Reynolds Rosy, Hope Russell, Williams Laura
Department of Medical Microbiology, Southmead Hospital, Southmead Road, Bristol BS10 5NB, UK.
J Antimicrob Chemother. 2008 Nov;62 Suppl 2:ii15-28. doi: 10.1093/jac/dkn349.
The British Society for Antimicrobial Chemotherapy (BSAC) Bacteraemia and Respiratory Resistance Surveillance Programmes are designed for long-term surveillance of antimicrobial resistance in key pathogens of bloodstream and community-acquired respiratory infection in the UK and Ireland. This paper describes their methods in detail.
Sentinel laboratories across the UK and Ireland contributed up to a fixed quota of isolates of defined bacterial groups. Collecting laboratories were compared with national benchmarks for size of Hospital Trust and distribution of bacteraemia pathogens. A central laboratory for each programme confirmed the identification of isolates, measured MICs by the BSAC agar dilution method and undertook further testing by standard methods. The variability of the MIC method was assessed by repeated annual testing of a panel of control isolates. Classification as susceptible, intermediate or resistant was by BSAC and European Committee on Antimicrobial Susceptibility Testing breakpoints. Statistical analysis was adjusted for inter-centre variation using random effects logistic regression.
Thirty-two laboratories contributed 16 550 respiratory isolates from 1999-2000 to 2006-07; 30 laboratories contributed 15 812 bacteraemia isolates from 2001 to 2006. Although large and teaching hospitals were over-represented, the pattern of bacteraemia organisms seen in the collecting laboratories in England and Wales was similar to that in national data reported to the Health Protection Agency. Replicate MIC measurements showed that >/=90% agreed within +/-1, and >/=98% within +/-2, doubling dilutions.
These surveillance programmes have provided reliable information on antimicrobial susceptibility in the UK and Ireland over six and eight seasons, respectively, so far. Detailed results showing non-susceptibility trends, and relationships with potential predictive factors, are presented in six linked papers in this Supplement.
英国抗菌化疗协会（BSAC）的菌血症和呼吸道耐药性监测计划旨在对英国和爱尔兰血流感染及社区获得性呼吸道感染的关键病原体的抗菌药物耐药性进行长期监测。本文详细描述了其方法。
英国和爱尔兰的哨点实验室提供了固定配额的特定细菌群体的分离株。将收集实验室与医院信托规模和菌血症病原体分布的国家基准进行比较。每个计划的中央实验室确认分离株的鉴定，通过BSAC琼脂稀释法测量最低抑菌浓度（MIC），并采用标准方法进行进一步检测。通过对一组对照分离株进行年度重复检测来评估MIC方法的变异性。根据BSAC和欧洲抗菌药物敏感性试验委员会的断点将其分类为敏感、中介或耐药。使用随机效应逻辑回归对中心间变异进行统计分析调整。
32个实验室在1999 - 2000年至2006 - 07年期间提供了16550株呼吸道分离株；30个实验室在2001年至2006年期间提供了15812株菌血症分离株。尽管大型医院和教学医院的占比过高，但英格兰和威尔士收集实验室中观察到的菌血症病原体模式与向健康保护局报告的国家数据中的模式相似。重复的MIC测量显示，≥90%的结果在±1倍稀释内一致，≥98%在±2倍稀释内一致。
到目前为止，这些监测计划分别在六个和八个季节中提供了关于英国和爱尔兰抗菌药物敏感性的可靠信息。本增刊中的六篇相关论文展示了显示非敏感性趋势以及与潜在预测因素关系的详细结果。
