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1.
Pseudomonas aeruginosa is an important life-threatening nosocomial pathogen and plays a prominent role in serious infections in burned patients. The current study was undertaken to characterize P. aeruginosa strains isolated from burned patients in Tehran, Iran. The study was conducted in a major burn center in Tehran, Iran in 2007. A total of seventy specimens obtained from different clinical origin with positive culture results for P. aeruginosa were included in the study. Antimicrobial susceptibility test was performed according to the standard CLSI guideline. The relationship between the strains was also determined using antimicrobial drug resistance pattern analysis and plasmid profiling. All strains were multi drug resistant. The percentage of resistance to tested antibiotics was: imipenem 97.5%, amikacin 90%, piperacillin 87.5%, ceftizoxime 72.7%, gentamicin 67.5%, ciprofloxacin 65%, ceftriaxone 60%, and ceftazidime 57.5%. Thirteen resistant phenotypes were recognized, R3 (TET, IPM, AMK, CIP, PIP, GM, CAZ, CRO, CT) was the predominant resistance pattern seen in 27.5% of isolates. Results obtained from E-test showed that 100% of P. aeruginosa strains were resistant to cefoxitin, 97% to cefotetan, 93% to ticarcillin, 89% to ticarcillin/clav, 76% to gentamicin and imipenem, 63% to piperacillin, 49% to tetracycline, and 20% to meropenem. Nine different plasmid profiles were observed among the strains. The current study showed an increase rate of resistance for some antibiotics tested among P. aeruginosa strains isolated from burned patients in Tehran. A combination of antibiotic susceptibility testing and profile plasmid analysis, which are relatively cheap and available methods, showed to be useful to characterize the clinical strains of P. aeruginosa isolated from burned patients in Iran.  相似文献   

2.
OBJECTIVES: Identification of imipenem resistance among selected gram-negative bacilli, especially Pseudomonas aeruginosa and Enterobacter species. METHODS: We analyzed 1986-1990 National Nosocomial Infection Surveillance (NNIS) data from 3,316 P aeruginosa isolates and 1,825 Enterobacter species isolates for which susceptibility results to imipenem were reported. RESULTS: For P aeruginosa, 11.1% of the isolates were resistant to imipenem; 16.1% were either intermediate-susceptible or resistant to the drug. A logistic regression model found that resistance was more common among P aeruginosa isolated from the respiratory tract, patients in intensive care units, and in teaching hospitals. Additionally, resistance to imipenem increased by 25% in teaching hospitals from 1986-1988 to 1989-1990. For Enterobacter species, 1.3% of the isolates were resistant to imipenem; 2.3% were either intermediate-susceptible or resistant to the drug. However, imipenem resistance for these isolates did not differ between the two periods and was not more common in patients in an intensive care unit or infections at any specific site. CONCLUSIONS: The frequency of resistance to imipenem is greater among P aeruginosa than among Enterobacter species. Resistance to imipenem among the P aeruginosa isolates is more common from strains isolated from patients with nosocomial infections in an intensive care unit, from the respiratory tract, and from teaching hospitals. Resistance appears to be increasing among nosocomial P aeruginosa isolated in teaching hospitals.  相似文献   

3.
医院感染革兰阴性杆菌的分布及耐药性调查分析   总被引:1,自引:1,他引:0  
目的 探讨医院感染革兰阴性杆菌的构成比及耐药性现状,为临床医师抗感染治疗提供实验室依据.方法 细菌培养按照《全国临床检验操作规程》进行;菌株鉴定采用法国生物梅里埃公司ATB Expression微生物分析仪;药物敏感试验采用CLSI推荐的K-B法,数据统计分析采用WHONET最新版本.结果 1087株革兰阴性杆菌对常用抗菌药物均表现出不同程度的耐药性,肠杆菌科细菌对碳青霉烯类抗菌药物美罗培南、亚胺培南100.0%敏感;但鲍氏不动杆菌分别对亚胺培南、美罗培南出现了45.5%、44.5%的耐药菌株,铜绿假单胞菌分别对亚胺培南、美罗培南出现了30.5%、31.7%的耐药菌株.结论 医院感染革兰阴性杆菌的耐药性已非常严重,应加强合理使用抗菌药物的管理,预防与控制多药耐药细菌导致的医院感染暴发流行.  相似文献   

