南非夸祖鲁-纳塔尔省ESKAPE病原体的抗生素耐药性趋势：一项五年回顾性分析

Antibiotic resistance trends of ESKAPE pathogens in Kwazulu-Natal, South Africa: A five-year retrospective analysis.

作者信息

Ramsamy Yogandree, Essack Sabiha Y, Sartorius Benn, Patel Miriam, Mlisana Koleka P

机构信息

Department of Medical Microbiology, School of Laboratory Medicine and Medical Sciences, Antimicrobial Research Unit, University of KwaZulu-Natal, National Health Laboratory Services, Durban, South Africa.

Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.

出版信息

Afr J Lab Med. 2018 Dec 6;7(2):887. doi: 10.4102/ajlm.v7i2.887. eCollection 2018.

BACKGROUND

To combat antimicrobial resistance, the World Health Organization developed a global priority pathogen list of antibiotic-resistant bacteria for prioritisation of research and development of new, effective antibiotics.

OBJECTIVE

This study describes a five-year resistance trend analysis of the ESKAPE pathogens: spp., from Kwazulu-Natal, South Africa.

METHODS

This retrospective study used National Health Laboratory Services data on 64 502 ESKAPE organisms isolated between 2011 and 2015. Susceptibility trends were ascertained from minimum inhibitory concentrations and interpreted using Clinical and Laboratory Standards Institute guidelines.

RESULTS

was most frequently isolated ( = 24, 495, 38%), followed by ( = 14, 282, 22%). Decreasing rates of methicillin-resistant (28% to 18%, < 0.001) and increasing rates of extended spectrum beta-lactamase producing (54% to 65% < 0.001) were observed. Carbapenem resistance among and spp. was less than 6% during 2011-2014, but increased from 4% in 2014 to 16% in 2015 ( < 0.001) among increased ( = 0.002), but resistance to anti-pseudomonal antimicrobials decreased from 2013 to 2015. High rates of multi-drug resistance were observed in (> 70%).

CONCLUSION

This study describes the magnitude of antimicrobial resistance in KwaZulu-Natal and provides a South African perspective on antimicrobial resistance in the global priority pathogen list, signalling the need for initiation or enhancement of antimicrobial stewardship and infection control measures locally.

背景

为应对抗菌药物耐药性问题，世界卫生组织制定了一份全球重点病原菌清单，列出了对抗生素耐药的细菌，以便确定新型有效抗生素研发的优先顺序。

目的

本研究描述了对南非夸祖鲁 - 纳塔尔省的ESKAPE病原菌（粪肠球菌、屎肠球菌、金黄色葡萄球菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌）进行的为期五年的耐药性趋势分析。

方法

这项回顾性研究使用了国家卫生实验室服务中心2011年至2015年间分离出的64502株ESKAPE病原菌的数据。通过最低抑菌浓度确定药敏趋势，并根据临床和实验室标准协会的指南进行解读。

结果

粪肠球菌分离频率最高（n = 24495，占38%），其次是屎肠球菌（n = 14282，占22%）。观察到耐甲氧西林金黄色葡萄球菌的比例下降（从28%降至18%，P < 0.001），产超广谱β - 内酰胺酶肺炎克雷伯菌的比例上升（从54%升至65%，P < 0.001）。2011 - 2014年间，鲍曼不动杆菌和铜绿假单胞菌对碳青霉烯类药物的耐药率低于6%，但鲍曼不动杆菌的耐药率从2014年的4%升至2015年的16%（P < 0.001），铜绿假单胞菌的耐药率上升（P = 0.002），但对抗假单胞菌抗菌药物的耐药率从2013年至2015年有所下降。粪肠球菌的多重耐药率较高（> 70%）。