Department of Infectious Disease Epidemiology, Robert Koch Institute, Seestr. 10, 13353 Berlin, Germany.
Postgraduate Training for Applied Epidemiology, Department of Infectious Disease Epidemiology, Robert Koch Institute, Seestr. 10, 13353 Berlin, Germany.
Antimicrob Resist Infect Control. 2018 Jun 5;7:71. doi: 10.1186/s13756-018-0362-9. eCollection 2018.
Carbapenem resistance in is of significant public health concern and recently spread across several countries. We investigated the extent of carbapenem non-susceptibility in isolates in Germany.
We analysed 2011-2016 data from the German Antimicrobial Resistance Surveillance (ARS) System, which contains routine data of antimicrobial susceptibility testing from voluntarily participating German laboratories. isolates tested resistant or intermediate against an antibiotic were classified as non-susceptible.
We included 154,734 isolates from 655 hospitals in the analysis. Carbapenem non-susceptibility in isolates was low in Germany 0.63% (95% CI 0.51-0.76%). However, in continuously participating hospitals the number of isolates almost doubled and we found evidence for a slowly increasing trend for non-susceptibility (OR = 1.20 per year, 95% CI 1.09-1.33, < 0.001). Carbapenem non-susceptibility was highest among isolates from patients aged 20-39 in men but not in women. Moreover, carbapenem non-susceptibility was more frequently reported for isolates from tertiary care, specialist care, and prevention and rehabilitation care hospitals as well as from intensive care units. Co-resistance of carbapenem non-susceptible isolates against antibiotics such as tigecycline, gentamicin, and co-trimoxazole was common. Co-resistance against colistin was 13.3% (95% CI 9.8-17.9%) in carbapenem non-susceptible isolates.
Carbapenem non-susceptibility in isolates in Germany is still low. However, it is slowly increasing and in the light of the strong increase of isolates over the last year this poses a significant challenge to public health. Continued surveillance to closely monitor trends as well as infection control and antibiotic stewardship activities are necessary to preserve treatment options.
碳青霉烯类耐药性在 中引起了严重的公共卫生关注，最近已传播到多个国家。我们调查了德国 分离株中碳青霉烯类药物不敏感的程度。
我们分析了 2011 年至 2016 年德国抗菌药物耐药监测系统（ARS）的数据，该系统包含来自自愿参与的德国实验室的常规抗菌药物敏感性检测数据。对一种抗生素表现出耐药或中介的 分离株被归类为不敏感。
我们将 655 家医院的 154734 株 分离株纳入分析。德国 分离株的碳青霉烯类药物不敏感率较低，为 0.63%（95%CI：0.51-0.76%）。然而，在持续参与的医院中， 分离株的数量几乎翻了一番，并且我们发现不敏感率呈缓慢上升趋势（每年增加 1.20，95%CI：1.09-1.33， < 0.001）。在男性中，年龄在 20-39 岁的患者的 分离株中碳青霉烯类药物不敏感率最高，但在女性中并非如此。此外，在三级护理、专科护理、预防和康复护理医院以及重症监护病房中，碳青霉烯类药物不敏感的 分离株更常报告对抗生素如替加环素、庆大霉素和复方磺胺甲噁唑的耐药性。碳青霉烯类药物不敏感的 分离株对多粘菌素的耐药率为 13.3%（95%CI：9.8-17.9%）。
德国 分离株的碳青霉烯类药物不敏感率仍然较低。然而，它正在缓慢上升，鉴于过去一年中 分离株的大量增加，这对公共卫生构成了重大挑战。需要继续进行监测，以密切监测趋势，以及感染控制和抗生素管理活动，以保留治疗选择。
