产广谱β -内酰胺酶的肠杆菌:法国某综合医院74例

M. Geier
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摘要

欧洲疾病预防和控制中心(ECDC)的新数据证实了这一观察结果,用于治疗人畜共患病(如弯曲杆菌病和沙门氏菌病)的抗生素变得不那么有效。肠杆菌是社区或医院感染的最常见原因。其中一些产生β -内酰胺酶扩展谱(ESBL),通常与抗生素耐药性有关。我们对2016年在昆佩尔医院住院的成年患者中发现的肠杆菌ESBL阳性进行了回顾性研究。纳入74例患者(48例女性),中位年龄80岁。30%住院,21%有EBLSE感染史,62%有尿路感染,12%有腹腔感染,9%有呼吸道感染。肠杆菌科细菌分布为:大肠杆菌(73%)、阴沟肠杆菌(16%)、肺炎克雷伯菌(5.4%)、弗氏柠檬酸杆菌(2.7%)、科斯利柠檬酸杆菌(1.4%)、肠沙门氏菌(1.4%)。给出了抗生素菌株的敏感性曲线。详细讨论了抗生素治疗的策略。概率性用药以头孢曲松为主,其次为氟喹诺酮类、碳青霉烯类和阿莫西林。64例患者进展有利,死亡8例,报告严重并发症6例。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Enterobacteria Producing Extended Spectrum Beta- Lactamases : 74 Cases in a General Hospital in France
Antibiotics used to treat zoonoses, such as campylobacteriosis and salmonellosis become less effective, new data from the European center for Disease Prevention and Control (ECDC) confirm this observation. Enterobacteria are the most common causes of community or nosocomial infections. Some of them produce beta-lactamases extended spectrum (ESBL) frequently associated with resistance to antibiotics. We conduct a retrospective study from positive levies of enterobacteria ESBL identified in adult patients hospitalized at the Quimper hospital, during the year 2016. 74 patients (48women) median age 80 years were included. 30% lifed in an institution, 21% had an history of infection of EBLSE, 62% had urinary tract infection, 12% intraabdominal infection, 9% respiratory infections. Distribution of Enterobacteriaceae was: E. coli (73%), E.cloacae complex (16%), K.pneumoniae (5.4%), Citrobacter freundii (2.7%), Citrobacter koseri(1.4%), Salmonella enterica (1.4%). Sensitivity profiles of antibiotics strains are presented. The strategies of antibiotic therapy are detailed and discussed. The most used molecule was ceftriaxone for probalistic treatment then fluoroquinolone, carbapenems and amoxicillinclavulanate for second line. The evolution was favorable for 64 patients, 8 deaths, 6 serious complications were notified.
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