In vitro activities of nine current antibiotics against culprit bacteria in nosocomial infections in an institution in Northern Taiwan.

Chang Gung medical journal Pub Date : 2011-11-01
Sai-Cheong Lee, Shie-Shian Huang, Lai-Chu See, Ming-Han Tsai, Wen-Ben Shieh
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Abstract

Background: In recent years, there has been a rapid worldwide emergence of multidrugresistant (MDR) pathogens, especially in cases of nosocomial infections. This study assesses the in vitro activities of ampicillin/sulbactam, cefpirome, colistin, daptomycin, ertapenem, meropenem, teicoplanin, tigecycline and vancomycin against 208 aerobic bacterial pathogens that caused 197 nosocomial infections in 184 patients.

Methods: Antimicrobial susceptibility was evaluated by Etest. Broth dilution method was utilized in tigecycline susceptibility testing.

Results: Most (140/208, 67%) of the isolates were facultative Gram-negative bacilli. Of the 31 oxacillin-resistant S. aureus (ORSA) isolates, 16 were susceptible to daptomycin (16/31, 51.6%) according to the breakpoint ≤ 1 μg/ml. All 31 ORSA isolates were susceptible to teicoplanin, and vancomycin but MICs of vancomycin for all 31 ORSA isolates were ≥ 1 μg/ml. Of the 21 isolates of A. baumannii that were multiple-drug-resistant, 19 isolates (19/21, 90%) were susceptible to colistin and 18 isolates (18/21, 86%) sensitive to tigecycline. Of the 22 isolates of E. coli with extended-spectrum beta-lactamase (ESBL), the most susceptible antimicrobial agent were colistin (20/22, 91%), ertapenem (21/22, 96%), meropenem and tigecycline (22/22, 100%). Of the 11 isolates of P. aeruginosa, 6 isolates were susceptible to colistin (6/11, 55%) and all isolates were susceptible to meropenem (11/11, 100%).

Conclusion: For nosocomial infections caused by MDR-Acinetobacter baumannii, colistin and tigecycline are usually susceptible according to the result of this study. For nosocomial infections caused by ORSA, ORSA has reduced susceptibility to vancomycin, teicoplanin and daptomycin. For MDR-P. aeruginosa, further study is needed.

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台湾北部某医院常用九种抗生素对院内感染病原菌的体外活性研究。
背景:近年来,多药耐药(MDR)病原体在世界范围内迅速出现,特别是在医院感染病例中。本研究评估了氨苄西林/舒巴坦、头孢匹罗、粘菌素、达托霉素、埃他培南、美罗培南、替柯planin、替加环素和万古霉素对184例引起197例医院感染的208种需氧细菌性病原体的体外活性。方法:采用Etest法进行药敏试验。采用肉汤稀释法进行替加环素药敏试验。结果:大多数分离株(140/208,67%)为兼性革兰氏阴性杆菌。31株耐oxacillin金黄色葡萄球菌(ORSA)中,16株对达托霉素敏感(16/31,51.6%),断点≤1 μg/ml;31株ORSA均对替柯planin和万古霉素敏感,但万古霉素的mic均≥1 μg/ml。21株鲍曼不动杆菌多重耐药菌株中,19株(19/ 21,90%)对粘菌素敏感,18株(18/ 21,86%)对替加环素敏感。在22株具有广谱β -内酰胺酶(ESBL)的大肠杆菌中,最敏感的抗菌药物是粘菌素(20/ 22,91%)、厄他培南(21/ 22,96%)、美罗培南和替加环素(22/ 22,100%)。11株铜绿假单胞菌中6株对粘菌素敏感(6/11,55%),6株对美罗培南敏感(11/11,100%)。结论:本研究结果显示,对于耐多药鲍曼不动杆菌引起的医院感染,粘菌素和替加环素通常易感。对于由ORSA引起的医院感染,ORSA降低了对万古霉素、替柯planin和达托霉素的敏感性。MDR-P。铜绿菌,需要进一步研究。
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