4.
神经外科患者脑脊液细菌流行病学和耐药性监测   总被引:11,自引:2,他引:11  
目的监测神经外科患者脑脊液致病菌流行病学分布及耐药状况。方法收集北京天坛医院神经外科2000年1月~2004年12月,送检脑脊液标本中分离的致病菌及药敏鉴定结果,统计致病菌分布和抗菌药物敏感率。结果分离到致病菌438株,其中革兰阳性球菌316株,占72.1%;革兰阴性杆菌122株,占27.9%;排名前5位的致病菌分别为凝固酶阴性葡萄球菌(53.7%)、金黄色葡萄球菌(10.5%)、肠杆菌属(6.2%)、不动杆菌(6.2%)、铜绿假单胞菌(3.7%);对革兰阴性菌的总体敏感率为亚胺培南86.9%、哌拉西林/他唑巴坦77.4%、阿米卡星68.0%、头孢吡肟63.9%、头孢他啶63.1%,其余抗菌药物的敏感率均〈60%。结论神经外科患者颅内感染以革兰阳性菌多见,尤其是凝固酶阴性葡萄球菌和金黄色葡萄球菌,本研究结果将为神经外科手术部位感染的预防和经验性抗菌药物治疗提供基本数据资料。  相似文献   

5.
Pseudomonas aeruginosa is an important opportunistic pathogen in recreational waters and the primary cause of hot tub folliculitis and otitis externa. The aim of this surveillance study was to determine the background prevalence and antimicrobial resistance profile of P. aeruginosa in swimming pools and hot tubs. A convenience sample of 108 samples was obtained from three hot tubs and eight indoor swimming pools. Water and swab samples were processed using membrane filtration, followed by confirmation with polymerase chain reaction. Twenty-three samples (21%) were positive for P. aeruginosa, and 23 isolates underwent susceptibility testing using the microdilution method. Resistance was noted to several antibiotic agents, including amikacin (intermediate), aztreonam, ceftriaxone, gentamicin, imipenem, meropenem (intermediate), ticarcillin/clavulanic acid, tobramycin (intermediate), and trimethoprim/sulfamethoxazole. The results of this surveillance study indicate that 96% of P. aeruginosa isolates tested from swimming pools and hot tubs were multidrug resistant. These results may have important implications for cystic fibrosis patients and other immune-suppressed individuals, for whom infection with multidrug-resistant P. aeruginosa would have greater impact. Our results underlie the importance of rigorous facility maintenance, and provide prevalence data on the occurrence of antimicrobial resistant strains of this important recreational water-associated and nosocomial pathogen.  相似文献   

6.
目的 探讨医院多药耐药铜绿假单胞菌(MDRPA)的医院感染现状和耐药特性,为临床医师选择使用抗菌药物提供科学依据.方法 铜绿假单胞菌的标本采集、培养与鉴定严格按照《全国临床检验操作规程》,采用常规方法进行;用CLSI推荐的纸片扩散法进行药敏试验操作和结果判断.结果 医院临床分离的135株MDRPA在呼吸道标本中检出率最高,占54.8%;泛耐药株占10.4%;MDRPA对亚胺培南、美罗培南、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦等广谱高效抗菌药物已产生了10.4%~15.6%的耐药率,对其他常用抗菌药物的耐药率均>40.0%,耐药率最高的抗菌药物是磺胺甲噁唑/甲氧苄啶为80.0%.结论 医院务必采取切实有效的干预对策,遏制细菌耐药性快速增长的不良趋势.  相似文献   

7.
老年患者铜绿假单胞菌医院感染的危险因素与耐药性分析   总被引:9,自引:1,他引:9  
目的探讨254例老年患者铜绿假单胞菌(PAE)医院感染的危险因素及耐药性,为临床监测与控制PAE感染提供依据。方法统计老年患者PAE医院感染的临床资料,采用K-B法对PAE进行体外耐药监测。结果老年患者PAE医院感染的危险因素为原发基础疾病、免疫功能低下、住院日长、侵入性治疗、抗菌药物使用时间长等;PAE对复方新诺明和头孢噻肟耐药率分别为74.8%、60.2%,对亚胺培南耐药率为3.9%。结论建议采取综合治理措施,控制耐药菌的传播,提高对老年患者PAE感染的防治水平。  相似文献   

