Bell Jan M, Gottlieb Thomas, Daley Denise A, Coombs Geoffrey W
University of Adelaide, Adelaide, South Australia, Australia.
Concord Hospital, Concord, New South Wales.
Commun Dis Intell (2018). 2018;42. Epub 2018 Dec 17.
The Australian Group on Antimicrobial Resistance (AGAR) performs regular period-prevalence studies to monitor changes in antimicrobial resistance in selected enteric Gram-negative pathogens. The 2015 survey was the third year to focus on blood stream infections, and included Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter species. Seven thousand three hundred and thirty species, comprising Enterobacteriaceae (6,567, 89.6%), P. aeruginosa (660, 9.0%) and Acinetobacter species (103, 1.4%), were tested using commercial automated methods (Vitek® 2, BioMérieux; Phoenix™, BD) and results were analysed using Clinical and Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints (January 2016). Of the key resistances, non-susceptibility to the third-generation cephalosporin, ceftriaxone, was found in 10.6%/10.6% of E. coli (CLSI/EUCAST criteria) and 5.9%/5.9% of Klebsiella pneumoniae, and 8.4%/8.4% K. oxytoca. Non-susceptibility rates to ciprofloxacin were 12.6%/13.6% for E. coli, 3.9%/7.2% for K. pneumoniae, 0.4%/0.4% for K. oxytoca, 3.4%/4.0% for Enterobacter cloacae, and 6.3%/6.5% for Pseudomonas aeruginosa. Resistance rates to piperacillin-tazobactam were 2.8%/6.3%, 3.5%/6.4%, 8.9%/10.2%, 15.9%/20.6%, and 7.1%/13.9% for the same four species respectively. Twenty-two isolates were shown to harbour a carbapenemase gene, 14 blaIMP, four blaOXA-48, one blaKPC, one blaGES, one blaNDM+OXA-48, and one blaIMP+VIM.
澳大利亚抗菌药物耐药性监测小组（AGAR）定期开展时期患病率研究，以监测特定肠道革兰氏阴性病原体的抗菌药物耐药性变化。2015年的调查是聚焦血流感染的第三年，涉及肠杆菌科、铜绿假单胞菌和不动杆菌属。共检测了7330株菌，其中肠杆菌科6567株（89.6%）、铜绿假单胞菌660株（9.0%）、不动杆菌属103株（1.4%），采用商业自动化方法（Vitek® 2，生物梅里埃公司；Phoenix™，BD公司）进行检测，并依据临床和实验室标准协会（CLSI）及欧洲抗菌药物敏感性试验委员会（EUCAST）的折点标准（2016年1月）分析结果。在主要耐药情况方面，根据CLSI/EUCAST标准，大肠埃希菌对第三代头孢菌素头孢曲松的不敏感率为10.6%/10.6%，肺炎克雷伯菌为5.9%/5.9%，产酸克雷伯菌为8.4%/8.4%。大肠埃希菌对环丙沙星的不敏感率为12.6%/13.6%，肺炎克雷伯菌为3.9%/7.2%，产酸克雷伯菌为0.4%/0.4%，阴沟肠杆菌为3.4%/4.0%，铜绿假单胞菌为6.3%/6.5%。上述四种菌对哌拉西林-他唑巴坦的耐药率分别为2.8%/6.3%、3.5%/6.4%、8.9%/10.2%、15.9%/20.6%。共发现22株菌携带碳青霉烯酶基因，其中14株携带blaIMP，4株携带blaOXA - 48，1株携带blaKPC，1株携带blaGES，1株携带blaNDM + OXA - 48，1株携带blaIMP + VIM。
