{"title":"铜绿假单胞菌除碳青霉烯类耐药外对氟喹诺酮类或氨基糖苷类耐药的危险因素","authors":"Kosuke Kosai, Norihito Kaku, Naoki Uno, Tomomi Saijo, Yoshitomo Morinaga, Yoshifumi Imamura, Hiroo Hasegawa, Taiga Miyazaki, Koichi Izumikawa, Hiroshi Mukae, Katsunori Yanagihara","doi":"10.2174/1874285801711010092","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Carbapenems, fluoroquinolones (FQs), and aminoglycosides (AGs) are key drugs for treating <i>Pseudomonas aeruginosa</i> infections, and accumulation of drug resistances make antibiotic therapy difficult.</p><p><strong>Methods: </strong>We evaluated 169 patients with imipenem (IPM)-resistant <i>P. aeruginosa</i> and compared patient background and microbiological characteristics between groups with or without FQ resistance. Similar analyses were performed for AG.</p><p><strong>Results: </strong>Of the 169 IPM-resistant strains, 39.1% showed resistance to FQs and 7.1% to AGs. The frequency of exposure to FQs within 90 days previously was higher in the group with FQ resistance (45.5%) than in the group without FQ resistance (13.6%). Similarly, 33.3% of patients in the group with AG resistance had been previously administered AGs, higher than the 7.6% of patients without AG resistance. Frequencies of metallo-β-lactamase (MBL) production were higher in the group with FQ or AG resistance (16.7% or 33.3%) than in the group without FQ or AG resistance (2.9% or 6.4%). Multivariate analyses showed exposures to FQs or AGs were related to the respective resistances. MBL production was a common factor for resistance to FQs or AGs, in addition to IPM-resistant <i>P. aeruginosa</i>.</p><p><strong>Conclusion: </strong>As well as promoting appropriate use of antibiotics, MBL production should be detected as a target of intervention for infection control.</p>","PeriodicalId":38953,"journal":{"name":"Open Microbiology Journal","volume":"11 ","pages":"92-97"},"PeriodicalIF":0.0000,"publicationDate":"2017-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5481610/pdf/","citationCount":"0","resultStr":"{\"title\":\"Risk Factors for Acquisition of Fluoroquinolone or Aminoglycoside Resistance in Addition to Carbapenem Resistance in <i>Pseudomonas Aeruginosa</i>.\",\"authors\":\"Kosuke Kosai, Norihito Kaku, Naoki Uno, Tomomi Saijo, Yoshitomo Morinaga, Yoshifumi Imamura, Hiroo Hasegawa, Taiga Miyazaki, Koichi Izumikawa, Hiroshi Mukae, Katsunori Yanagihara\",\"doi\":\"10.2174/1874285801711010092\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Carbapenems, fluoroquinolones (FQs), and aminoglycosides (AGs) are key drugs for treating <i>Pseudomonas aeruginosa</i> infections, and accumulation of drug resistances make antibiotic therapy difficult.</p><p><strong>Methods: </strong>We evaluated 169 patients with imipenem (IPM)-resistant <i>P. aeruginosa</i> and compared patient background and microbiological characteristics between groups with or without FQ resistance. Similar analyses were performed for AG.</p><p><strong>Results: </strong>Of the 169 IPM-resistant strains, 39.1% showed resistance to FQs and 7.1% to AGs. The frequency of exposure to FQs within 90 days previously was higher in the group with FQ resistance (45.5%) than in the group without FQ resistance (13.6%). Similarly, 33.3% of patients in the group with AG resistance had been previously administered AGs, higher than the 7.6% of patients without AG resistance. Frequencies of metallo-β-lactamase (MBL) production were higher in the group with FQ or AG resistance (16.7% or 33.3%) than in the group without FQ or AG resistance (2.9% or 6.4%). Multivariate analyses showed exposures to FQs or AGs were related to the respective resistances. MBL production was a common factor for resistance to FQs or AGs, in addition to IPM-resistant <i>P. aeruginosa</i>.</p><p><strong>Conclusion: </strong>As well as promoting appropriate use of antibiotics, MBL production should be detected as a target of intervention for infection control.</p>\",\"PeriodicalId\":38953,\"journal\":{\"name\":\"Open Microbiology Journal\",\"volume\":\"11 \",\"pages\":\"92-97\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2017-05-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5481610/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Open Microbiology Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2174/1874285801711010092\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2017/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"Immunology and Microbiology\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open Microbiology Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2174/1874285801711010092","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2017/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"Immunology and Microbiology","Score":null,"Total":0}
Risk Factors for Acquisition of Fluoroquinolone or Aminoglycoside Resistance in Addition to Carbapenem Resistance in Pseudomonas Aeruginosa.
Background: Carbapenems, fluoroquinolones (FQs), and aminoglycosides (AGs) are key drugs for treating Pseudomonas aeruginosa infections, and accumulation of drug resistances make antibiotic therapy difficult.
Methods: We evaluated 169 patients with imipenem (IPM)-resistant P. aeruginosa and compared patient background and microbiological characteristics between groups with or without FQ resistance. Similar analyses were performed for AG.
Results: Of the 169 IPM-resistant strains, 39.1% showed resistance to FQs and 7.1% to AGs. The frequency of exposure to FQs within 90 days previously was higher in the group with FQ resistance (45.5%) than in the group without FQ resistance (13.6%). Similarly, 33.3% of patients in the group with AG resistance had been previously administered AGs, higher than the 7.6% of patients without AG resistance. Frequencies of metallo-β-lactamase (MBL) production were higher in the group with FQ or AG resistance (16.7% or 33.3%) than in the group without FQ or AG resistance (2.9% or 6.4%). Multivariate analyses showed exposures to FQs or AGs were related to the respective resistances. MBL production was a common factor for resistance to FQs or AGs, in addition to IPM-resistant P. aeruginosa.
Conclusion: As well as promoting appropriate use of antibiotics, MBL production should be detected as a target of intervention for infection control.
期刊介绍:
The Open Microbiology Journal is a peer-reviewed open access journal which publishes research articles, reviews/mini-reviews, case studies, guest edited thematic issues and short communications/letters covering theoretical and practical aspects of Microbial systematics, evolutionary microbiology, immunology, virology, parasitology , bacteriology, mycology, phycology, protozoology, microbial ecology, molecular biology, microbial physiology, biochemistry, microbial pathogenesis, host-microbe interaction, systems microbiology, synthetic microbiology, bioinformatics. The Open Microbiology Journal , a peer-reviewed journal, is an important and reliable source of current information on developments in the field. The emphasis will be on publishing quality papers rapidly and freely available to researchers worldwide.