Guarascio Anthony J, Brickett Laura M, Porter Timothy J, Lee Nancy D, Gorse Erin E, Covvey Jordan R
1 Division of Pharmacy Practice, Duquesne University School of Pharmacy, Pittsburgh, PA, USA.
2 Allegheny General Hospital, Pittsburgh, PA, USA.
J Pharm Pract. 2019 Feb;32(1):19-27. doi: 10.1177/0897190017735425. Epub 2017 Oct 10.
: Hospitals and other facilities utilize antibiograms as tools for optimal antibiotic selection. Currently, no measures compare broad trends on the regional level, despite interest for more comprehensive data, particularly for antibiotic-resistant ESKAPE organisms.
: To collect and compare regional health-care facility antibiogram data for ESKAPE organisms to form a cumulative antibiogram.
: Health-care facilities were identified using the publicly accessible Pennsylvania Department of Health web site. Facilities were contacted by phone from June 2015 to 2016 to ascertain participation/consent for the study. An electronic questionnaire ascertained baseline facility characteristics. Facilities provided quantitative antibiotic susceptibility data via antibiograms. Antibiogram data were synthesized as cumulative susceptibilities, stratified by urban/suburban versus rural location.
: Forty-five facilities were included in the study (n = 18 urban/suburban, n = 27 rural). The overall prevalence of methicillin-resistant S aureus was 41.5%, stratified at 40.6% and 43.3% in urban/suburban and rural facilities, respectively ( P < .001). Vancomycin-resistant Enterococcus prevalence was 18.8% overall, with 27.7% in urban/suburban and 14.0% in rural facilities ( P < .001). Generally, lower susceptibility rates were found for high-utilization beta-lactams across gram-negative organisms in urban/suburban facilities.
: Development of a regional cumulative antibiogram that targets key ESKAPE pathogens is feasible, while observed trends may help aid future antimicrobial stewardship efforts.
医院及其他医疗机构将抗菌谱作为优化抗生素选择的工具。目前，尽管人们对更全面的数据，尤其是针对耐抗生素的ESKAPE菌属有兴趣，但尚无措施可比较区域层面的总体趋势。
收集并比较医疗机构针对ESKAPE菌属的抗菌谱数据，以形成累积抗菌谱。
利用宾夕法尼亚州卫生部网站上公开的信息确定医疗机构。在2015年6月至2016年期间通过电话联系这些机构，以确定其参与研究/同意参与研究。通过电子问卷确定机构的基线特征。各机构通过抗菌谱提供定量的抗生素敏感性数据。抗菌谱数据综合为累积敏感性，按城市/郊区与农村地区分层。
45家机构纳入研究（18家城市/郊区机构，27家农村机构）。耐甲氧西林金黄色葡萄球菌的总体患病率为41.5%，城市/郊区机构和农村机构分别为40.6%和43.3%（P < .001）。耐万古霉素肠球菌的总体患病率为18.8%，城市/郊区机构为27.7%，农村机构为14.0%（P < .001）。一般而言，城市/郊区机构中革兰阴性菌对高使用量β-内酰胺类抗生素的敏感性率较低。
针对关键ESKAPE病原体制定区域累积抗菌谱是可行的，观察到的趋势可能有助于未来的抗菌管理工作。
