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墨西哥抗菌药物耐药性概览。20 个州的 47 个中心在六个月期间的结果。

A snapshot of antimicrobial resistance in Mexico. Results from 47 centers from 20 states during a six-month period.

机构信息

Hospital Universitario Dr. José Eleuterio González, Monterrey, Nuevo León, Mexico.

Hospital Civil de Guadalajara e Instituto de Patología Infecciosa, Guadalajara, Jalisco, Mexico.

出版信息

PLoS One. 2019 Mar 26;14(3):e0209865. doi: 10.1371/journal.pone.0209865. eCollection 2019.

Abstract

AIM

We aimed to assess the resistance rates of antimicrobial-resistant, in bacterial pathogens of epidemiological importance in 47 Mexican centers.

MATERIAL AND METHODS

In this retrospective study, we included a stratified sample of 47 centers, covering 20 Mexican states. Selected isolates considered as potential causatives of disease collected over a 6-month period were included. Laboratories employed their usual methods to perform microbiological studies. The results were deposited into a database and analyzed with the WHONET 5.6 software.

RESULTS

In this 6-month study, a total of 22,943 strains were included. Regarding Gram-negatives, carbapenem resistance was detected in ≤ 3% in Escherichia coli, 12.5% in Klebsiella sp. and Enterobacter sp., and up to 40% in Pseudomonas aeruginosa; in the latter, the resistance rate for piperacillin-tazobactam (TZP) was as high as 19.1%. In Acinetobacter sp., resistance rates for cefepime, ciprofloxacin, meropenem, and TZP were higher than 50%. Regarding Gram-positives, methicillin resistance in Staphylococcus aureus (MRSA) was as high as 21.4%, and vancomycin (VAN) resistance reached up to 21% in Enterococcus faecium. Acinetobacter sp. presented the highest multidrug resistance (53%) followed by Klebsiella sp. (22.6%) and E. coli (19.4%).

CONCLUSION

The multidrug resistance of Acinetobacter sp., Klebsiella sp. and E. coli and the carbapenem resistance in specific groups of enterobacteria deserve special attention in Mexico. Vancomycin-resistant enterococci (VRE) and MRSA are common in our hospitals. Our results present valuable information for the implementation of measures to control drug resistance.

摘要

目的

我们旨在评估 47 家墨西哥中心具有流行病学意义的抗菌药物耐药的细菌病原体的耐药率。

材料和方法

在这项回顾性研究中,我们纳入了一个分层样本,涵盖了墨西哥 20 个州的 47 家中心。在 6 个月的时间内,收集了被认为是潜在疾病原因的选定分离株。实验室采用常规方法进行微生物学研究。结果存入数据库,并使用 WHONET 5.6 软件进行分析。

结果

在这项 6 个月的研究中,共纳入了 22943 株菌株。对于革兰氏阴性菌,在大肠杆菌中发现碳青霉烯类耐药率≤3%,在克雷伯菌属和肠杆菌属中为 12.5%,在铜绿假单胞菌中高达 40%;在后者中,哌拉西林他唑巴坦(TZP)的耐药率高达 19.1%。在不动杆菌属中,头孢吡肟、环丙沙星、美罗培南和 TZP 的耐药率高于 50%。对于革兰氏阳性菌,金黄色葡萄球菌(MRSA)的耐甲氧西林率高达 21.4%,屎肠球菌的万古霉素(VAN)耐药率高达 21%。不动杆菌属的多药耐药率最高(53%),其次是克雷伯菌属(22.6%)和大肠杆菌(19.4%)。

结论

在墨西哥,不动杆菌属、克雷伯菌属和大肠杆菌属的多药耐药性以及特定肠杆菌科细菌的碳青霉烯类耐药性值得特别关注。万古霉素耐药肠球菌(VRE)和耐甲氧西林金黄色葡萄球菌(MRSA)在我们的医院中很常见。我们的结果为实施耐药控制措施提供了有价值的信息。

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