韩国碳青霉烯类、阿米卡星和氟喹诺酮类耐药不动杆菌属和铜绿假单胞菌分离株的进一步增加：2009 年 KONSAR 研究。
Further increases in carbapenem-, amikacin-, and fluoroquinolone-resistant isolates of Acinetobacter spp. and P. aeruginosa in Korea: KONSAR study 2009.
机构信息
Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.
出版信息
Yonsei Med J. 2011 Sep;52(5):793-802. doi: 10.3349/ymj.2011.52.5.793.
PURPOSE
The increasing prevalence of antimicrobial resistant bacteria has become a serious worldwide problem. The aim of this study was to analyze antimicrobial resistance data generated in 2009 by hospitals and commercial laboratories participating in the Korean Nationwide Surveillance of Antimicrobial Resistance program.
MATERIALS AND METHODS
Susceptibility data were collected from 24 hospitals and two commercial laboratories. In the analysis, resistance did not include intermediate susceptibility. Duplicate isolates were excluded from the analysis of hospital isolates, but not from the commercial laboratory isolates.
RESULTS
Among the hospital isolates, methicillin-resistant Staphylococcus aureus, penicillin G-nonsusceptible Streptococcus pneumoniae based on meningitis breakpoint, and ampicillin- resistant Enterococcus faecium remained highly prevalent. The proportion of vancomycin-resistant E. faecium gradually increased to 29%. Ceftazidime-resistant Escherichia coli and Klebsiella pneumoniae increased to 17% and 33%, respectively, and fluoroquinolone-resistant K. pneumoniae, Acinetobacter spp. and Pseudomonas aeruginosa increased to 33%, 67% and 39%, respectively. Amikacin-resistant Acinetobacter spp. increased to 48%. Imipenem-resistant Acinetobacter spp. and P. aeruginosa increased to 51% and 26%, respectively. Higher resistance rates were observed in intensive care unit (ICU) isolates than in non-ICU isolates among the isolates from hospitals. Resistance rates were higher in hospital isolates than in clinic isolates among the isolates from commercial laboratories.
CONCLUSION
Among the hospital isolates, ceftazidime-resistant K. pneumoniae and fluoroquinolone- resistant K. pneumoniae, Acinetobacter spp., and P. aeruginosa further increased. The increase in imipenem resistance was slight in P. aeruginosa, but drastic in Acinetobacter spp. The problematic antimicrobial-organism combinations were much more prevalent among ICU isolates.
目的
抗菌药物耐药菌的不断增加已成为一个严重的全球性问题。本研究旨在分析参与韩国全国抗菌药物耐药性监测计划的医院和商业实验室于 2009 年生成的抗菌药物耐药性数据。
材料与方法
从 24 家医院和 2 家商业实验室收集药敏数据。分析中，耐药性不包括中介度耐药。医院分离株的分析中排除重复分离株，但商业实验室分离株的分析中未排除。
结果
在医院分离株中，耐甲氧西林金黄色葡萄球菌、青霉素 G 中介度敏感的脑膜炎折点肺炎链球菌和氨苄西林耐药屎肠球菌仍高度流行。万古霉素耐药屎肠球菌的比例逐渐增加至 29%。头孢他啶耐药大肠埃希菌和肺炎克雷伯菌分别增加至 17%和 33%，氟喹诺酮耐药肺炎克雷伯菌、不动杆菌属和铜绿假单胞菌分别增加至 33%、67%和 39%。阿米卡星耐药不动杆菌属增加至 48%。亚胺培南耐药不动杆菌属和铜绿假单胞菌分别增加至 51%和 26%。医院分离株中 ICU 分离株的耐药率高于非 ICU 分离株，商业实验室分离株中医院分离株的耐药率高于门诊分离株。
结论
在医院分离株中，头孢他啶耐药肺炎克雷伯菌和氟喹诺酮耐药肺炎克雷伯菌、不动杆菌属和铜绿假单胞菌进一步增加。铜绿假单胞菌对亚胺培南的耐药性略有增加，但不动杆菌属的耐药性急剧增加。问题抗菌药物-病原体组合在 ICU 分离株中更为常见。
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