加拿大医院 22746 株病原体的抗菌药敏试验结果：CANWARD 2007-11 研究结果。

Antimicrobial susceptibility of 22746 pathogens from Canadian hospitals: results of the CANWARD 2007-11 study.

机构信息

Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada R3E 0J9.

出版信息

J Antimicrob Chemother. 2013 May;68 Suppl 1:i7-22. doi: 10.1093/jac/dkt022.

DOI:10.1093/jac/dkt022

PMID:23587781

Abstract

OBJECTIVES

The purpose of the CANWARD study was to assess the antimicrobial activity of a variety of available agents against 22,746 pathogens isolated from patients in Canadian hospitals between 2007 and 2011.

METHODS

Between 2007 and 2011, 27,123 pathogens were collected from tertiary-care centres from across Canada; 22,746 underwent antimicrobial susceptibility testing using CLSI broth microdilution methods. Patient demographic data were also collected.

RESULTS

Of the isolates collected, 45.2%, 29.6%, 14.8% and 10.4% were from blood, respiratory, urine and wound specimens, respectively. Patient demographics were as follows: 54.4%/45.6% male/female, 12.8% ≤ 17 years old, 45.1% 18-64 years old and 42.1% ≥65 years old. Isolates were obtained from patients in medical and surgical wards (37.8%), emergency rooms (25.7%), clinics (18.0%) and intensive care units (18.5%). The three most common pathogens were Escherichia coli (20.1%), Staphylococcus aureus [methicillin-susceptible S. aureus and methicillin-resistant S. aureus (MRSA)] (20.0%) and Pseudomonas aeruginosa (8.0%), which together accounted for nearly half of the isolates obtained. Susceptibility rates (SRs) for E. coli were 100% meropenem, 99.9% tigecycline, 99.7% ertapenem, 97.7% piperacillin/tazobactam, 93.7% ceftriaxone, 90.5% gentamicin, 77.9% ciprofloxacin and 73.4% trimethoprim/sulfamethoxazole. Twenty-three percent of the S. aureus were MRSA. SRs for MRSA were 100% daptomycin, 100% linezolid, 100% telavancin, 99.9% vancomycin, 99.8% tigecycline, 92.2% trimethoprim/sulfamethoxazole and 48.2% clindamycin. SRs for P. aeruginosa were 90.1% amikacin, 93.1% colistin, 84.0% piperacillin/tazobactam, 83.5% ceftazidime, 82.6% meropenem, 72.0% gentamicin and 71.9% ciprofloxacin.

CONCLUSIONS

The CANWARD surveillance study has provided important data on the antimicrobial susceptibility of pathogens commonly causing infections in Canadian hospitals.

摘要

目的

CANWARD 研究的目的是评估 2007 年至 2011 年间从加拿大医院患者中分离的 22746 种病原体的各种现有药物的抗菌活性。

方法

2007 年至 2011 年间，从加拿大各地的三级护理中心收集了 27123 种病原体；对 22746 种病原体进行了 CLSI 肉汤微量稀释法的药敏试验。还收集了患者的人口统计学数据。

结果

收集的分离物中，45.2%、29.6%、14.8%和 10.4%分别来自血液、呼吸道、尿液和伤口标本。患者的人口统计学特征如下：54.4%/45.6%为男性/女性，12.8%≤17 岁，45.1%为 18-64 岁，42.1%≥65 岁。分离物来自内科和外科病房（37.8%）、急诊室（25.7%）、诊所（18.0%）和重症监护病房（18.5%）。三种最常见的病原体是大肠埃希菌（20.1%）、金黄色葡萄球菌[甲氧西林敏感金黄色葡萄球菌和耐甲氧西林金黄色葡萄球菌（MRSA）]（20.0%）和铜绿假单胞菌（8.0%），这三种病原体约占分离物的一半。大肠埃希菌的药敏率（SRs）为：美罗培南 100%、替加环素 99.9%、厄他培南 99.7%、哌拉西林/他唑巴坦 97.7%、头孢曲松 93.7%、庆大霉素 90.5%、环丙沙星 77.9%和复方磺胺甲噁唑 73.4%。23%的金黄色葡萄球菌为 MRSA。MRSA 的 SR 为：达托霉素 100%、利奈唑胺 100%、替拉凡星 100%、万古霉素 99.9%、替加环素 99.8%、复方磺胺甲噁唑 92.2%和克林霉素 48.2%。铜绿假单胞菌的 SR 为：阿米卡星 90.1%、黏菌素 93.1%、哌拉西林/他唑巴坦 84.0%、头孢他啶 83.5%、美罗培南 82.6%、庆大霉素 72.0%、环丙沙星 71.9%。