Reacher M H, Shah A, Livermore D M, Wale M C, Graham C, Johnson A P, Heine H, Monnickendam M A, Barker K F, James D, George R C
Public Health Laboratory Service Communicable Disease Surveillance Centre, London NW9 5EQ.
BMJ. 2000 Jan 22;320(7229):213-6. doi: 10.1136/bmj.320.7229.213.
Determination of causes, trends, and antibiotic resistance in reports of bacterial pathogens isolated from blood in England and Wales from 1990 to 1998.
Description of bacterial isolates from blood, judged to be clinically significant by microbiology staff, reported to the Communicable Disease Surveillance Centre.
Microbiology laboratories in England and Wales.
Patients yielding clinically significant isolates from blood.
Frequency and Poisson regression analyses for trend of reported causes of bacteraemia and proportions of antibiotic resistant isolates.
There was an upward trend in total numbers of reports of bacteraemia. The five most cited organisms accounted for over 60% of reports each year. There was a substantial increase in the proportion of reports of Staphylococcus aureus resistant to methicillin, Streptococcus pneumoniae resistance to penicillin and erythromycin, and Enterococcus faecalis and Enterococcus faecium resistance to vancomycin. No increase was seen in resistance of Escherichia coli to gentamicin.
Reports from laboratories provide valuable information on trends and antibiotic resistance in bacteraemia and show a worrying increase in resistance to important antibiotics.
确定1990年至1998年在英格兰和威尔士从血液中分离出的细菌病原体报告中的病因、趋势及抗生素耐药性。
对微生物学工作人员判定具有临床意义的血液细菌分离株进行描述,并向传染病监测中心报告。
英格兰和威尔士的微生物实验室。
血液中分离出具有临床意义分离株的患者。
对菌血症报告病因趋势及抗生素耐药分离株比例进行频率和泊松回归分析。
菌血症报告总数呈上升趋势。每年提及最多的五种微生物占报告的60%以上。耐甲氧西林金黄色葡萄球菌、对青霉素和红霉素耐药的肺炎链球菌以及对万古霉素耐药的粪肠球菌和屎肠球菌报告比例大幅增加。大肠杆菌对庆大霉素的耐药性未见增加。
实验室报告提供了关于菌血症趋势和抗生素耐药性的宝贵信息,并显示出对重要抗生素耐药性令人担忧的增加。