8.
目的 探讨铜绿假单胞菌(PAE)医院感染的耐药性及其变迁,为临床合理用药提供依据.方法 对医院2008年1月-2010年12月住院患者各种标本中分离到的铜绿假单胞菌175株,采用13种抗菌药物进行药敏试验.结果 痰液中PAE检出率最高占65.7%,其次是脓液标本占17.1%,尿液标本占10.3%;PAE对头孢他啶、头孢吡肟、环丙沙星、左氧氟沙星耐药率均<20.0%,对头孢噻肟、头孢曲松的耐药率均>40.0%,最敏感的是阿米卡星、妥布霉素,对亚胺培南/西司他丁的耐药率为21.3%.结论 医院感染铜绿假单胞菌的临床检出率呈逐年上升趋势,且对多种抗菌药物具有耐药性,临床抗感染治疗应根据体外药敏试验结果选用抗菌药物.  相似文献   

9.
BACKGROUND: Pseudomonas aeruginosa plays a predominant role as an etiological agent involved in serious infections in burned patients. Treatment of these infections is frequently complicated by antibiotic resistance, a problem that is is increasing in recent years. AIM: The objective of this study is to analyze epidemiological profile and antibiotic susceptibility of P. aeruginosa isolates within the burned patients admitted in our intensive care department. METHODS: During a period of 4 years (2000/2003), 828 burn patients were admitted. RESULTS: The survey of antibiotic susceptibility of P. aeruginosa showed high percentages of resistance to the different antibiotics. 60.9% of strains were resistant to piperacillin, 53.4% to ceftazidime, 37.6% to imipenem, 70.6% to cefsulodine, 59.3% to tobramycin, 80% to gentamicin, 62.4% to amikacin and 53.4% to ciprofloxacin. CONCLUSION: It is necessary to implement urgent measures to prevent the spreading of this multiresistant strain. These measures include: sensible limitation of the use of antimicrobial agent, strict disinfection and hygienic procedures.  相似文献   

10.
目的了解亚胺培南/西司他丁、美罗培南治疗机械通气患者多重耐药铜绿假单胞菌感染的耐药情况及药物疗效。 方法选取某院2010年1月-2015年12月痰培养为耐药铜绿假单胞菌的78例机械通气患者,分为亚胺培南/西司他丁治疗组(44例)和美罗培南治疗组(34例),比较两组患者的基础状况,细菌对所用抗菌药物产生耐药的时间,以及药物疗效差异。 结果两组患者的基础资料具有可比性,应用亚胺培南/西司他丁和美罗培南治疗前,两组患者分离的铜绿假单胞菌对喹诺酮类、头孢他啶、哌拉西林、阿米卡星的耐药情况比较,差异均无统计学意义(均P>0.05)。应用抗菌药物治疗至第6天,亚胺培南治疗组和美罗培南治疗组患者对所使用的抗菌药物耐药率(22.73% vs 8.82%)比较,差异无统计学意义(P>0.05);治疗至第8、10、12天,亚胺培南治疗组耐药率分别为40.91%、77.27%、97.73%,均高于美罗培南治疗组(分别为17.65%、32.35%、44.12%;均P<0.05)。不同抗菌药物治疗后铜绿假单胞菌产生耐药的平均时间:亚胺培南/西司他丁治疗组为9.0 d,美罗培南治疗组为13.5 d。两组患者疗效(64.71% vs 74.19%)比较,差异无统计学意义(P=0.41)。结论应用亚胺培南/西司他丁治疗机械通气患者多重耐药铜绿假单胞菌感染发生耐药的风险高于美罗培南,治疗第7天两组患者药物疗效无明显差异。  相似文献   

