Rodríguez Noriega E, Morfín Otero R, Esparza Ahumada S
Hospital Civil de Guadalajara, Instituto de Patología Infecciosa y Experimental Dr. Francisco Ruiz Sánchez, Universidad de Guadalajara, Jalisco, México.
Gac Med Mex. 1994 Sep-Oct;130(5):355-60.
The adequate use of antimicrobial agents depends to a great degree on the results obtained from the continuous surveillance of bacterial resistance patterns. In order to determine these resistance patterns of bacterial pathogens responsible for community and nosocomial infections a sentinel surveillance program was started in 1988. An analysis of both pediatric and adult cases revealed 4942 bacteria isolated from different sites. Most samples from community infections were obtained from out patients seen in the infections disease clinic of the Hospital Civil de Guadalajara. Of the bacteria identified, 3584 were derived from community infections. Of those 1138 were gram positive and 2446 were gram-negative. The study also included 1350 nosocomial isolated of which 509 were gram-positive bacteria and 849 were gram-negative bacteria. Overall the gram-negative bacteria were more frequently Beta-lactamase producers than the gram-positive bacteria. Resistance to beta-lactam antibiotics ranged from 64-100% in gram negative bacteria and from 81.96% in some gram positive bacteria. During the last 2 years the resistance to third generation cephalosporins, imipenem and quinolones in gram-negative bacteria has steadily increased. Only through the continuous surveillance of bacterial resistance and the implementation of programs to combat bacterial resistance will the use of valuable antibiotics be prolonged and the activity of other ones be preserved for future use.
抗菌药物的合理使用在很大程度上取决于对细菌耐药模式持续监测所获得的结果。为了确定引起社区感染和医院感染的细菌病原体的这些耐药模式，1988年启动了一项哨点监测计划。对儿科和成人病例的分析显示，从不同部位分离出4942株细菌。社区感染的大多数样本来自瓜达拉哈拉市民医院传染病诊所的门诊患者。在鉴定出的细菌中，3584株来自社区感染。其中1138株为革兰氏阳性菌，2446株为革兰氏阴性菌。该研究还包括1350株医院感染分离菌，其中509株为革兰氏阳性菌，849株为革兰氏阴性菌。总体而言，革兰氏阴性菌比革兰氏阳性菌更频繁地产生β-内酰胺酶。革兰氏阴性菌对β-内酰胺类抗生素的耐药率在64%-100%之间，某些革兰氏阳性菌的耐药率为81.96%。在过去两年中，革兰氏阴性菌对第三代头孢菌素、亚胺培南和喹诺酮类药物的耐药性稳步上升。只有通过持续监测细菌耐药性并实施抗击细菌耐药性的计划，才能延长宝贵抗生素的使用时间，并保留其他抗生素的活性以供未来使用。
