乌克兰外科医院肠杆菌耐药医院菌株:多中心研究结果

A. Salmanov, O. M. Verner
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引用次数: 2

摘要

目标。目的测定乌克兰不同医院外科住院患者分离的肠杆菌抗菌药物的活性。材料和方法。从乌克兰17个地区24家外科医院手术部位感染患者中共分离出3991株肠杆菌。采用全自动微生物分析仪对肠杆菌进行鉴定和药敏试验。部分药敏试验采用Kirby - Bauer抗生素试验。解释性标准是由临床和实验室标准协会(CLSI)提出的。结果。最有效的抗菌剂是亚胺培南、美罗培南、头孢克肟和阿米卡辛。耐药率最高的是青霉素(46.2%)、氨苄西林/舒巴坦(42.9%)、庆大霉素(40.4%)、头孢他啶(39.4%)、氨苄西林(38.2%)和头孢呋辛(36.3%)。结论。(1)患者医疗机构中肠杆菌医院内菌株的耐药是一个严重的治疗和流行病学问题,是有待研究的课题。亚胺培南、美罗培南、头孢克肟和阿米卡敏对医院内肠杆菌菌株最活跃。(2)考虑到不同地区肠杆菌医院内菌株的最新变化和耐药水平,需要在每个患者医疗机构持续监测对抗菌素的耐药性。此外,应根据收到的当地数据详细编制医院抗生素记录单。(3)根据当地抗菌药物耐药数据,确定各住院医院外科的抗菌药物使用政策。(4)在地方、区域和国家层面建立抗菌药物耐药性流行病学监测体系。
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Antimicrobial Resistance Nosocomial Strains of Enterobacter spp. in Ukrainian surgical Hospitals: results of multicenter study
Objective. To determine activity of antimicrobials against Enterobacter spp. isolated from patients hospitalized to surgical departments in different Ukrainian hospitals. Materials and methods. A total of 3991 Enterobacter spp. isolated from patients with surgical site infections in 24 surgical hospitals in 17 Ukrainian regions. The identification and antimicrobial susceptibility of Enterobacter spp. were determined, using automated microbiology analyzer. Some antimicrobial susceptibility test used Kirby - Bauer antibiotic testing. Interpretative criteria were those suggested by the Clinical and Laboratory Standards Institute (CLSI). Results. The most potent antimicrobials were imipenem, meropenem, cefixime and amikacinum. The high rates of resistance were found to penicillin (46,2%), ampicillin/sulbactam (42,9%), gentamicin (40,4%), ceftazidime (39,4%), ampicillin (38,2%), and cefuroxime (36,3%). Conclusions. (1) Resistance of nosocomial strains of Enterobacter spp. at in patient medical institutions, that are subject to research, is a serious therapeutic and epidemiologic issue. Imipenem, meropenem, cefixime and amikacinum have been the most active to nosocomial strains of Enterobacter spp. (2) Taking into account resent changes and resistance levels of nosocomial strains of Enterobacter spp., which take place in various regions, constant monitoring over resistance to antimicrobials at every in patient medical institution is required. Also, hospital record sheets of antibiotics should be elaborated based upon the local data received. (3) Antibiotics utilization policy in each surgical in patient institution should be determined based in accordance with the local data on resistance to antimicrobials. (4) System of epidemiologic surveillance over antimicrobial resistance should be established on the local, regional, and national level.
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