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題名 | Antimicrobial Susceptibilities of Gram-negative Bacilli Isolated from Adult Intensive Care Unit Patients=由成人加護病房病患分離之格蘭氏陰性桿菌之抗生素感受性 |
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作者 | 余文良; 林振文; 王任賢; 陳慧珊; | 書刊名 | 中臺灣醫學科學雜誌 |
卷期 | 4:3 1999.09[民88.09] |
頁次 | 頁164-170 |
分類號 | 419.38 |
關鍵詞 | 抗生素敏感性; 格蘭氏陰性桿菌; 加護病房; Antimicrobial susceptibility; Gram-negative bacillus; Intensive care unit; |
語文 | 英文(English) |
中文摘要 | 本研究為分析1997年1月至6月間,在中國醫藥學院附設醫院成人加護病房內病患分離之格蘭氏陰性桿菌之抗生素敏感性。總共分離152菌株,包括55株Pseudomonas aeruginosa,37株Serratia marcescens,31株klebsiella pneumoniae及29株Acinetobacter baumannii。內科與外科加護病房之菌種分佈相當一致,其差異並無統計學上之意義。由外科加護病房病患分離之P. aeruginosa及S. marcescens對gentamicin之敏感性比由內科加護病房分離者高,並有統計學上之意義。整體而言,對P. aeruginosa最有效之抗生素有amikacin,ceftazidime,imipenem及ciprofloxacin。大部份之S. marcescens及K. pneumoniae僅對moxalactam和imipenem有效,暗示有廣效性之β-lactamase存在。臨床醫師應知曉使用廣效性之cephalosporins可篩選出多重抗藥菌種之潛力。根據血液分離菌株之E-test結果,ciprofloxacin對S. marcescens(MIC□=0.19 μg╱mL)及K. pneumoniae(MIC□=1 μg╱mL)有很好之抗菌效果。Imipenem仍是對抗A. baumannii最有效之抗生素,應保留於加護病房抗微生物療法策略中之最後一線用藥。 |
英文摘要 | Antibiotic resistance among pathogens isolated from patients in the intensive care units (ICUs) is a cause of major concern. A prospective in vitro survey of common gram-negative isolates obtained from patients hospitalized in the medical ICU (MICU) and surgical ICU (SICU) was undertaken to document current susceptibility patterns and the differences between both ICUs. One hundred and fifty-two isolates were obtained, including 55 Pseudomonas aeruginosa, 37 Serratia marcescens, 31 Klebsiella pneumoniae, and 29 Acinetobacter baumannii isolates. The distribution frequency of isolates between the MICU and SICU was relatively uniform without statistically significant differences. The activities of gentamicin against P. aeruginosa and S. marcescens from patients in the SICU were significantly higher than those in the MICU. Overall, the most potent compounds against P. aeruginosa included amikacin, ceftazidime, imipenem and ciprofloxacin. Most S. marcescens and K. pneumoniae isolates were only susceptible to moxalactam and imipenem, implicating the existence of extended spectrum β-lactamase producers. Clinicians should be aware of the multi-drug resistant strains and use the appropriate broad-spectrum cephalosporins. Based on the results of E-tests for bacteremic isolates, ciprofloxacin had good activity against S. marcescens (MIC□=0.19 μg/mL) and K. pneumoniae (MIC□=1 μg/mL), and should be restricted in use unless all other cephalosporins are not effective. Imipenem remained the most potent antimicrobial agent against A. baumannii and should be kept as the last resort in the strategy of antimicrobial therapy for patients in the ICUs. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。