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中国多黏菌素E的抗菌药物耐药性监测

Antimicrobial resistance surveillance of doripenem in China.

作者信息

Li Yun, Lv Yuan, Xue Feng, Zheng Bo, Liu Jian, Zhang Jia

机构信息

Institute of Clinical Pharmacology, Peking University First Hospital, Beijing, China.

出版信息

J Antibiot (Tokyo). 2015 Aug;68(8):496-500. doi: 10.1038/ja.2015.25. Epub 2015 Apr 8.

Abstract

To investigate the antibacterial resistance to doripenem in China and to understand the distribution trends of resistant bacteria. All the clinical isolates were collected from hospitals and the susceptibility tests were performed using the agar dilution method recommended by the Clinical Laboratory Standards Institute (CLSI) central laboratory. The susceptibility of the isolates to antimicrobial agents was determined using the CLSI (2014) or European Committee on Antimicrobial Susceptibility Testing (EUCAST) (2013) guidelines. A total of 4047 pathogenic strains were isolated from 18 tertiary hospitals in 18 cities across China between July 2011 and June 2012. MIC results indicated that the vast majority of Enterobacteriaceae maintained high susceptibility to doripenem, with a lower resistance rate (1.9%) than that observed for other drugs tested. In the case of non-fermenting Gram-negative isolates, the resistance rate of Pseudomonas aeruginosa was 16.2%, which was less than that of imipenem and meropenem, and the Acinetobacter baumannii doripenem resistance rate was 67.4%. Doripenem also showed good in vitro activity against other the bacteria tested. This study suggests that the gradual increase in carbapenem nonsusceptible Enterobacteriaceae should be monitored carefully alongside the increasing multidrug-resistant and extensively drug-resistant A. baumannii.

摘要

调查中国多黏菌素对多黏菌素的抗菌耐药性,并了解耐药菌的分布趋势。所有临床分离株均从医院收集,并使用临床实验室标准协会(CLSI)中央实验室推荐的琼脂稀释法进行药敏试验。使用CLSI(2014年)或欧洲抗菌药物敏感性试验委员会(EUCAST)(2013年)指南确定分离株对抗菌药物的敏感性。2011年7月至2012年6月期间,从中国18个城市的18家三级医院共分离出4047株病原菌。MIC结果表明,绝大多数肠杆菌科细菌对多黏菌素保持高度敏感性,耐药率(1.9%)低于其他受试药物。在非发酵革兰阴性菌分离株中,铜绿假单胞菌的耐药率为16.2%,低于亚胺培南和美罗培南,鲍曼不动杆菌对多黏菌素的耐药率为67.4%。多黏菌素对其他受试细菌也显示出良好的体外活性。本研究表明,应密切监测碳青霉烯不敏感肠杆菌科细菌的逐渐增加,以及多重耐药和广泛耐药鲍曼不动杆菌的增加。

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