11.
儿科院内临床常见细菌耐药性监测   总被引:7,自引:1,他引:7  
目的调查儿科临床常见致病菌的耐药性现状。方法药物敏感性试验采用Kirby-Bauer纸片扩散法(苛养菌用浓度梯度法),耐药性数据分析采用WHONET5软件。结果2002年1月~2003年12月共收集儿科医院患者首次分离2 303株,其中革兰阳性菌占29.7%,革兰阴性菌占70.3%;耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS),分别占金黄色葡萄球菌和凝固酶阴性葡萄球菌的9.7%与67.6%,无万古霉素耐药株;肠球菌耐万古霉素株4.1%;11.9%的肺炎链球菌对青霉素耐药;肠杆菌科细菌对亚胺培南的耐药率最低;产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌和肺炎克雷伯菌株的检出率分别为49.7%和63.1%。结论细菌耐药性仍是目前临床上的严重问题,应重视开展儿科抗感染治疗中耐药性监测工作,同时合理使用抗菌药物以降低耐药性和采取有效措施控制其传播也是非常重要的。  相似文献   

12.
Antimicrobial resistance in Pseudomonas aeruginosa is a serious clinical problem. To determine the incidence of multi-drug resistant P. aeruginosa, resistance rates of P. aeruginosa clinical isolates against commonly used antibiotics were evaluated for the period 1998 to 2002. Multi-drug resistance was defined as resistance to at least three of the four drugs, ceftazidime, imipenem, ciprofloxacin, and tobramycin. Resistance to most anti-pseudomonal agents has increased by >20% over the five-year period, with dramatic increases observed with fluoroquinolones, tobramycin, and imipenem (resistance increased by 34-37%). In 1998, 78% of isolates were susceptible to all four anti-pseudomonal agents and no isolate was considered multi-drug resistant. However, in 2002, only 27% of isolates were sensitive to all four of the drugs and 32% were considered multi-drug resistant. Multi-drug resistance in individual institutions may be significantly higher than rates reported in nationwide surveillance studies and may more accurately reflect the true magnitude of local resistance problems. On-going surveillance within individual institutions is critical for the selection of appropriate empiric antimicrobial therapy.  相似文献   

13.
To determine the distribution and antimicrobial drug resistance in bacterial pathogens causing nosocomial infections, surveillance data on nosocomial infections documented from 1981 to 1999 at National Taiwan University Hospital were analyzed. During this period, 35,580 bacterial pathogens causing nosocomial infections were identified. Candida species increased considerably, ranking first by 1999 in the incidence of pathogens causing all nosocomial infections, followed by Staphylococcus aureus and Pseudomonas aeruginosa. Candida species also increased in importance as bloodstream infection isolates, from 1.0% in 1981-1986 to 16.2% in 1999. The most frequent isolates from urinary tract infections were Candida species (23.6%), followed by Escherichia coli (18.6%) and P. aeruginosa (11.0%). P. aeruginosa remained the most frequent isolates for respiratory tract and surgical site infections in the past 13 years. A remarkable increase in incidence was found in methicillin-resistant S. aureus (from 4.3% in 1981-1986 to 58.9% in 1993-1998), cefotaxime-resistant E. coli (from 0% in 1981-1986 to 6.1% in 1993-1998), and cefotaxime-resistant Klebsiella pneumoniae (from 4.0% in 1981-1986 to 25.8% in 1993-1998). Etiologic shifts in nosocomial infections and an upsurge of antimicrobial resistance among these pathogens, particularly those isolated from intensive care units, are impressive and alarming.  相似文献   

14.
目的了解某院2016年重症监护病房(ICU)与普通病房铜绿假单胞菌分布状况及其耐药性,为临床合理使用抗菌药物提供科学依据。方法采用VITEK 2 Compact 全自动微生物分析系统对该院2016年临床分离菌株进行鉴定及药敏试验, 比较ICU与普通病房铜绿假单胞菌耐药性的差异。结果ICU与普通病房送检标本均以痰为主,分别占78.7%、66.5%。ICU铜绿假单胞菌的检出率(11.7%)与普通病房(11.0%)比较,差异无统计学意义(P>0.05)。ICU检出的铜绿假单胞菌对氨曲南耐药率最高,达73.8% ,对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、头孢他啶、亚胺培南、美罗培南的耐药率也高达50%以上;普通病房检出的铜绿假单胞菌对氨曲南耐药率最高,达59.6%,其次是哌拉西林/他唑巴坦、亚胺培南,分别为48.0%、44.3%;ICU铜绿假单胞菌对被检测的12种抗菌药物耐药率均高于普通病房(P<0.05)。结论ICU铜绿假单胞菌的耐药率高于普通病房,应引起临床高度重视;临床上治疗其感染时,应根据药敏试验结果合理选用抗菌药物。  相似文献   

