Inglis T J, Kumarasinghe G, Chow C, Liew H Y
Department of Microbiology, National University of Singapore.
Singapore Med J. 1994 Dec;35(6):602-4.
A common pattern of multiple antibiotic resistance has been noted in bacteria isolated from Singaporean patients. The resistance pattern includes: ampicillin, cefuroxime, ceftazidime and other third generation cephalosporins, aztreonam, gentamicin and other aminoglycosides. The bacterial species implicated are Klebsiellas and other members of the Enterobacteriaceae. Preliminary laboratory investigation with a disk-diffusion augmentation test suggests the presence of extended-spectrum beta-lactamases. A retrospective study of laboratory blood culture records shows a rising incidence of resistance in Klebsiella spp. since 1985. Antimicrobial susceptibility results suggest a high degree of co-transfer of aminoglycoside resistance. The high frequency of this type of multiple antibiotic resistance should result in greater caution in the selection of presumptive antibiotic therapy for septicaemia, in order to avoid treatment failure and further selection of resistant strains.
在从新加坡患者身上分离出的细菌中，已发现一种常见的多重抗生素耐药模式。耐药模式包括：氨苄青霉素、头孢呋辛、头孢他啶及其他第三代头孢菌素、氨曲南、庆大霉素及其他氨基糖苷类抗生素。涉及的细菌种类为克雷伯菌属及肠杆菌科的其他成员。采用纸片扩散增强试验进行的初步实验室调查表明存在超广谱β-内酰胺酶。一项对实验室血培养记录的回顾性研究显示，自1985年以来，克雷伯菌属的耐药发生率呈上升趋势。抗菌药敏结果表明氨基糖苷类耐药存在高度的共同转移。这种类型的多重抗生素耐药的高频率应导致在选择败血症的经验性抗生素治疗时更加谨慎，以避免治疗失败和进一步选择耐药菌株。
