Development of resistance by Enterobacter cloacae during therapy of pulmonary infections in intensive care patients.

R Füssle, J Biscoping, R Behr, A Sziegoleit
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引用次数: 5

Abstract

The emergence of resistance during therapy and the efficacy of different antibiotic therapy regimens were studied in 38 intensive care patients suffering from pulmonary infections caused by Enterobacter cloacae. Every three days a fresh isolate was obtained from each patient and tested in vitro for susceptibility to 16 antibiotics by determination of the minimal inhibitory concentrations. During therapy with cefotaxime and tobramycin the E. cloacae strains from 47% of the patients became resistant to cefotaxime within 6 days. In all cases resistance encompassed all other broad-spectrum penicillins and cephalosporins tested, as well as aztreonam. Development of resistance regularly led to persistence of bacteria. Resistance to tobramycin, ciprofloxacin or imipenem was not observed. Treatment of 25 patients with persisting E. cloacae infections was successful in 17 out of 18 patients treated with imipenem and in 6 out of 7 patients receiving ciprofloxacin.

重症监护患者肺部感染治疗过程中阴沟肠杆菌耐药性的发展。
对38例阴沟肠杆菌引起肺部感染的重症监护患者在治疗过程中出现的耐药情况及不同抗生素治疗方案的疗效进行了研究。每隔三天从每位患者身上获得一个新鲜的分离物,并通过测定最低抑制浓度进行对16种抗生素的体外敏感性测试。在头孢噻肟和妥布霉素治疗期间,47%患者的阴沟肠杆菌菌株在6天内对头孢噻肟产生耐药性。在所有病例中,耐药性包括所有其他经检测的广谱青霉素和头孢菌素以及氨曲南。耐药性的发展经常导致细菌的持续存在。未见对妥布霉素、环丙沙星或亚胺培南耐药。25例持续性阴沟肠杆菌感染患者,18例亚胺培南治疗中17例成功,7例环丙沙星治疗中6例成功。
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