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抗微生物药物耐药性分析及凝固酶阴性葡萄球菌的分子特征:来自两家三级医院的报告,分别在韩国实施药品处方和配药政策之前和之后的 15 年。

Antimicrobial Resistance Profiles and Molecular Characteristics of Coagulase-Negative Staphylococci Isolated from Two Tertiary Hospitals Before and 15 Years After Implementation of the Separation of Drug Prescribing and Dispensing Policy of Korea.

机构信息

Culture Collection of Antimicrobial Resistant Microbes, Department of Horticulture, Biotechnology, and Landscape Architecture, College of Natural Sciences, Seoul Women's University, Seoul, Korea.

Department of Laboratory Medicine, School of Medicine, Kyung Hee University, Seoul, Korea.

出版信息

Microb Drug Resist. 2020 Mar;26(3):251-260. doi: 10.1089/mdr.2019.0151. Epub 2019 Sep 24.

Abstract

This study compared changes in antimicrobial susceptibilities and molecular characteristics of coagulase-negative staphylococci (CNS) between the year 2000 and the year 2014-2015 to evaluate the policy of separating drug prescribing and dispensing in Korea. We obtained 68 CNS clinical isolates from two tertiary general hospitals before (the year 2000;  = 25) and after (the year 2014 - 2015;  = 43) implementation of the separation. Isolates were identified as , , , , , and When minimal inhibitory concentrations of 14 antimicrobials were applied to isolates, resistance rates to gentamicin and oxacillin in 2000 were significantly higher than in 2014-2015 ( < 0.05). Fifty-seven isolates were methicillin-resistant CNS (MR-CNS), 42 of which were also multidrug resistant; overall, multidrug resistance decreased from 72% in the year 2000 to 55.8% in 2014-2015. Staphylococcal cassette chromosome (SCC) type III was the dominant type of MR-CNS in the year 2000, while SCC type IV was the dominant type in 2014-2015. Twenty-five sequence types (STs) were identified; ST2 appeared most frequently in both periods. After 15 years of implementation of this policy, multidrug resistance as well as methicillin and gentamicin resistance in CNS decreased, but not resistance to other antibiotics. Long-term surveillance at both genotypic and phenotypic levels of various species is necessary for further evaluation of this policy.

摘要

这项研究比较了 2000 年至 2014-2015 年期间凝固酶阴性葡萄球菌(CNS)的抗菌药物敏感性和分子特征变化,以评估韩国实施的处方与配药分离政策。我们从两家三级综合医院获得了 68 株 CNS 临床分离株,分别来自政策实施前(2000 年;25 株)和实施后(2014-2015 年;43 株)。分离株鉴定为 、 、 、 、 和 。当应用 14 种抗菌药物的最小抑菌浓度时,2000 年分离株对庆大霉素和苯唑西林的耐药率明显高于 2014-2015 年(<0.05)。57 株为耐甲氧西林凝固酶阴性葡萄球菌(MR-CNS),其中 42 株为多药耐药;总体而言,多药耐药率从 2000 年的 72%下降到 2014-2015 年的 55.8%。2000 年,葡萄球菌盒染色体(SCC)型 III 是 MR-CNS 的主要类型,而 2014-2015 年,SCC 型 IV 是主要类型。共鉴定出 25 种序列类型(STs);ST2 在两个时期均最为常见。该政策实施 15 年后,CNS 的多药耐药性以及耐甲氧西林和庆大霉素的耐药性有所下降,但对其他抗生素的耐药性没有下降。需要在各种物种的基因型和表型水平进行长期监测,以进一步评估该政策。

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