Antimicrobial resistance development following surgical site infections.
Antimicrobial resistance development following surgical site infections.
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DOI：
10.3892/mmr.2016.6034
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发表时间：
2017-02
影响因子：
3.4
通讯作者：
Gofita E
中科院分区：
文献类型：
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作者：
Călina D;Docea AO;Rosu L;Zlatian O;Rosu AF;Anghelina F;Rogoveanu O;Arsene AL;Nicolae AC;Drăgoi CM;Tsiaoussis J;Tsatsakis AM;Spandidos DA;Drakoulis N;Gofita E
手术部位感染（SSI）决定了住院时间和抗生素治疗费用的增加。本研究的目的是确定克拉约瓦临床急诊县医院（SCJUC）患者SSI中涉及的细菌，并评估其对抗菌药物的耐药性，并比较外科病房和重症监护室（ICU）。对生物样品进行经典细菌学诊断。纸片扩散法检测细菌耐药性。我们使用层次聚类作为一种方法来分组的基础上的抗生素耐药谱的分离株。分离出的最常见的细菌种类是金黄色葡萄球菌（S.金黄色葡萄球菌（50.72%），其次为大肠埃希菌（E.大肠杆菌17.22%;铜绿假单胞菌10.05%。此外，在较低的百分比，我们分离葡萄糖非发酵，革兰氏阴性菌和其他肠杆菌科。不同菌种的抗生素耐药性差异很大;最耐药的是非发酵革兰氏阴性杆菌。E.大肠埃希菌对第三代头孢菌素、喹诺酮类和碳青霉烯类耐药率较低。相比之下，克雷伯菌属对许多头孢菌素类和青霉素类耐药，并且由于产生碳青霉烯酶而对碳青霉烯类耐药。非发酵菌对抗生素高度耐药，但对粘菌素普遍敏感。S.金黄色葡萄球菌对头孢曲松耐药率100%，对青霉素耐药率91.36%，对阿莫西林/克拉维酸耐药率87.50%，对阿米卡星耐药率80.00%，对左氧氟沙星、强力霉素、庆大霉素、替加环素、替考拉宁敏感。ICU中肠杆菌科细菌的耐药性仅略高，特别是对碳青霉烯类（亚胺培南，ICU中为31.20%，外科病房中为14.30%;风险比= 2.182）。对于葡萄球菌属，但对于非发酵细菌，即使中位数几乎相同，ICU中的抗生素耐药指数值也限制在上限。从这项研究中收集的数据可能有助于感染控制团队在各种外科手术中建立有效的抗生素治疗指南，以便通过有效应用抗感染设备来最大限度地降低发生SSI的风险。
Surgical site infections (SSIs) determine an increase in hospitalization time and antibiotic therapy costs. The aim of this study was to identify the germs involved in SSIs in patients from the Clinical Emergency County Hospital of Craiova (SCJUC) and to assess their resistance to antimicrobials, with comparisons between surgical wards and the intensive care unit (ICU). The biological samples were subjected to classical bacteriological diagnostics. Antibiotic resistance was tested by disc diffusion. We used hierarchical clustering as a method to group the isolates based upon the antibiotic resistance profile. The most prevalent bacterial species isolated were Staphylococcus aureus (S. aureus; 50.72%), followed by Escherichia coli (E. coli; 17.22%) and Pseudomonas aeruginosa; 10.05%). In addition, at lower percentages, we isolated glucose-non-fermenting, Gram-negative bacteria and other Enterobacteriaceae. The antibiotic resistance varied greatly between species; the most resistant were the non-fermenting Gram-negative rods. E. coli exhibited lower resistance to third generation cephalosporins, quinolones and carbapenems. By contrast, Klebsiella was resistant to many cephalosporins and penicillins, and to a certain extent to carbapenems due to carbapenemase production. The non-fermenting bacteria were highly resistant to antibiotics, but were generally sensitive to colistin. S. aureus was resistant to ceftriaxone (100%), penicillin (91.36%), amoxicillin/clavulanate (87.50%), amikacin (80.00%) and was sensitive to levofloxacin, doxycycline, gentamycin, tigecycline and teicoplanin. The Enterobacteriaceae resistance was only slightly higher in the ICU, particularly to carbapenems (imipenem, 31.20% in the ICU vs. 14.30% in the surgical wards; risk ratio = 2.182). As regards Staphylococcus species, but for non-fermenting bacteria, even if the median was almost the same, the antibiotic resistance index values were confined to the upper limit in the ICU. The data gathered from this study may help infection control teams to establish effective guidelines for antibiotic therapies in various surgical procedures, in order to minimize the risk of developing SSIs by the efficient application of the anti-infection armamentarium.