Rodloff Arne C, Dowzicky Michael J
Institut für Medizinische Mikrobiologie und Infektionsepidemiologie, Leipzig, Germany.
Chemotherapy. 2017;62(1):1-11. doi: 10.1159/000445022. Epub 2016 May 24.
European centers (n = 226) involved in the Tigecycline Evaluation and Surveillance Trial (TEST, 2004-2014) submitted data and bacterial isolates.
Minimal inhibitory concentrations and susceptibility were determined using Clinical and Laboratory Standards Institute methods and European Committee on Antimicrobial Susceptibility Testing breakpoints.
The rates of the following resistant pathogens increased from 2004 to 2014: extended-spectrum β-lactamase (ESBL)-positive Escherichia coli (from 8.9 to 16.9%), multidrug-resistant Acinetobacter baumannii complex (from 15.4 to 48.5%), and ESBL-positive Klebsiella pneumoniae (from 17.2 to 23.7%). The rate of methicillin-resistant Staphylococcus aureus was 27.5% in 2004 and 28.9% in 2014. Resistance to the carbapenems (imipenem and meropenem) was 37.4 and 14.5% for A. baumannii complex and Pseudomonas aeruginosa, respectively. Carbapenem resistance was ≤4.3% among the Enterobacteriaceae and 0.2% against Streptococcus pneumoniae. The resistance to tigecycline ranged between 7.4% against ESBL-producing K. pneumoniae and 0.0% against S. aureus.
The carbapenems and tigecycline were active against Enterobacteriaceae. Agents with activity against A. baumannii complex and P. aeruginosa are limited. The carbapenems, tigecycline, linezolid, and vancomycin were active against Gram-positive organisms.
参与替加环素评估与监测试验(TEST,2004 - 2014年)的欧洲中心(n = 226)提交了数据和细菌分离株。
采用临床和实验室标准协会方法及欧洲抗菌药物敏感性试验委员会的断点值来测定最低抑菌浓度和敏感性。
以下耐药病原体的发生率在2004年至2014年期间有所上升:产超广谱β-内酰胺酶(ESBL)的大肠埃希菌(从8.9%升至16.9%)、多重耐药鲍曼不动杆菌复合体(从15.4%升至48.5%)以及产ESBL的肺炎克雷伯菌(从17.2%升至23.7%)。耐甲氧西林金黄色葡萄球菌的发生率在2004年为27.5%,2014年为28.9%。鲍曼不动杆菌复合体和铜绿假单胞菌对碳青霉烯类(亚胺培南和美罗培南)的耐药率分别为37.4%和14.5%。肠杆菌科细菌对碳青霉烯类的耐药率≤4.3%,肺炎链球菌对其耐药率为0.2%。对替加环素的耐药率在产ESBL的肺炎克雷伯菌中为7.4%,而对金黄色葡萄球菌为0.0%。
碳青霉烯类和替加环素对肠杆菌科细菌有活性。对鲍曼不动杆菌复合体和铜绿假单胞菌有活性的药物有限。碳青霉烯类、替加环素、利奈唑胺和万古霉素对革兰氏阳性菌有活性。