頁籤選單縮合
題名 | Surveillance of Antibiotic Resistance in Taiwan, 1998=1998年臺灣地區之抗生素抗藥性監測 |
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作者 | 何曼德; 楊采菱; 葉梁蘭蘭; 陳珮琛; 蕭溢茹; | 書刊名 | 微免與感染雜誌 |
卷期 | 32:4 1999.12[民88.12] |
頁次 | 頁239-249 |
分類號 | 418.281 |
關鍵詞 | 臺灣地區; 抗生素抗藥性; 監測; Antibiotic resistance; Surveillance; Taiwan; |
語文 | 英文(English) |
中文摘要 | 為進行第一次全國性抗生素抗藥性監測工作,我們於1998年10月至12月自臺灣各地的22所醫院(醫學中心6所,區域醫院15所,地區醫院1所)收集了3,211株細菌株,每所醫院除了以隨機且連續的方法,提供住院病人分離的50株菌株外,還分別自陽性血液、院內感染、門診病人及小兒科,各提供25株細菌株。我們將收集的菌株重新鑑定,並測得其對抗生素的抗藥性及感受性。綜而言之,最常見的細菌屬於Enterobacteriaceae(即Escherichia coli及Klebsiella pneumoniae)、Staphylococcus aureus及Pseudomonas aeruginosa。從院內感染分離的細菌中,Acinetobacter spp.亦佔10%以上。自院內感染與門診分離出的金黃色葡萄球菌中,各有82%與40%對oxacillin 有抗藥性。Enterobacter spp.中,有14%對vancomycin有抗藥性。革蘭氏陰性菌中,從院內感染分離的Klebsiella spp.與Acinetobacter spp.,其對抗生素的抗藥性比自非院內感染的來源分離出的要高,而Enterobacter cloacae、Serratia marcescens與P. aeruginosa沒有如此顯著的差別。大體而言,此三種細菌不管其來源為何,都有相當高的抗藥性。細菌的抗藥性有些隨地區而變異,但很難作一概括性的定論,若測量抗生素感受性所產生的抑制環直徑(inhibition zone diameter),我們可自三種不同的細菌與抗生素的感受性關係中,找到一些對某些抗生素具感受性,但抑制環偏小的細菌群。此三種關係為vancomycin對S. aureus、ciprofloxacin對E.coli、以及ciprofloxacin 對Salmonella spp. 。發現這種定量現象也是我們監視抗藥性的目的之一,這亦可能是特定細菌群之抗藥性正在醞釀的初步現象。 |
英文摘要 | For the first national surveillance of antibiotic resistance in Taiwan, we collected in 1998 from 22 hospitals (6 medical centers, 15 regional hospitals, and 1 local hospital) 3,211 isolates in all parts of the country. Besides 50 random successive isolates from inpatients, each hospital was requested to collect 25 isolates each from positive blood cultures, hospital-acquired infections, outpatients and the pediatric department. We re-speciated all the submitted specimens and determined their antibiotic susceptibility patterns. The most common isolates were Enterobacteriaceae (Escherichia coli, Klebsiella pneumoniae), Staphylococcus aureus, and Pseudomonas aeruginosa. Among hospital-acquired infections, Acinetobacter spp. were among those which accounted for over 10% of the isolates. The oxacillin resistance of S. aureus was 82% in isolates from hospital-acquired infections, and 40% from outpatients. Among Enterococcus spp., 85% were either E. faecalis or E. faecium. They were 14% resistant to vancomycin. Among gram-negative bacteria, K. pneumoniae and Acinetobacter baumanii were hospital acquired isolates that were most clearly more resistant than communit acquired isolates. This difference was less apparent in the case of Enterobacter cloacae, Serratia marcescens, and P. aeruginosa. These bacteria were generally more resistant fromm all sources. Fifty-one percent of Salmonella were resistant to ampicillin; however, these were all sensitive to ciprofloxacin. Isolates from the East were least resistant. Plotting the disc zone diameters of antibiotics within the susceptible range, we identified subpopulations with smaller diameters in the case of vancomycin against S. aureus, ciprofloxacin against E. coli, and ciprofoxacin against Salmonella spp. These findings represent one of the purposes of this surveillance as they may portend developing resistances which bear careful watching in the future. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。