15.
摘要:目的 了解2014年某三甲医院老年病人临床分离菌对常见抗菌药物的耐药性。方法 使用自动化细菌鉴定仪VITEK 2- COMPACT对分离菌株的耐药性进行鉴定,药敏结果按CLSI 2014年版标准判断。结果 临床分离的2167株细菌中,G-菌占69.4%,G+菌占30.6%。耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林的凝固酶阴性葡萄球菌(MRSCNS)的检出率分别为 29.5%、85.8%。葡萄球菌属中甲氧西林耐药株对所测试抗菌药物的耐药率显著高于甲氧西林敏感株,未发现对万古霉素和利奈唑胺耐药的菌株。对大部分所测抗菌药物,屎肠球菌的耐药率高于粪肠球菌。在屎肠球菌中发现9株万古霉素耐药株,在粪肠球菌中发现2株利奈唑胺耐药株。青霉素耐药的非脑膜炎肺炎链球菌占6.2%,非脑膜炎肺炎链球菌对红霉素耐药率为95.4%。检出53.8%的大肠埃希菌和28.2%的肺炎克雷伯菌产超广谱β-内酰胺酶。鲍曼不动杆菌对亚胺培南和美罗培南的耐药率分别为53.9%、52.9%,铜绿假单胞菌对上述两种药物的耐药率分别为33.9%、28.0%。结论 在大于65岁患者中分离的细菌耐药情况应引起足够重视,加强对医院感染控制和指导抗生素合理使用。  相似文献   

16.
INTRODUCTION: The aim of our study was to determine the epidemiological profile and the antibiotics susceptibility of bacteria identified in blood culture in the intensive care unit, to improve empirical antibiotherapy. MATERIAL AND METHOD: A retrospective study was made over a four-year period (2002-2005) in the intensive care unit of the Mohammed-V Military Hospital. It included all the bacteria identified in blood culture. RESULTS: During this period, we collected 286 isolates, Gram-negative bacilli 49.3% and Gram-positive cocci 46.85%. The most frequently identified species were Acinetobacter baumannii (13.63%), Staphylococcus epidermidis (12.6%), Staphylococcus aureus (11.9%), and Pseudomonas aeruginosa (7%). Enterobacteriaceae accounted for 25.54%: Klebsiella pneumoniae 7%, and Enterobacter cloacae 7%. The rate of methicillin-resistant Staphylococcus aureus was 52.94 % and coagulase negative staphylococci 60.24%. No resistance to glycopeptides was observed. Enterobacteriaceae were resistant to third generation cephalosporins in 42.6 % and had a broad-spectrum betalactamase phenotype in 18%. The resistance rate of A. baumannii was 68.7% for ceftazidime and 31.4% for imipenem. The resistance rate of P. aeruginosa to the third generation cephalosporines and the imipenem were respectively 16.6% and 10.5%. CONCLUSION: A regular epidemiologic study of blood culture isolates and determination of susceptibility to antibiotics are necessary to improve empiric therapy.  相似文献   

