Munson Erik, Hueppchen Erin, Zeman Heather
College of Health Sciences, Marquette University, Milwaukee, Wisconsin.
Wisconsin Clinical Laboratory Network Laboratory Technical Advisory Group, Madison, Wisconsin.
WMJ. 2018 Aug;117(3):116-121.
Antimicrobial resistance merits surveillance because of its impact on quality health care. Past surveillance efforts in Wisconsin involved generation of a statewide antibiogram on the basis of antibiogram compilation. However, this modality of surveillance possesses limitations.
To characterize Wisconsin antimicrobial susceptibility patterns and elucidate geographic variation in antimicrobial resistance, a statewide surveillance network was created. Clinical microbiology laboratories submitted clinically significant bacterial isolates to a centralized testing facility for performance of standardized broth microdilution testing. Analyzed data included organism-specific susceptible, intermediate, and resistant percentages, along with median and 90th percentile minimum inhibitory concentration values.
In comparison of 378 isolates of and 279 isolates of , susceptibility rates of were generally lower than , particularly in areas of Wisconsin bordering Lake Winnebago. resistance rates were generally higher in northern Wisconsin. From a 211-isolate collection of , it was determined that higher rates of antimicrobial resistance were found in Southeast Wisconsin. On a geographic basis, susceptibility rates within a 212-isolate collection of were fairly consistent. However, Southcentral Wisconsin experienced increased rates of erythromycin resistance with this organism, as well as increased aminoglycoside resistance trending with other organisms. Antimicrobial agents with generally lower susceptibility rates statewide included fluoroquinolones and trimethoprim-sulfamethoxazole.
A surveillance program has been initiated in Wisconsin that not only summarizes susceptibility patterns but also has the capacity to indicate potential emerging resistance trends. Future annual studies can begin to characterize antimicrobial resistance in Wisconsin on a temporal basis.
由于抗菌药物耐药性对优质医疗保健产生影响，因此值得进行监测。威斯康星州过去的监测工作包括根据抗菌谱汇编生成全州范围的抗菌谱。然而，这种监测方式存在局限性。
为了描述威斯康星州的抗菌药物敏感性模式并阐明抗菌药物耐药性的地理差异，建立了一个全州范围的监测网络。临床微生物学实验室将具有临床意义的细菌分离株提交给一个集中检测设施，以进行标准化肉汤微量稀释检测。分析的数据包括特定菌株的敏感、中介和耐药百分比，以及最低抑菌浓度的中位数和第90百分位数。
在比较378株[具体菌株1]和279株[具体菌株2]时，[具体菌株1]的药敏率普遍低于[具体菌株2]，特别是在与温尼贝戈湖接壤的威斯康星州地区。[具体菌株3]的耐药率在威斯康星州北部普遍较高。从211株[具体菌株4]的样本中确定，威斯康星州东南部的抗菌药物耐药率较高。在地理基础上，212株[具体菌株5]样本中的药敏率相当一致。然而，威斯康星州中南部该菌株的红霉素耐药率有所上升，其他菌株的氨基糖苷类耐药率也呈上升趋势。全州药敏率普遍较低的抗菌药物包括氟喹诺酮类和甲氧苄啶-磺胺甲恶唑。
威斯康星州已启动一项监测计划，该计划不仅能总结药敏模式，还能指出潜在的新出现的耐药趋势。未来的年度研究可以开始从时间角度描述威斯康星州的抗菌药物耐药性。
