האיגוד הישראלי לרפואת משפחה
כעת 6785 ערכים
רופאים, הרשמו עכשיו למועדון העורכים כניסה עקבו אחרינו בפייסבוק
האיגוד הישראלי לרפואת משפחה
רופאים, הרשמו עכשיו למועדון העורכים כניסה עקבו אחרינו בפייסבוק
כעת 6785 ערכים
האיגוד הישראלי לרפואת משפחה

טבלאות רגישויות מבית החולים שערי צדק - תרביות דם - Shaare zedek medical center antibiotic sensitivity table - blood cultures

מתוך ויקירפואה
שם הספר: שימוש מושכל באנטיביוטיקה ונהלים למניעת זיהומים
Antibiotic.png
שם המחבר פרופ' עמוס ינון, פרופ' יחיאל שלזינגר, דר' דוד רווה
שם הפרק טבלאות רגישויות מבית החולים שערי צדק - תרביות דם - Shaare zedek medical center antibiotic sensitivity table - blood cultures
מוציא לאור
שערי צדק1.png
מועד הוצאה תשע"א – 2010
מספר עמודים 196
הקדשה ספר זה מוקדש
לפרופ' חיים הרשקו
בהוקרה עמוקה

טבלה 1. Number (%) of positive blood cultures/drawn cultures and rates of the most frequently isolated patient-specific isolated organisms/1000 admissions.

Variable/Year 1990-2000‏[1] 2001-2008‏[1]
Annual Mean ± SD 11year Total Annual Mean ± SD 8Year Total
Drawn blood cultures (BC) (n)‏[2] 15,779 ± 4787 173,571 15,070 ± 1047 120,565
No. of true positive BC (n) 1609 ± 524 17,703 1413 ± 125 11,308
Rate of true positive BC (%) 10.2 ± 1.5 10.2 9.4 ± 1.1 9.4
No. of false positive BC (n) NA‏[3] NA 1273 ± 132 10190
Rate of false positive BC (%) NA NA 8.4±1.3 8.4
Rate/1000 admissions‏[4]
Enterobacteriaceae 12.7±2 3394 13.2 4309
E. coli 5.5±1 1494 6.4 2102
S. aureus 4.7±0.9 1240 3.3 1238
K. pneumoniae 3±0.8 779 3.3 1063
Enterococcus spp. 2.3±0.7 631 2.9 939
P. aeruginosa 1.9±0.5 488 1.5 505
S. pneumoniae 1.7±0.4 447 2.1 681
Enterobacter spp. 1.3±0.5 338 1.1 347
Acinetobacter spp. 1±0.3 298 1.5 482
P. mirabilis 1±0.2 260 1.4 449

טבלה 2: Enterobacteriaceae, producing Extended-Spectrum β-lactamases (ESBL) (n,%)2002-2008‏[5]

טבלה 2א: Collected in the Emergency Department

Year All Enterobacteriaceae N=2330 (%) E.coli N=1336 (%)

K.pneumoniae N=341 (%)

P.mirabilis N=228 (%)
2002 42/286 (15) 16/151 (11) 13/54 (24) 5/21 (24)
2003 35/322 (11) 15/191 (8) 15/47 (32) 4/28 (14)
2004 41/307 (13) 17/165 (10) 8/40 (20) 9/33 (27)
2005 42/354 (11) 20/218 (9) 9/49 (18) 11/38 (29)
2006 61/319 (19) 28/198 (14) 17/37 (46) 7/32 (22)
2007 84/348 (24) 46/190 (24) 10/44 (23) 19/33 (58)
2008 79/357 (22) 40/208 (19) 18/59 (30) 10/37 (27)
Total 393/2330 (16) 185/1336 (14) 92/341 (27) 67/228 (29)

טבלה 2ב': Collected from hospitalized patients

Year All Enterobacteriaceae N=1562 (%) E.coli N=347 (%) K.pneumoniae N=495 (%) P.mirabilis N=143 (%)
2002 54/147 (37) 7/35 (20) 34/53 (64) 2/6 (33)
2003 62/213 (29) 10/46 (22) 22/55 (40) 13/26 (50)
2004 64/183 (35) 11/48 (23) 28/51 (55) 10/18 (56)
2005 93/234 (40) 22/58 (38) 35/68 (51) 17/30 (57)
2006 97/267 (36) 13/54 (24) 54/86 (63) 15/29 (52)
2007 58/244 (24) 12/44 (27) 35/99 (35) 7/14 (50)
2008 75/243 (31) 13/57 (23) 29/77 (37) 4/16 (25)
Total 512/1562 (33) 88/347 (25) 239/495 (48) 70/143 (49)

טבלה 3: Enterobacteriaceae – antimicrobial susceptibilities (%) 2001-2008. Breakdown by source of patient

מקרא
  • Amp-Ampicillin;
  • Amk-Amikacin;
  • Aug-Amoxycillin-clavulanate,
  • Carbap-Carbapenems;
  • Caz-Ceftazidime;
  • Cef-Cefazolin;
  • Chl-Chloramphenicol;
  • Cip-Ciprofloxacin;
  • Col-colistin (polymyxin-B);
  • Cpm,-Cefepime,
  • Cro-Ceftriaxone;
  • Cxm-Cefuroxime;
  • Ert-Ertapenem (since 2005);
  • Gen-Gentamicin;
  • Imp-Imipenem;
  • Mez-Mezlocillin (up to mid-2006);
  • Meth-Methicillin; Sep-Cotrimoxazole;
  • Tob-Tobramycin;
  • Tzp-Piperacillin-Tazobactam;
  • Van-Vancomycin.


