Burwen D R, Banerjee S N, Gaynes R P
Hospital Infections Program, Centers for Disease Control and Prevention, US Public Health Service, Atlanta, Georgia.
J Infect Dis. 1994 Dec;170(6):1622-5. doi: 10.1093/infdis/170.6.1622.
To examine temporal trends in ceftazidime resistance, susceptibility data reported to the National Nosocomial Infections Surveillance system during 1987-1991 were analyzed among nosocomial Enterobacter species, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Linear increases in resistance were observed for Enterobacter species and K. pneumoniae. One hospital experienced a dramatic rise from 1.0% in 1987-1989 to 40% in 1990-1991 (P < .001) in ceftazidime resistance among K. pneumoniae isolates. No increase was observed during this period for P. aeruginosa. Logistic regression analysis confirmed these trends (or the lack thereof) for Enterobacter species and P. aeruginosa; for K. pneumoniae, ceftazidime resistance was found to be increasing among isolates from teaching hospitals and intensive care units. Ceftazidime resistance is an emerging problem that has the potential for dramatic increases. Selective pressures for the development of ceftazidime resistance need to be identified and addressed.
为研究头孢他啶耐药性的时间趋势，我们对1987 - 1991年期间向国家医院感染监测系统报告的医院内肠杆菌属、肺炎克雷伯菌和铜绿假单胞菌的药敏数据进行了分析。观察到肠杆菌属和肺炎克雷伯菌的耐药性呈线性增加。一家医院肺炎克雷伯菌分离株对头孢他啶的耐药性从1987 - 1989年的1.0%急剧上升至1990 - 1991年的40%（P <.001）。在此期间，铜绿假单胞菌未观察到耐药性增加。逻辑回归分析证实了肠杆菌属和铜绿假单胞菌的这些趋势（或无趋势）；对于肺炎克雷伯菌，发现教学医院和重症监护病房分离株中的头孢他啶耐药性在增加。头孢他啶耐药性是一个新出现的问题，有可能急剧增加。需要确定并解决头孢他啶耐药性产生的选择性压力。
