| Autor: |
Ferreira, Andrea C. B., Gobara, Satiko, Costa, Silvia F., Sauaia, Nairn, Mamizuka, Elsa M., Van der Heijden, Inneke M., Soares, Robson E., Almeida, Gisele D., Fontana, Carlos, Levin, Anna S. |
| Zdroj: |
Infection Control & Hospital Epidemiology; October 2004, Vol. 25 Issue: 10 p868-872, 5p |
| Abstrakt: |
AbstractObjectives:To evaluate the emergence of resistance of Pseudomonas aeruginosaand Acinetobacterspecies to imipenem, ciprofloxacin, or both after the use of these drugs and to compare resistant with susceptible isolates by molecular typing.Design:Cohort study.Setting:Burn intensive care unit (ICU) with 4 beds in a tertiary-care university hospital.Methods:During 16 months, surveillance cultures were performed for all patients admitted to the ICU. Demographic information was obtained for each patient. Molecular typing was done by pulsed-field gel electrophoresis using restriction enzymes for 71 isolates of P. aeruginosaand Acinetobacterspecies.Results:Thirty-four patients were admitted and 22 were colonized by susceptible P. aeruginosaor Acinetobacterspecies before they used the antimicrobials. Nine (41%) of these patients had a resistant isolate after antimicrobial use: 5 had used imipenem alone, 1 had used ciprofloxacin, and 3 had used both drugs. The interval between isolation of the susceptible and resistant isolates ranged from 4 to 25 days, but was 10 or more days for 6 patients. Molecular typing revealed that susceptible and resistant isolates from each patient were different and that although there were no predominant clones among susceptible isolates, there was a predominant clone among resistant isolates of P. aeruginosaand of Acinetobacter.Conclusions:Resistance was not due to the acquisition of resistance mechanisms by a previously susceptible strain, but rather to cross-transmission. Although various measures involving antimicrobial use have received great attention, it would seem that practices to prevent cross-transmission are more important in controlling resistance. |
| Databáze: |
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