International Health Management Associates, Inc., Schaumburg, Illinois, USA.
Clin Ther. 2013 Jun;35(6):872-7. doi: 10.1016/j.clinthera.2013.03.022. Epub 2013 Apr 25.
The Study for Monitoring Antimicrobial Resistance Trends is an ongoing global surveillance program that has monitored the susceptibilities of Gram-negative bacilli from inpatient urinary tract infections (UTIs) since late 2009.
This analysis reports on the in vitro susceptibility of 2,135 isolates collected by 24 US sites from hospitalized patients with UTIs between 2009 and 2011.
Minimum inhibitory concentrations and susceptibility were determined according to the guidelines of the Clinical and Laboratory Standards Institute.
Of the isolates collected, 88.6% (1,892) were Enterobacteriaceae, which included 48.9% (n = 1,045) Escherichia coli, 14.5% (n = 310) Klebsiella pneumoniae, 6.4% (n = 136) Proteus mirabilis, 2.5% (n = 54) Klebsiella oxytoca, and 16.3% (n = 347) other Enterobacteriaceae species. Overall, 6.8% of E coli, 10.3% of K pneumoniae, 3.7% of P mirabilis, and 11.1% of K oxytoca isolates were extended-spectrum β-lactamase-producing strains. Of the Enterobacteriaceae isolates, 67.5% were community associated and 26.9% were hospital associated (5.7% had no demographics). Highest overall rates of activity for the study period were seen with amikacin, ertapenem, and imipenem. The least active antimicrobials tested were ampicillin-sulbactam, ciprofloxacin, and levofloxacin.
Ertapenem, imipenem, and amikacin were the most active study drugs against extended-spectrum β-lactamase-producing strains, although the activity against extended-spectrum β-lactamase-producing K pneumoniae did not exceed 69% throughout the study period. The results of the Study for Monitoring Antimicrobial Resistance Trends surveillance study document the rates of antimicrobial resistance in UTI pathogens in the United States, which can assist health care practitioners in selecting the appropriate treatment for UTIs.
监测抗菌药物耐药趋势研究是一个正在进行的全球监测项目，自 2009 年末以来，该项目一直在监测住院患者尿路感染（UTI）中革兰氏阴性杆菌的药敏情况。
本分析报告了 2009 年至 2011 年期间，24 个美国站点从住院 UTI 患者中收集的 2135 株分离株的体外药敏情况。
根据临床和实验室标准协会的指南，测定最小抑菌浓度和药敏性。
在所收集的分离株中，88.6%（1892 株）为肠杆菌科，其中包括 48.9%（n=1045）大肠埃希菌、14.5%（n=310）肺炎克雷伯菌、6.4%（n=136）奇异变形杆菌、2.5%（n=54）产酸克雷伯菌和 16.3%（n=347）其他肠杆菌科。总的来说，6.8%的大肠埃希菌、10.3%的肺炎克雷伯菌、3.7%的奇异变形杆菌和 11.1%的产酸克雷伯菌分离株为产超广谱β-内酰胺酶菌株。肠杆菌科分离株中，67.5%为社区相关，26.9%为医院相关（5.7%无人口统计学资料）。在整个研究期间，对氨基糖苷类药物阿米卡星、厄他培南和亚胺培南的活性最高。测试的最不活跃的抗菌药物是氨苄西林-舒巴坦、环丙沙星和左氧氟沙星。
尽管在整个研究期间，产超广谱β-内酰胺酶的肺炎克雷伯菌对厄他培南、亚胺培南和阿米卡星的活性未超过 69%，但厄他培南、亚胺培南和阿米卡星是针对产超广谱β-内酰胺酶菌株最有效的研究药物。监测抗菌药物耐药趋势研究的结果记录了美国 UTI 病原体的抗菌药物耐药率，这有助于临床医生为 UTI 选择合适的治疗方法。
