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2018 - 2023年奥洛穆茨大学医院鲍曼不动杆菌、铜绿假单胞菌和嗜麦芽窄食单胞菌的抗生素耐药性

[Antibiotic resistance of Acinetobacter baumannii, Pseudomonas aeruginosa and Stenotrophomonas maltophilia in the University Hospital Olomouc in 2018-2023].

作者信息

Fišerová Kateřina, Nováková Kristýna, Pudová Vendula, Htoutou Sedláková Miroslava, Střídová Alexandra, Urbánek Karel, Langová Kateřina, Kolář Milan

机构信息

Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University in Olomouc, Czech Republic, e-mail:

出版信息

Klin Mikrobiol Infekc Lek. 2024 Dec;30(4):100-109.

Abstract

Due to increasing bacterial resistance to a wide range of antibiotics, there is a renaissance of colistin, an old polymyxin antibiotic that was previously abandoned for its adverse effects and is now increasingly used worldwide as a reserve antibiotic, especially in intensive care patients. Given the global increase in the prevalence of multidrug-resistant bacteria, this study focuses on secondary colistin resistance in clinically significant gram-negative non-fermenting bacteria Acinetobacter baumannii, Pseudomonas aeruginosa and Stenotrophomonas maltophilia at the University Hospital Olomouc in 2018-2023. According to the results of the present study, the prevalence of colistin-resistant isolates of Acinetobacter baumannii, Pseudomonas aeruginosa and Stenotrophomonas maltophilia at the hospital was 1 %, 2 % and 45 %, respectively, with none of the species showing an increasing trend over the six-year period. Additionally, no increase in the prevalence of multidrug-resistant and extensively drug-resistant isolates was observed in colistin-resistant gram-negative non-fermenting bacteria. The highest proportion of colistin-resistant Stenotrophomonas maltophilia strains was detected in departments providing the highest level of acute intensive care, which correlates with the nature of these facilities. Colistin consumption peaked in the COVID-19 year 2021, but returned to its original level by the end of the study period. In the selected set of colistin-resistant Pseudomonas aeruginosa isolates, no plasmid-mediated mcr 1-5 genes were detected. A significant finding was the detection of clonal spread of colistin-resistant Pseudomonas aeruginosa strains between acute admission and intensive care units, em-phasizing the need for strict adherence to preventive measures in these departments.

摘要

由于细菌对多种抗生素的耐药性不断增加,多粘菌素迎来了复兴。多粘菌素是一种古老的多粘菌素类抗生素,曾因其不良反应而被弃用,如今在全球范围内越来越多地用作储备抗生素,尤其是在重症监护患者中。鉴于全球多重耐药菌的流行率上升,本研究聚焦于2018年至2023年在奥洛穆茨大学医院临床上重要的革兰氏阴性非发酵菌鲍曼不动杆菌、铜绿假单胞菌和嗜麦芽窄食单胞菌中的继发性多粘菌素耐药性。根据本研究结果,该医院鲍曼不动杆菌、铜绿假单胞菌和嗜麦芽窄食单胞菌的耐多粘菌素分离株的流行率分别为1%、2%和45%,在这六年期间,没有一个菌种呈现上升趋势。此外,在耐多粘菌素的革兰氏阴性非发酵菌中,未观察到多重耐药和广泛耐药分离株的流行率增加。在提供最高水平急性重症监护的科室中,检测到的耐多粘菌素嗜麦芽窄食单胞菌菌株比例最高,这与这些科室的性质相关。多粘菌素的消耗量在2021年新冠疫情期间达到峰值,但在研究期结束时恢复到原来的水平。在所选的一组耐多粘菌素铜绿假单胞菌分离株中,未检测到质粒介导的mcr 1-5基因。一个重要发现是在急性入院科室和重症监护病房之间检测到耐多粘菌素铜绿假单胞菌菌株的克隆传播,这强调了在这些科室严格遵守预防措施的必要性。

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