Title: Surveillance of antimicrobial resistance in gram-negative bacilli isolated from lower respiratory tract of patients in respiratory wards for 5 consecutive years
Abstract: Objective To investigate the change pattern of antimicrobial resistance among gram-negative bacilli isolated from lower respiratory tract for rational antibiotic therapy in clinical practice.MethodsAntimicrobial susceptibility of 1 709 isolates of gram-negative bacilli from 2003 to 2007 was tested by disk diffusion(K-B) method.Whonet 5.4 software was used to analyze the data.ResultsThe most common pathogens were Pseudomonas aeruginosa(43.7%),Klebsiella pneumoniae(11.1%),Stenotrophomonas maltophilia(9.2%) and Acinetobacter baumannii(9.0%).Resistance rate of P.aeruginosa was relatively lower to cefoperazone-sulbactam,amikacin(10.1%-27.7%) and meropenem(17.3%-31.8%).Resistance rate of S.maltophilia was relatively lower to cefoperazone-sulbactam(5.9%-17.9%) and levofloxacin(7.1%-17.4%).Most of A.baumannii isolates were susceptible to imipenem and meropenem.Resistance rate of A.baumannii isolates to cefoperazone-sulbactam(0-22.2%) was lower than ticarcillin-clavulanic acid(17.4%-50.0%) and piperacillin-tazobactam(16.7%-61.5%).Isolates of Enterobacteriaceae were still highly sensitive to imipenem and meropenem,but highly resistant to fluoroquinolones.Resistance rate of K.pneumoniae was lower to cefepime(0-32.6%) and cefoperazone-sulbactam(2.4%-38.1%) than the third generation cephalosporins(11.9%-69.0%).The prevalence of extended-spectrum β-lactamases(ESBLs) in K.pneumoniae increased from 16.1% in 2003 to 76.7% in 2005,but decreased to 28.6% in 2007,while in Escherichia coli the prevalence increased from 45.5% in 2003 to 80.6% in 2007.ESBLs-producing strains were resistant to most β-lactams and some other antimicrobial agents.ConclusionsMost pathogens show significant resistance to the most commonly used antibiotics.It is very important to select antibiotics for the treatment of infections based on the results of susceptibility testing in respiratory wards.
Publication Year: 2009
Publication Date: 2009-01-01
Language: en
Type: article
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