三级医院革兰氏阴性病原菌药敏特征及流行模式

P. Joshi, Z. Khan, Reema Tandle, A. Harshe, A. Bhutada, Sunita Gogavale
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引用次数: 2

摘要

背景与目的:人类大量使用抗生素导致对多种药物具有耐药性的致病菌达到顶峰。病原菌的耐药情况因地理位置的不同而不同,并不断发生变化。方法:回顾性观察分析不同临床来源的不同病原菌的药敏模式。2015年6月至2016年6月期间鉴定的临床分离株共213株纳入研究。结果:213株革兰氏阴性分离株中,尿液36.6%,呼吸道23.9%,血液11.74%,脓液10.33%,其他17.37%。检出的主要病原菌为大肠杆菌(42.25%),其次为肺炎克雷伯菌。(25.35%)和假单胞菌(15.96%),其他革兰阴性病原菌占16.4%。抗生素谱分析显示,CSE-1034对大肠杆菌、肺炎克雷伯菌、鲍曼不动杆菌和铜绿假单胞菌的敏感性分别为91.1%、77.8%、82.4%和82.3%,是最敏感的药物。在碳青霉烯类中,美罗培南和亚胺培南-西拉斯汀对大肠杆菌最有效。美罗培南对肺炎克雷伯菌效果最差(50%),亚胺培南对铜绿假单胞菌效果最差(32.35%)。与亚胺培南一样,哌拉西林-他唑巴坦对大肠杆菌的效果最高(20%),对铜绿假单胞菌的效果最低(26.47%)。结论:药敏分析表明,CSE-1034(一种新型抗生素耐药抑制剂)是抗革兰氏阴性病原菌最有效的药物。由于对哌拉西林-他唑巴坦和培南具有高耐药性,因此提倡将se -1034作为治疗细菌感染性疾病的经验药物选择,其中病原体分离物疑似对β-内酰胺和β-内酰胺酶抑制剂组合具有耐药性。
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Antibiotic Susceptibility Profile and Prevalence Pattern of Gram Negative Pathogens in Tertiary Care Hospital
Background and Objective: Large amounts of antibiotics consumed by the human population have resulted in the culmination of pathogenic bacteria resistant to multiple drugs. The resistance profile of pathogens differ from one geographical location to another and keeps on changing continuously. Methods: A retrospective observational analysis of antibiogram data was performed to characterize the susceptibility pattern of different pathogen isolates from various clinical sources. A total of 213 clinical isolates identified from the period June 2015 to June 2016 were included in the study. Results: Of the 213 Gram-negative isolates, 36.6% were from urine, 23.9% from respiratory specimens, 11.74% from blood, 10.33% from pus whereas 17.37% were from other sources. E. coli (42.25%) was most predominant pathogen isolated followed by K. pnuemoniae. (25.35%) and Pseudomonas spp. (15.96%) while other Gram-negative pathogens contributed 16.4%.  Antibiogram analysis has shown CSE-1034 as the most susceptible drug exhibiting 91.1%, 77.8%, 82.4% and 82.3% susceptibility against E. coli, K. pneumoniae, A. baumannii and P. aeruginosa. Among carbapenems, both meropenem and imipenem-Cilastin were most effective against E. coli. Meropenem was least effective against K. pneumoniae (50%) and imipenem against P. aeruginosa (32.35%). Like imipenem, Piperacillin-Tazobactam was highest effective against E. coli (20%) and lowest against P. aeruginosa (26.47%). Conclusion: Susceptibility profile indicates CSE-1034 (a novel antibiotic resistance breaker) as the most effective drug among all the classes of antibiotics against the Gram-negative pathogens. A high resistance to piperacillin-tazobactam and penems, advocates use of CSE-1034 as empiric drug of choice in the treatment of bacterial infectious diseases where the pathogen isolates are suspected resistant towards β-lactam and β-lactamase inhibitor combinations.
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