Department of Clinical Microbiology, University Hospital for Infectious Diseases, Mirogojska 8, 10000 Zagreb, Croatia.
Int J Antimicrob Agents. 2012 Feb;39(2):115-23. doi: 10.1016/j.ijantimicag.2011.10.010. Epub 2011 Dec 19.
Here we report on the antimicrobial resistance amongst Gram-negative isolates (excluding Acinetobacter spp.) collected from blood culture sources at European study sites as part of the global Tigecycline Evaluation and Surveillance Trial (T.E.S.T.) from the study start in 2004 until August 2009. All isolates were collected and tested for minimum inhibitory concentrations using Clinical and Laboratory Standards Institute methodology. Over the collection period, extended-spectrum β-lactamase (ESBL) production was recorded in 21.1% of Klebsiella pneumoniae, 2.6% of Klebsiella oxytoca and 11.3% of Escherichia coli, primarily in Croatia, Greece, Hungary, Italy, Poland, Romania and the Slovak Republic. ESBL rates stabilised amongst K. pneumoniae over 2006-2009, but doubled amongst E. coli in 2008-2009. The patterns of antimicrobial resistance changed accordingly for both organisms. Generally, Greece had the highest antimicrobial resistance for K. pneumoniae, Italy for E. coli, Serratia marcescens and Enterobacter spp., and Croatia for Pseudomonas aeruginosa. High resistance rates amongst K. pneumoniae were also seen in Croatia and Italy. Imipenem resistance amongst K. pneumoniae was reported exclusively in Greece (13.8%); amongst other Enterobacteriaceae, imipenem resistance was absent or low. Similarly, meropenem resistance was low amongst the Enterobacteriaceae except K. pneumoniae from Greece (42.6%). Across Europe, the most active antimicrobial agents against the Enterobacteriaceae were tigecycline, amikacin and the carbapenems, each with <10% resistance each year. Against the other antimicrobials, significant increases in non-susceptibility were reported for K. pneumoniae and E. coli, both important causative pathogens of bacteraemia.
在这里，我们报告了在 2004 年研究开始至 2009 年 8 月期间，从欧洲研究点的血培养源中收集的革兰氏阴性分离株（不包括不动杆菌属）的抗生素耐药情况，这些分离株是作为全球替加环素评估和监测试验（T.E.S.T.）的一部分进行收集和检测的，最低抑菌浓度的检测采用了临床和实验室标准协会的方法。在收集期间，产超广谱β-内酰胺酶（ESBL）的肺炎克雷伯菌、产酸克雷伯菌和大肠埃希菌的比例分别为 21.1%、2.6%和 11.3%，主要发生在克罗地亚、希腊、匈牙利、意大利、波兰、罗马尼亚和斯洛伐克。2006-2009 年期间，肺炎克雷伯菌的 ESBL 率保持稳定，但 2008-2009 年期间，大肠埃希菌的 ESBL 率增加了一倍。这两种细菌的抗生素耐药模式也相应发生了变化。一般来说，希腊的肺炎克雷伯菌耐药率最高，意大利的大肠埃希菌、粘质沙雷菌和肠杆菌属耐药率最高，克罗地亚的铜绿假单胞菌耐药率最高。克罗地亚和意大利的肺炎克雷伯菌也出现了较高的耐药率。在希腊仅报告了肺炎克雷伯菌对亚胺培南的耐药性（13.8%）；其他肠杆菌科对亚胺培南的耐药性缺失或较低。同样，除了来自希腊的肺炎克雷伯菌（42.6%）外，其他肠杆菌科对美罗培南的耐药率也较低。在整个欧洲，针对肠杆菌科最有效的抗菌药物是替加环素、阿米卡星和碳青霉烯类，每年的耐药率都<10%。对其他抗菌药物，肺炎克雷伯菌和大肠埃希菌的非敏感性显著增加，这两种菌都是菌血症的重要病原体。
