Var Susette K, Hadi Rouba, Khardori Nancy M
Department of Internal Medicine, Eastern Virginia Medical School, 825 Fairfax Ave, Hofheimer Hall, Ste 572, Norfolk, VA 23507, USA.
Ann Clin Microbiol Antimicrob. 2015 Apr 9;14:22. doi: 10.1186/s12941-015-0080-6.
We studied recent antibiograms (2010 to 2011) from 12 hospitals in the Hampton Roads area, Virginia, that refer patients to a tertiary-care facility affiliated with Eastern Virginia Medical School. The data was compiled into a regional antibiogram, and sensitivity rates of common isolates from the tertiary-care facility (central) were compared to those of referring hospitals grouped by locale. Staphylococcus aureus was the most common Gram- positive and E. coli the most common Gram- negative organism grown from clinical samples in the area. Overall 53% of S.aureus isolates were resistant to oxacillin. There was a broad scatter of MIC (minimum inhibitory concentration) for vancomycin within the susceptibility range, and MIC of 4 μg/mL was reported in 2012. Penicillin resistance was seen in 50% and erythromycin resistance in 45% of Streptococcus pneumoniae. Vancomycin resistance was seen in 75% of Enterococcus faecium and 2% of Enterococcus faecalis respectively. Acinetobacter baumannii was the most resistant Gram negative organism in the data compiled. Among the Escherichia coli, 26%, 44% and 52%were resistant to Trimethoprim/Sulfamethoxazole ( SXT) ampicillin- sulbactam and ampicillin respectively. We found significant differences in methodology, interpretation and antibiotic panels used by area laboratories. Based on these findings, we are now prospectively following resistance patterns in the tertiary-care facility, sharing data, and creating a consistent approach to antimicrobial susceptibility testing in the region.
我们研究了弗吉尼亚州汉普顿锚地地区12家医院（这些医院会将患者转诊至与东弗吉尼亚医学院相关的三级护理机构）2010年至2011年的近期抗菌谱。数据被汇编成一份区域抗菌谱，并将三级护理机构（中心）常见分离株的敏感性率与按地区分组的转诊医院的敏感性率进行比较。金黄色葡萄球菌是该地区临床样本中培养出的最常见革兰氏阳性菌，大肠杆菌是最常见革兰氏阴性菌。该地区总体上53%的金黄色葡萄球菌分离株对苯唑西林耐药。在敏感范围内，万古霉素的最低抑菌浓度（MIC）分布较广，2012年报告的MIC为4μg/mL。50%的肺炎链球菌对青霉素耐药，45%对红霉素耐药。粪肠球菌和屎肠球菌对万古霉素的耐药率分别为75%和2%。鲍曼不动杆菌是汇编数据中耐药性最强的革兰氏阴性菌。在大肠杆菌中，分别有26%、44%和52%对甲氧苄啶/磺胺甲恶唑（SXT）、氨苄西林-舒巴坦和氨苄西林耐药。我们发现该地区各实验室在方法、解读和抗生素检测项目方面存在显著差异。基于这些发现，我们目前正在前瞻性地跟踪三级护理机构中的耐药模式，共享数据，并制定该地区一致的抗菌药物敏感性检测方法。
