Sader Helio S, Mendes Rodrigo E, Le Jennifer, Denys Gerald, Flamm Robert K, Jones Ronald N
JMI Laboratories, North Liberty, Iowa.
Skaggs School of Pharmacy, University of California San Diego, San Diego, California.
Open Forum Infect Dis. 2019 Mar 15;6(Suppl 1):S14-S23. doi: 10.1093/ofid/ofy263. eCollection 2019 Mar.
The SENTRY Antimicrobial Surveillance Program monitors the frequency of occurrence and antimicrobial susceptibility of organisms from various infection types worldwide. In this investigation, we evaluated the antimicrobial susceptibility of isolates collected worldwide over 20 years (1997-2016).
A total of 65 993 isolates were consecutively collected (1 per infection episode) from North America (NA; n = 34 626; 2 nations), Europe (EUR; n = 19 123; 23 nations), the Asia-Pacific region (APAC; n = 7111; 10 nations), and Latin America (LATAM; n = 5133; 7 nations) and tested for susceptibility using reference broth microdilution methods. Resistant subgroups included multidrug-resistant (MDR; nonsusceptible to ≥3 classes of agents) and extensively drug-resistant (XDR; nonsusceptible to ≥5 classes).
The isolates were collected primarily from respiratory tract infections (77.3%), and 25.4% were from pediatric patients. Penicillin susceptibility (≤0.06 mg/L) rates varied from 70.7% in EUR to 52.4% in APAC for all years combined. In NA, there was a slight improvement in susceptibility for the first few years of the program, from 66.5% in 1997-1998 to 69.4% in 1999-2000, followed by a decline until 2011-2012 (57.0%). Similar declines in penicillin susceptibility rates were observed in all regions, with the lowest rates of 67.3% in EUR (2011-2012), 41.6% in the APAC region (2007-2008), and 48.2% in LATAM (2013-2014). These declines were followed by improved susceptibility rates in all regions in later program years, with susceptibility rates of 55.6% to 71.8% in 2015-2016 (65.8% overall). Susceptibility rates to ceftriaxone, erythromycin, clindamycin, tetracycline, and trimethoprim-sulfamethoxazole followed a similar pattern, with a decrease in the first 12-14 years and a continued increase in the last 6-8 years of the program. MDR and XDR frequencies were highest in APAC (49.8% and 17.3% overall, respectively) and lowest in LATAM (10.8% and 1.9% overall, respectively). The most active agents for MDR/XDR isolates were ceftaroline (99.7%/99.1% susceptible), tigecycline (96.8%/95.9% susceptible), linezolid (100.0%/100.0% susceptible), and vancomycin (100.0%/100.0% susceptible).
susceptibility to many antibiotics increased in all regions in the last few years, and these increases may be related to PCV13 immunization, which was introduced in 2010.
哨兵抗菌监测计划监测全球各种感染类型中微生物的发生频率和抗菌药敏性。在本研究中，我们评估了20年间（1997 - 2016年）全球收集的分离株的抗菌药敏性。
共连续收集了65993株分离株（每次感染发作1株），分别来自北美（NA；n = 34626；2个国家）、欧洲（EUR；n = 19123；23个国家）、亚太地区（APAC；n = 7111；10个国家）和拉丁美洲（LATAM；n = 5133；7个国家），并采用参考肉汤微量稀释法检测药敏性。耐药亚组包括多重耐药（MDR；对≥3类药物不敏感）和广泛耐药（XDR；对≥5类药物不敏感）。
分离株主要来自呼吸道感染（77.3%），25.4%来自儿科患者。所有年份合并计算，青霉素敏感性（≤0.06 mg/L）率在欧洲为70.7%，在亚太地区为52.4%。在北美，该计划最初几年敏感性略有提高，从1997 - 1998年的66.5%提高到1999 - 2000年的69.4%，随后下降至2011 - 2012年（57.0%）。所有地区均观察到青霉素敏感性率有类似下降，欧洲最低率为67.3%（2011 - 2012年），亚太地区为41.6%（2007 - 2008年），拉丁美洲为48.2%（2013 - 2014年）。这些下降之后，在该计划后期所有地区的敏感性率均有所提高，2015 - 2016年敏感性率为55.6%至71.8%（总体为65.8%）。对头孢曲松、红霉素、克林霉素、四环素和甲氧苄啶 - 磺胺甲恶唑的敏感性率遵循类似模式，在该计划的前12 - 14年下降，在最后6 - 8年持续上升。多重耐药和广泛耐药频率在亚太地区最高（总体分别为49.8%和17.3%），在拉丁美洲最低（总体分别为10.8%和1.9%）。对多重耐药/广泛耐药分离株最有效的药物是头孢洛林（敏感性99.7%/99.1%）、替加环素（敏感性96.8%/95.9%）、利奈唑胺（敏感性100.0%/100.0%）和万古霉素（敏感性100.0%/100.0%）。
在过去几年中，所有地区对多种抗生素的敏感性均有所提高，这些提高可能与2010年引入的13价肺炎球菌结合疫苗（PCV13）免疫接种有关。
