Antibiotic resistance among gram-negative bacilli in US intensive care units - Implications for fluoroquinolone use
Antibiotic resistance among gram-negative bacilli in US intensive care units - Implications for fluoroquinolone use
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DOI：
10.1001/jama.289.7.885
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发表时间：
2003-02-19
影响因子：
120.7
通讯作者：
Quinn, JP
中科院分区：
文献类型：
--
作者：
Neuhauser, MM;Weinstein, RA;Quinn, JP
目的评估美国重症监护病房(ICU)患者革兰氏阴性需氧菌的耐药率，并将这些耐药率与抗菌药物的使用进行比较。设计和设置参与机构，代表美国43个州和哥伦比亚特区，提供1994年至2000年期间从ICU患者中回收的35790株非重复革兰氏阴性需氧菌的药敏结果。生物体被鉴定到物种水平。结果大多数抗菌药物对革兰阴性需氧菌的抗菌活性在研究期间绝对下降6%或以下。对环丙沙星的总体敏感性从1994年的86%稳步下降到2000年的76%，并与全国氟喹诺酮类药物使用量的增加显著相关。结论本研究记录了环丙沙星耐药率在革兰氏阴性杆菌中的增加与氟喹诺酮类药物的使用增加是一致的。为了限制这一下降趋势，有必要更明智地使用氟喹诺酮类药物。
Context Previous surveillance studies have documented increasing rates of antimicrobial resistance in US intensive care units (ICUs) in the early 1990S.Objectives To assess national rates of antimicrobial resistance among gram-negative aerobic isolates recovered from ICU patients and to compare these rates to antimicrobial use.Design and Setting Participating institutions, representing a total of 43 US states plus the District of Columbia, provided antibiotic susceptibility results for 35790 non-duplicate gram-negative aerobic isolates recovered from ICU patients between 1994 and 2000.Main Outcome Measures Each institution tested approximately 100 consecutive gram-negative aerobic isolates recovered from ICU patients. Organisms were identified to the species level. Susceptibility tests were performed, and national fluoroquinolone consumption data were obtained.Results The activity of most antimicrobial agents against gram-negative aerobic isolates showed an absolute decrease of 6% or less over the study period. The overall susceptibility to ciprofloxacin decreased steadily from 86% in 1994 to 76% in 2000 and was significantly associated with increased national use of fluoroquinolones.Conclusions This study documents the increasing incidence of ciprofloxacin resistance among gram-negative bacilli that has occurred coincident with increased use of fluoroquinolones. More judicious use of fluoroquinolones will be necessary to limit this downward trend.