米国集中治療室のグラム陰性バチルの抗生物質耐性:フッ素ヒノロンの使用への影響

Melinda M Neuhauser¹, Robert A Weinstein, Robert Rydman

¹Department of Clinical Sciences and Administration, University of Houston College of Pharmacy, Houston, Tex, USA.

JAMA

|February 18, 2003

まとめ

抗生物質耐性は,米国の集中治療室で増加しました. シプロフロキサシン耐性は,フッ素ヒノロンの使用量増加に伴い,著しく増加し,より賢明な処方が必要になりました.

科学分野:

感染症感染症は感染症です.
クリニカルマイクロバイオロジー
薬理学薬理学とは

背景:

以前の研究では,1990年代初頭,米国の集中治療室 (ICU) で抗菌剤耐性が増加していることが示されました.
グラム陰性有酸素細菌は,ICUでの感染症の一般的な原因です.

研究の目的:

ICU患者からのグラム陰性有酸素単離体における抗菌剤耐性の国内動向を評価する.
これらの耐性パターンを,国内での抗生物質使用,特にフッ素キノロンとの相関関係にするために.

主な方法:

米国ICU (1994-2000) の35,790グラム陰性有酸素単離物の抗生物質感受性データの分析.
43州とコロンビア地区の複数の機関から収集されたデータです.
単離剤の感受性の相関関係と国内におけるフルオロキノロン消費データ.

主要な成果:

テストされたほとんどの抗微生物剤に対する全体的な感受性は6%またはそれ以下で減少しました.
シプロフロクサシン感受性は1994年の86%から2000年の76%に減少した.
国内におけるフルオロキノロン使用量の増加は,シプロフロクサシンに対する感受性の低下と有意に関連していた.

結論:

この研究は,グラム陰性バチルの間でシプロフロクサシン耐性の上昇を確認しています.
この抵抗性の増加は,フッ素ヒノロンの消費量の増加と一致しました.
フルオロキノロン剤の適正な使用は,さらなる耐性疾患の発症を緩和するために推奨されます.

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