Group n Penicillins Carbap.‏[6] Cephalosporins Aminogly. Other
Aug Mez Tzp Ert Imp Cef Cxm Cro Caz Cpm Gen Amk Chl Sep Cip Col
≤48hr 3447 66 49 91 99 99 61 75 83 85 85 83 97 79 62 73 86
>48hr 1898 39 42 76 92 98 32 47 60 62 67 66 89 58 52 59 78

טבלה 4

Table 4a: Antimicrobial susceptibilities (%) of selected organisms (in alphabetical order), isolated from blood cultures, 2001-2008.

Enterobacter species
Organism n Amp Amk Aug Caz Cef Chl Cip Col Cpm Cro Cxm Ert Gen Imp Mez Sep Tzp
Acinetobacter baumanii 589 44 13 9 98 24 62 17 19
Citrobacter species 189 15 97 74 85 74 85 91 100 87 86 82 100 94 100 84 81 94
E. coli 2753 34 98 68 86 64 86 74 100 86 84 79 100 83 100 37 61 93
189 15 97 74 85 74 91 100 87 86 82 99 94 100 84 81 94
Enterococcus faecalis# 410 95

Klebsiella oxytoca 119 98 87 93 86 92 94 99 93 91 90 94 100 81 89 94 Klebsiella pneumoniae 1161 81 51 54 44 52 53 99 57 52 49 85 61 95 43 48 60 Morganella morganii 109 95 11 78 6 49 56 91 83 17 60 99 69 48 94 Proteus mirabilis 569 25 98 66 73 44 42 48 67 66 61 99 63 99 41 37 98 Pseudomonas aeruginosa 691 93 91 71 100 92 83 89 76 91 Salmonella* 108 97 100 98 73 100 Serratia marcescens 164 98 85 78 89 86 88 4 100 88 99 88 73 93 S. aureus ** 1646 Steno- trophomonas 156 79 89 82 86 78 88 90 90 Streptococcus pneumoniae* **

הערות שוליים

  1. ↑ 1.0 1.1 Data for 1990-2000 were manually computerized by volunteers from microbiology records; data for 2001-2008 were obtained with the cubes computer program.
  2. ↑ BC, blood cultures
  3. ↑ NA, not available
  4. ↑ Trend statistical analysis demonstrated an absence of significant changes in annual incidence of any of these organisms for 1990-2000.
  5. ↑ * Routine testing for ESBL was initiated in 2002
  6. ↑ Susceptibilities of Imipenem (Imp) and Meropenem (Mer) are not identical, but similar. Since 2006, the microbiology laboratory determines susceptibility to both imipenem and meropenem

ביבליוגרפיה

לטבלה 1
  1. Yinnon AM, Schlesinger Y, Gabbay D, Rudensky B. Analysis of 5 years of bacteraemias: importance of stratification of microbial susceptibilities by source of patients. J Infect 1007 Jul; 35(1):17-23.
  2. Raveh D, Rudensky B, Schlesinger Y, Benenson S, Yinnon AM. Susceptibility trends in bacteraemias: Analysis of 7544 patient-unique bacteraemic episodes spanning 11 years (1990-2000). J Hosp Infect 2003.
לטבלה 2
  1. Friedmann R, Raveh D, Zartzer E, Rudensky B, Broide E, Attias D, Yinnon AM. Prospective evaluation of colonization with extended-spectrum beta-lactamase (ESBL)-producing enterobacteriaceae among patients at hospital admission and of subsequent colonization with ESBL-producing enterobacteriaceae among patients during hospitalization. Infect Control Hosp Epidemiol. 2009;30(6):534-42.
  2. Raveh D, Yinnon AM, Broide E, Rudensky B. Susceptibilities of ESBL-producing Enterobacteriaceae to ertapenem, meropenem and piperacillin-tazobactam with and without clavulanic acid. Chemotherapy. 2007;53(3):185-9.
  3. Cohen MJ, Anshelevich O, Raveh D, Broide E, Rudensky B, Yinnon AM. Acquisition of multidrug-resistant organisms among hospital patients hospitalized in beds adjacent to critically ill patients. Infect Control Hosp Epidemiol. 2006;27(7):675-81.
  4. Henshke-Bar-Meir R, Yinnon AM, Rudensky B, Attias D, Schlesinger Y, Raveh D. Assessment of the clinical significance of production of extended-spectrum beta-lactamases (ESBL) by Enterobacteriaceae. Infection. 2006;34(2):66-74.
  5. Tallis E, Rudensky B, Attias D, Raveh D, Schlesinger Y, Yinnon AM. In-vitro activity of cefepime and other broad-spectrum antimicrobials against several groups of gram-negative bacilli and Staphylococcus aureus. Diagn Microbiol Infect Dis. 1999;35(2):121-6

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