Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Doherty Institute for Infection and Immunity, Melbourne, Australia
Melbourne Sexual Health Centre, Alfred Health, Carlton, Australia.
Antimicrob Agents Chemother. 2019 Sep 23;63(10). doi: 10.1128/AAC.01221-19. Print 2019 Oct.
Antimicrobial resistance (AMR) in is a major public health problem. Traditionally, AMR surveillance programs for have focused mainly on laboratory data to describe the prevalence and trends of resistance. However, integrating individual-level risk factors (e.g., sexual orientation or international travel) with laboratory data provides important insights into factors promoting the spread of resistant Here, over a 12-year period, we assessed the trends and risk factors for resistant in individuals attending a large publicly funded sexual health center in Melbourne, Australia. A total of 7,588 isolates were cultured from 5,593 individuals between 1 January 2007 and 31 December 2018. The proportion of isolates with penicillin resistance decreased from 49.5% in 2007 to 18.3% in 2018 ( < 0.001) and from 63.5% in 2007 to 21.1% in 2018 for ciprofloxacin resistance ( < 0.001). In contrast, the proportion of isolates displaying decreased susceptibility to ceftriaxone increased from 0.5% in 2007 to 2.9% in 2018 ( < 0.001), with a significant increase in low-level azithromycin resistance, from 2.5% in 2012 to 8.2% in 2018 ( < 0.001). Multivariate analysis identified risk factors for multidrug-resistant (MDR) , namely, female sex and country of birth, with MDR isolates more common in individuals born in northeast Asia, further highlighting the importance of this region and international travel as factors in the cross-border transmission of MDR Future surveillance work should incorporate additional epidemiological and genomic data to provide a comprehensive overview of the emergence and spread of resistant .
耐抗生素性病原体（AMR）是一个主要的公共卫生问题。传统上，耐抗生素性病原体监测计划主要集中在实验室数据上，以描述耐药性的流行和趋势。然而，将个体层面的风险因素（例如，性取向或国际旅行）与实验室数据相结合，可以深入了解促进耐药性病原体传播的因素。在这里，我们在 12 年的时间里，评估了在澳大利亚墨尔本一家大型公共资助的性健康中心就诊的个体中耐药性病原体的趋势和风险因素。在 2007 年 1 月 1 日至 2018 年 12 月 31 日期间，从 5593 个人中培养了 7588 个分离株。青霉素耐药性分离株的比例从 2007 年的 49.5%下降到 2018 年的 18.3%（<0.001），环丙沙星耐药性的比例从 2007 年的 63.5%下降到 2018 年的 21.1%（<0.001）。相比之下，头孢曲松显示出降低敏感性的分离株比例从 2007 年的 0.5%增加到 2018 年的 2.9%（<0.001），低水平的阿奇霉素耐药性也显著增加，从 2012 年的 2.5%增加到 2018 年的 8.2%（<0.001）。多变量分析确定了多药耐药性病原体（MDR）的危险因素，即女性和出生地，出生在东亚国家的个体中更常见 MDR 分离株，进一步强调了该地区和国际旅行作为 MDR 跨边境传播因素的重要性。未来的监测工作应纳入额外的流行病学和基因组数据，以提供对耐药性病原体出现和传播的全面了解。
