered and were discharged, while 33.3% succumbed during hospitalization despite treatment.
The study underscores a notable presence of colistin-resistant gram-negative isolates, predominantly in blood cultures, with being predominant. The combination of CAZ-AVI + ATM exhibited the highest sensitivity. However, the mortality rate of 33.3% despite sensitive antibiotic treatment highlights the urgency for ongoing vigilance and research to combat colistin-resistant infections and improve patient outcomes.
Diwane D, Rajhans PA, Jog SA, Dalvi M. Study of Colistin Resistant Gram Negative Organism in Hospitalized Patients: A Retrospective Study. Indian J Crit Care Med 2024;28(3):286-289.
重症监护病房已成为抗菌药物耐药性的热点地区，尤其是对黏菌素耐药而言，这对无法治疗的感染构成了威胁。
本研究旨在分析携带黏菌素耐药菌的患者的流行病学和临床特征。重点是确定危险因素、微生物谱、药敏模式和治疗结果。
2022年1月至12月期间，在我们微生物科，通过BD PHOENIX鉴定出黏菌素最低抑菌浓度（MIC）>2μg/mL的分离株，进行黏菌素肉汤纸片洗脱试验（按照美国临床和实验室标准协会指南）。
在30例患者中，黏菌素耐药革兰阴性菌分离株主要在血培养中发现（50%），其次是气管/气管切开处培养（23.3%）、尿培养（10%）和其他部位（16.7%）。肺炎克雷伯菌是最常见的病原体（80%），对头孢他啶-阿维巴坦+氨曲南（CAZ-AVI+ATM）显示出最高敏感性（76.7%）。在这些患者中，66.7%康复出院，而33.3%尽管接受了治疗，但在住院期间死亡。
该研究强调黏菌素耐药革兰阴性菌分离株显著存在，主要在血培养中，肺炎克雷伯菌占主导。CAZ-AVI+ATM组合表现出最高敏感性。然而，尽管使用了敏感抗生素治疗，死亡率仍为33.3%，这凸显了持续保持警惕和开展研究以对抗黏菌素耐药感染并改善患者结局的紧迫性。
迪瓦内D，拉詹斯PA，乔格SA，达尔维M。住院患者中耐黏菌素革兰阴性菌的研究：一项回顾性研究。《印度重症监护医学杂志》2024；28（3）：286 - 289。
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