Zur Gila, Gurevich Bella, Elad Daniel
Veterinary Teaching Hospital, The Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, PO Box 12, Rehovot, 76100, Israel.
Department of Clinical Bacteriology and Mycology, Kimron Veterinary Institute, Veterinary Services, Ministry of Agriculture, Beit Dagan, 50250, Israel.
Vet Dermatol. 2016 Dec;27(6):468-e125. doi: 10.1111/vde.12382.
Antimicrobial resistance within bacteria continues to present therapeutic challenges. One presumed risk factor for increased rates of resistance is prior exposure to antimicrobial drugs.
To examine the impact of time since most recent exposure, the number of prior antimicrobial exposures and duration of use on antimicrobial resistance rates in Staphylococcus pseudintermedius isolates.
Inclusion of a case in the study required laboratory isolation of S. pseudintermedius from a clinical specimen. Antibiograms and information regarding prior antimicrobial exposures were extracted from the medical records of dogs diagnosed with pyoderma or otitis externa.
Meticillin resistance (MR) was identified in 48.1% of isolates. Recent use of beta-lactam antimicrobials was associated with increased odds of resistance to meticillin (P < 0.001) and fluoroquinolones (P < 0.001). Antimicrobial therapy within 1 month prior to sampling was also associated with MR (60.7%; P = 0.009) and multidrug resistance (61.9%; P = 0.029). The number of prior exposures to beta-lactams or fluoroquinolones were associated with resistance to these same classes (P = 0.001 and 0.02, respectively) and to other antimicrobial classes (P = 0.016 for resistance to fluoroquinolones following treatment with beta-lactams and P = 0.015 for MR following treatment with fluoroquinolones). Longer treatment duration with beta-lactam drugs was associated with higher proportion of MR (P = 0.004).
Treatment based upon culture and susceptibility testing is highly recommended for dogs that have received multiple antimicrobial drug exposures or that were treated within the preceding month. This may be especially important when the prior therapeutic regimen included a drug from the beta-lactam or fluoroquinolone classes.
细菌的抗菌药物耐药性持续带来治疗挑战。耐药率增加的一个假定风险因素是先前接触过抗菌药物。
研究距最近一次接触的时间、先前抗菌药物接触的次数以及使用持续时间对中间型葡萄球菌分离株抗菌药物耐药率的影响。
纳入本研究的病例需从临床标本中通过实验室分离出中间型葡萄球菌。从诊断为脓皮病或外耳炎的犬只病历中提取药敏谱及有关先前抗菌药物接触的信息。
48.1%的分离株鉴定为耐甲氧西林（MR）。近期使用β-内酰胺类抗菌药物与对甲氧西林（P<0.001）和氟喹诺酮类（P<0.001）耐药的几率增加相关。采样前1个月内的抗菌治疗也与MR（60.7%；P=0.009）和多重耐药（61.9%；P=0.029）相关。先前接触β-内酰胺类或氟喹诺酮类药物的次数与对这些同类药物（分别为P=0.001和0.02）以及其他抗菌药物类别（β-内酰胺类治疗后对氟喹诺酮类耐药为P=0.016，氟喹诺酮类治疗后对MR为P=0.015）的耐药相关。β-内酰胺类药物较长的治疗持续时间与较高比例的MR相关（P=0.004）。
对于接受过多次抗菌药物治疗或在前一个月内接受过治疗的犬只，强烈建议根据培养和药敏试验进行治疗。当先前的治疗方案包括β-内酰胺类或氟喹诺酮类药物时，这可能尤为重要。
