Benoit S R, Ellingson K D, Waterman S H, Pearson M L
Division of Healthcare Quality Promotion,National Center For Emerging & Zoonotic Infectious Diseases,CDC, Atlanta, GA,USA.
Division of Global Migration And Quarantine,National Center For Emerging & Zoonotic Infectious Diseases,CDC, Atlanta, GA,USA.
Epidemiol Infect. 2014 Nov;142(11):2378-87. doi: 10.1017/S095026881300318X. Epub 2013 Dec 17.
Antimicrobial resistance (AR) is a growing problem worldwide and international travel, cross-border migration, and antimicrobial use may contribute to the introduction or emergence of AR. We examined AR rates and trends along the US-Mexico border by analysing microbiology data from eight US hospitals in three states bordering Mexico. Microbiology data were ascertained for the years 2000-2006 and for select healthcare and community pathogens including, three Gram-negative (Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae) and three Gram-positive (Staphylococcus aureus, Enterococcus, Streptococcus pneumoniae) pathogens and 10 antimicrobial-pathogen combinations. Resistance was highest in S. aureus (oxacillin resistance 45·7%), P. aeruginosa (quinolone resistance 22·3%), and E. coli (quinolone resistance 15·6%); six (60%) of the 10 antimicrobial-pathogen combinations studied had a significantly increasing trend in resistance over the study period. Potential contributing factors in the hospital and community such as infection control practices and antimicrobial use (prescription and non-prescription) should be explored further in the US-Mexico border region.
抗菌药物耐药性(AR)在全球范围内是一个日益严重的问题,国际旅行、跨境移民以及抗菌药物的使用可能会导致AR的传入或出现。我们通过分析来自美国与墨西哥接壤的三个州的八家美国医院的微生物学数据,研究了美墨边境沿线的AR发生率和趋势。确定了2000年至2006年期间的微生物学数据,以及包括三种革兰氏阴性菌(大肠杆菌、铜绿假单胞菌、肺炎克雷伯菌)和三种革兰氏阳性菌(金黄色葡萄球菌、肠球菌、肺炎链球菌)病原体和10种抗菌药物-病原体组合在内的特定医疗保健和社区病原体的数据。金黄色葡萄球菌(苯唑西林耐药率45.7%)、铜绿假单胞菌(喹诺酮耐药率22.3%)和大肠杆菌(喹诺酮耐药率15.6%)的耐药率最高;在研究的10种抗菌药物-病原体组合中,有六种(60%)在研究期间耐药性呈显著上升趋势。美国-墨西哥边境地区应进一步探索医院和社区中的潜在促成因素,如感染控制措施和抗菌药物的使用(处方和非处方)。