PATIENT FACTORS CONTRIBUTING TO THE EMERGENCE OF GENTAMICIN-RESISTANT SERRATIA-MARCESCENS

被引:45
作者
YU, VL
OAKES, CA
AXNICK, KJ
MERIGAN, TC
机构
[1] STANFORD UNIV,MED CTR,SCH MED,DEPT INFECT CONTROL,STANFORD,CA 94305
[2] STANFORD UNIV,MED CTR,SCH MED,DEPT MED,DIV INFECT DIS,STANFORD,CA 94305
关键词
D O I
10.1016/0002-9343(79)91074-X
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
One hundred forty nosocomial Serratia marcescens infections (including 76 cases of bacteremia) were identified by prospective surveillance from 1975 through 1977 and retrospective chart review from 1968 through 1974. Thirty-four cases (24 per cent) involved gentamicin-resistant strains. All gentamicin-resistant strains appeared after 1974. Ninety per cent of the patients had undergone surgery, and 88 per cent had received prior antimicrobial therapy. The emergence of gentamicin-resistant S. marcescens paralleled the increase in usage of gentamicin. Prior use of gentamicin for more than two days in an individual patient was a significant risk factor (P = 0.0002) for being infected with a Serratia that was gentamicin-resistant. Other factors which separated gentamicin-resistant Serratia infections from gentamicin-sensitive Serratia infections were (1) urinary site of infection (P = 0.0005), (2) urinary catheter (P = 0.002), (3) endotracheal tube or tracheotomy (P = 0.03) and (4) increasing duration of hospitalization (P < 0.05). Thirty-three of 34 (97 per cent) patients with gentamicin-resistant strains had urinary catheters. Specific measures to control infection were effective in decreasing the incidence of infections caused by gentamicin-resistant Serratia. © 1979.
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页码:468 / 472
页数:5
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