中國醫藥大學機構典藏 China Medical University Repository, Taiwan:Item 310903500/29791
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    题名: Preliminary experience using a polyetheretherketone (PEEK) cage in the treatment of cervical disc disease
    作者: Cho, DY;Liau, WR;Lee, WY;Liu, JT;Chiu, CL;Sheu, PC
    贡献者: 附設醫院神經外科;China Med Coll Hosp, Dept Neurosurg, Taichung, Taiwan
    日期: 2002
    上传时间: 2010-09-24 14:42:41 (UTC+8)
    出版者: LIPPINCOTT WILLIAMS & WILKINS
    摘要: Strains of extended-spectrum P-lactamase-producing Klebsiella pneumoniae (ESBL-KP) have emerged worldwide. Concomitant ciprofloxacin resistance with ESBL production in K. pneumoniae isolates would severely restrict treatment options. Among 39 (18.5%) of 211 ESBL-KP isolates resistant to ciprofloxacin (MIC, greater than or equal to4 mug/ ml), 37 (95%) were high level resistant (MIC, greater than or equal to16 mug/ml). These isolates were also cross resistant to the newer fluoroquinolones, including levofloxacin, gatifloxacin, gemifloxacin, and garenoxacin (BMS 284756). Sitafloxacin was most active against these ciprofloxacin-resistant ESBL-KP isolates with MICs for 67% of the isolates being less than or equal to2 mug/ml. The molecular epidemiology of these multiresistant isolates was investigated by automated ribotyping and pulsed-field gel electrophoresis (PFGE). Ribotyping identified 18 different strains among the 39 ciprofloxacin-resistant ESBL-KP isolates. The majority (67%) of these isolates were contained in six ribo-groups which were further confirmed by PFGE. The distribution of the six major strains of ciprofloxacin-resistant ESBL-KP within Taiwan included one (ribogroup 255.3-PFGE type E) with a nationwide distribution and several institution-specific strains. Interhospital cooperation appears necessary, with strict infection control practices coupled with restriction of fluoroquinolone and extended-spectrum P-lactam use to control both the major epidemic strain and the more diverse strains observed within individual institutions.
    關聯: NEUROSURGERY 51(6):1343-1349
    显示于类别:[台中附設醫院] 期刊論文

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