伊朗鲍曼不动杆菌的抗生素耐药性：已发表文献的系统评价
Antibiotic Resistance of Acinetobacter baumannii in Iran: A Systemic Review of the Published Literature.
作者信息
Moradi Jale, Hashemi Farhad B, Bahador Abbas
机构信息
Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
出版信息
Osong Public Health Res Perspect. 2015 Apr;6(2):79-86. doi: 10.1016/j.phrp.2014.12.006. Epub 2015 Feb 19.
OBJECTIVES
Acinetobacter baumannii is a bacterium responsible for health care-associated infections, and it frequently develops multiple drug resistance (MDR). The prevalence of antibiotic-resistant A. baumannii in Iran has increased, and this may cause significant clinical problems. Therefore, in order to elucidate the development of antibiotic resistance, we performed a systematic review of the literature published on antibiotic-resistant A. baumannii reported in Iran.
METHODS
Thirty-six publications that met the criteria for inclusion were reviewed from an initial 87 papers. Selected papers published between 2008 and September 2014, were categorized on the basis of the sample collecting year been between 2001 and 2013.
RESULTS
Analysis of data revealed that, in general, there was an increase in antimicrobial resistance. During the initial time point of these studies (2001-2007) there was a high rate of resistance to all antibiotics, with the exception of carbapenems, lipopeptides, and aminoglycosides that had a low resistance rate in comparison with the others. Also, the resistance rate was increased in one group of these three antimicrobial groups from 2010 to 2013. In particular, there was an increase in resistance to carbapenems (imipenem and meropenem) from 2010-2011 and 2012-2013, whereas no significant change in the resistance rate of the other two antimicrobial groups (lipopeptides and aminoglycosides) during the study time was observed, although we did observe certain trends in amikacin (aminoglycoside group antibiotic) between 2011-2012 and 2012-2013.
CONCLUSION
These findings indicate that antimicrobial resistance of A. baumannii in Iran has increased, which may very well affect the antimicrobial resistance of this organism worldwide. Based on these results, novel prevention and treatment strategies against A. baumannii infections are warranted. Furthermore, these data may assist in revising treatment guidelines and regional policies in care units to slow the emergence of antimicrobial resistance.
目的
鲍曼不动杆菌是一种引起医疗保健相关感染的细菌，且它经常产生多重耐药性（MDR）。伊朗耐抗生素鲍曼不动杆菌的患病率有所上升，这可能会导致严重的临床问题。因此，为了阐明抗生素耐药性的发展情况，我们对伊朗报道的耐抗生素鲍曼不动杆菌的相关文献进行了系统综述。
方法
从最初的87篇论文中筛选出36篇符合纳入标准的出版物进行综述。所选论文发表于2008年至2014年9月之间，根据样本收集年份在2001年至2013年之间进行分类。
结果
数据分析显示，总体而言，抗菌药物耐药性有所增加。在这些研究的初始时间点（2001 - 2007年），除碳青霉烯类、脂肽类和氨基糖苷类抗生素外，对所有抗生素的耐药率都很高，与其他抗生素相比，这三类抗生素的耐药率较低。此外，在2010年至2013年期间，这三类抗菌药物中的一组耐药率有所上升。特别是，2010 - 2011年和2012 - 2013年对碳青霉烯类（亚胺培南和美罗培南）的耐药性增加，而在研究期间，其他两类抗菌药物（脂肽类和氨基糖苷类）的耐药率没有显著变化，尽管我们在2011 - 2012年和2012 - 2013年观察到阿米卡星（氨基糖苷类抗生素）有一定趋势。
结论
这些发现表明，伊朗鲍曼不动杆菌的抗菌药物耐药性有所增加，这很可能会影响全球该菌株的抗菌药物耐药性。基于这些结果，有必要制定针对鲍曼不动杆菌感染的新型预防和治疗策略。此外，这些数据可能有助于修订护理单位的治疗指南和区域政策，以减缓抗菌药物耐药性的出现。
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