| Autor: |
Österblad, Monica, Hakanen, Antti, Manninen, Raija, Leistevuo, Tiina, Peltonen, Reijo, Meurman, Olli, Huovinen, Pentti, Kotilainen, Pirkko |
| Zdroj: |
Antimicrobial Agents and Chemotherapy; June 2000, Vol. 44 Issue: 6 p1479-1484, 6p |
| Abstrakt: |
ABSTRACTEnterobacteria in fecal flora are often reported to be highly resistant. Escherichia coliis the main species; resistance data on other species are rare. To assess the effect of the host's environment, antimicrobial resistance was determined in fecal species of the family Enterobacteriaceaefrom three populations: healthy people (HP)(n= 125) with no exposure to antimicrobials for 3 months preceding sampling, university hospital patients (UP) (n= 159) from wards where the antibiotic use was 112 defined daily doses (DDD)/bed/month, and geriatric long-term patients (LTP) (n= 74) who used 1.8 DDD/bed/month. The mean length of hospital stay was 5 days for the UP and 22 months for the LTP. The isolates were identified to at least genus level, and MICs of 16 antimicrobials were determined. From the university hospital, resistance data on clinicalEnterobacteriaceaeisolates were also collected. Resistance data for on average two different isolates per sample (range, 1 to 5) were analyzed: 471 E. coliisolates and 261 otherEnterobacteriaceaespp. Resistance was mainly found amongE. coli; even in HP, 18% of E. coliisolates were resistant to two or more antimicrobial groups, with MIC patterns indicative of transferable resistance. Other fecal enterobacteria were generally susceptible, with little typically transferable multiresistance. Clinical KlebsiellaandEnterobacterisolates were significantly more resistant than fecal isolates. The resistance patterns at both hospitals mirrored the patterns of antibiotic use, but LTP E. coliisolates were significantly more resistant than those from UP. Conditions permitting an efficient spread may have been more important in sustaining high resistance levels in the LTP. E. coliwas the main carrier of antimicrobial resistance in fecal flora; resistance in other species was rare in the absence of antimicrobial selection. |
| Databáze: |
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