Sader Helio S, Jones Ronald N
JMI Laboratories Inc., 345 Beaver Kreek Centre, Suite A, North Liberty, IA 52317, USA.
Int J Antimicrob Agents. 2005 Feb;25(2):95-109. doi: 10.1016/j.ijantimicag.2004.10.002.
The frequency of occurrence and antimicrobial susceptibility patterns of 3059 non-enteric Gram-negative bacilli (NGB), other than Pseudomonas aeruginosa and Acinetobacter spp., consecutively collected as part of the SENTRY Antimicrobial Surveillance Program (1997-2003) were reviewed. During this period, a total of 221,084 bacterial isolates were collected from several clinical specimens worldwide, including 25,305 (11.5%) NGB. Acinetobacter spp. and P. aeruginosa accounted for 82.7% of the NGB isolates and have been excluded from this analysis. The antimicrobial susceptibility results of 3509 strains from 13 species/genera have been analysed in this review. The isolates were tested by reference broth microdilution methods in three central laboratories using common reagents and procedures. More than 30 antimicrobial agents were tested and the results for the 18 most active compounds are reported here. Stenotrophomonas maltophilia (2076 strains; 59.2%) was the most frequently isolated pathogen in this group, followed by Aeromonas spp. (385 strain; 11.0%), Burkholderia cepacia (269 strains; 7.7%), Pseudomonas fluorescens/putida (253 strains; 7.2%) and Alcaligenes spp. (236 strains; 6.7%). All other species/genera accounted for less than 3% of the isolates analysed. The antimicrobial agents with the most consistent activity against the NGB evaluated in the present study were the newer fluoroquinolones gatifloxacin and levofloxacin with 84.1 and 84.9% susceptibility overall. Trimethoprim/sulphamethoxazole was active against 85.3% of the isolates tested, but showed reduced activity against P. fluorescens/putida (22.1% susceptibility). Antimicrobial susceptibility varied significantly between species/genera and the geographical regions evaluated. Thus, proper identification and quantitative susceptibility testing will be required for the treatment of NGB infections. Extensive worldwide surveillance programmes remain extremely important to guide empirical antimicrobial therapy for rarely isolated pathogens and also for pathogens that are not routinely tested due to the lack of standardised susceptibility testing methods.
回顾了作为哨兵抗菌监测计划（1997 - 2003年）一部分连续收集的3059株非肠道革兰氏阴性杆菌（NGB）（不包括铜绿假单胞菌和不动杆菌属）的发生频率和抗菌药敏模式。在此期间，共从全球多个临床标本中收集了221,084株细菌分离株，其中包括25,305株（11.5%）NGB。不动杆菌属和铜绿假单胞菌占NGB分离株的82.7%，已被排除在本分析之外。本综述分析了来自13个种/属的3509株菌株的抗菌药敏结果。这些分离株在三个中心实验室采用常用试剂和程序通过参考肉汤微量稀释法进行检测。检测了30多种抗菌药物，本文报告了18种最具活性化合物的结果。嗜麦芽窄食单胞菌（2076株；59.2%）是该组中最常分离出的病原体，其次是气单胞菌属（385株；11.0%）、洋葱伯克霍尔德菌（269株；7.7%）、荧光假单胞菌/恶臭假单胞菌（253株；7.2%）和产碱菌属（236株；6.7%）。所有其他种/属占所分析分离株的比例均不到3%。在本研究中，对所评估的NGB活性最一致的抗菌药物是新型氟喹诺酮类药物加替沙星和左氧氟沙星，总体药敏率分别为84.1%和84.9%。甲氧苄啶/磺胺甲恶唑对85.3%的受试分离株有活性，但对荧光假单胞菌/恶臭假单胞菌的活性降低（药敏率为22.1%）。不同种/属以及所评估的地理区域之间的抗菌药敏存在显著差异。因此，治疗NGB感染需要进行准确的鉴定和定量药敏试验。广泛的全球监测计划对于指导针对罕见分离病原体以及由于缺乏标准化药敏试验方法而未常规检测的病原体的经验性抗菌治疗仍然极其重要。
