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2005 年至 2016 年瑞士耐碳青霉烯鲍曼不动杆菌的流行情况。

Prevalence of carbapenem-resistant Acinetobacter baumannii from 2005 to 2016 in Switzerland.

机构信息

Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, CH-3001, Bern, Switzerland.

出版信息

BMC Infect Dis. 2018 Apr 3;18(1):159. doi: 10.1186/s12879-018-3061-5.

Abstract

BACKGROUND

We describe the prevalence of invasive carbapenem-resistant Acinetobacter spp. isolated from 2005 to 2016 in different regions of Switzerland.

METHODS

Using the Swiss Antibiotic Resistance Centre (anresis) database that includes data from 70% of all hospitalized patients and one third of all ambulatory practitioners in Switzerland, we analysed the number of carbapenem-susceptible and resistant Acinetobacter spp. isolated from blood or cerebrospinal fluid, and further described their temporal and regional fluctuations.

RESULTS

From 2005 to 2016, 58 cases of resistant or intermediate strains to carbapenem were observed among 632 cases of invasive Acinetobacter. Multivariable analyses indicated that the number of carbapenem-resistant isolates (mean 4.8 ± sd 2.12) and carbapenem resistance rates per region per annum (8.4% ± 13.9%) were low and stable over the studied period. Large fluctuations were observed at the regional level, with e.g. the North East region displaying resistance rates twice as high as that found in other regions.

CONCLUSION

Despite a relatively stable number of carbapenem-resistant Acinetobacter isolates in Switzerland, our results suggest the existence of a diverse pool of A. baumannii species in hospital settings, and confirm the implication of carbapenem-resistant Acinetobacter calcoaceticus-Acinetobacter baumannii (ACB) complex in the vast majority of clinical infections and nosocomial outbreaks with notable regional fluctuations.

摘要

背景

我们描述了 2005 年至 2016 年瑞士不同地区分离出的侵袭性碳青霉烯类耐药不动杆菌属的流行情况。

方法

利用包括瑞士抗生素耐药中心(anresis)数据库的数据,该数据库包含了瑞士 70%住院患者和三分之一的门诊医生的数据,我们分析了从血液或脑脊液中分离出的碳青霉烯类敏感和耐药不动杆菌属的数量,并进一步描述了它们的时间和地区波动情况。

结果

2005 年至 2016 年,在 632 例侵袭性不动杆菌属中观察到 58 例对碳青霉烯类耐药或中介的菌株。多变量分析表明,碳青霉烯类耐药分离株的数量(平均值 4.8±标准差 2.12)和每个地区每年的碳青霉烯类耐药率(8.4%±13.9%)在研究期间较低且稳定。在地区水平上观察到了较大的波动,例如东北地区的耐药率是其他地区的两倍。

结论

尽管瑞士碳青霉烯类耐药不动杆菌属的分离株数量相对稳定,但我们的结果表明,医院环境中存在着多样化的鲍曼不动杆菌种池,并且证实了碳青霉烯类耐药鲍曼不动杆菌-鲍曼不动杆菌复合体(ACB)复合物在绝大多数临床感染和医院感染暴发中的作用,同时也存在显著的地区波动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62cd/5883518/0ec797313393/12879_2018_3061_Fig1_HTML.jpg

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