17.
目的 通过分析甘肃医学院附属医院2017年1 - 12月医院感染病原菌谱及药敏试验结果,为医院合理使用抗生素来控制医院感染提供依据。方法 采用VITEK 2 Compact全自动微生物鉴定药敏分析仪对送检标本进行鉴定和药敏试验,进而对分离的951株病原菌分布及耐药性进行分析;走访和了解医院抗生素用药情况。结果 2017年经上报确认并统计的医院感染患者共送检标本1 263份,培养阳性标本854份,阳性率为67.6%;共分离951株病原菌(主要来自痰标本),以骨科和呼吸内科居多。标本分离率位于前4位的病原菌中最多的是大肠埃希菌(221株),占分离菌株的23.2%,其中产超广谱β - 内酰胺酶(Extended - Spectrum Beta - Lactamase, ESBLs)菌株104株,占大肠埃希菌的47.1%;最少的是铜绿假单孢菌(54株),占整个分离菌株的5.7%。大肠埃希菌及肺炎克雷伯菌对氨苄西林的耐药率大于90%,铜绿假单胞菌对亚胺培南的耐药率已达29.6%,未发现耐万古霉素的金黄色葡萄球菌。结论 医院感染病原菌具有较强的耐药性,并且分布存在差异,多重耐药菌比例较高。医院应科学分析和掌握感染病原菌分布特点及耐药性情况,指导临床精准合理选择抗菌药物,减少医院感染的发生。  相似文献   

18.
革兰阴性杆菌对亚胺培南耐药率的变迁   总被引:6,自引:4,他引:6  
目的调查革兰阴性杆菌对亚胺培南的耐药率变化。方法收集2003年10月-2006年6月从住院患者各种临床标本中分离的革兰阴性杆菌,使用VITEK-32全自动微生物分析仪进行菌种的鉴定和药敏试验,对结果进行回顾性调查。结果共分离出革兰阴性杆菌2045株,35个细菌种,肠杆菌科细菌912株,占44.6%;非发酵菌1120株,占54.8%;分离率前5位的病原菌分别是铜绿假单胞菌、大肠埃希菌、鲍氏不动杆菌、肺炎克雷伯菌和洋葱伯克霍尔德菌;肠杆菌科细菌对亚胺培南的耐药率非常低,除弗氏柠檬酸杆菌外,其他肠杆菌科细菌对亚胺培南的耐药率均<1.0%;嗜麦芽寡养单胞菌、洋葱伯克霍尔德菌、脑膜脓毒金黄杆菌、铜绿假单胞菌和鲍氏不动杆菌对亚胺培南的耐药率分别为100.0%、98.6%、98.3%、22.3%和20.6%。结论临床分离的革兰阴性杆菌以非发酵菌为主,亚胺培南对肠杆菌科细菌具有非常强的体外抗菌活性,对非发酵菌的体外抗菌活性较差,铜绿假单胞菌和鲍氏不动杆菌对亚胺培南的耐药率呈上升趋势。  相似文献   

19.
目的研究老年呼吸机相关性肺炎(VAP)铜绿假单胞菌(PAE)感染及耐药特征,为临床合理选用抗菌药物提供依据。方法对256例使用呼吸机治疗的老年住院患者进行目标监测,对分离的铜绿假单胞菌采用纸片扩散法进行药敏试验,并对抗菌药物耐药结果进行回顾性分析。结果 63株铜绿假单胞菌对阿米卡星的耐药率最低,为23.81%,其次为庆大霉素、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亚胺培南、美罗培南、左氧氟沙星,耐药率为34.92%~53.97%,对其余8种抗菌药物的耐药率为55.56%~100.00%;共检出34株耐亚胺培南PAE,3株泛耐药菌株。结论铜绿假单胞菌对常用抗菌药物呈多药耐药;VAP感染已十分严重,应引起临床医师的重视;治疗应选择科学的联合用药方案;首选药物为头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亚胺培南、美罗培南。  相似文献   

20.
目的 了解医院铜绿假单胞菌的耐药性变迁,为临床合理使用抗菌药物及控制医院感染提供依据.方法 对2006-2010年临床分离的1966株铜绿假单胞菌,用纸片扩散法检测其对亚胺培南等13种抗菌药物的耐药率.结果 收集的1966株铜绿假单胞菌中,铜绿假单胞菌对阿米卡星、头孢他啶、头孢哌酮/舒巴坦的耐药率均<40.0%,分别为30.2%、30.4%、35.9%,对左氧氟沙星、亚胺培南的耐药率均>60.0%,分别为61.9%、63.1%,泛耐药铜绿假单胞菌呈逐年增加趋势.结论 医院临床分离的铜绿假单胞菌耐药率高,临床应根据耐药特点合理选用抗菌药物,预防耐药菌在医院的暴发流行.  相似文献   

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