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儿科医院搬迁:抗生素耐药性是否会发生变化?

Relocating a pediatric hospital: Does antimicrobial resistance change?

机构信息

Hospital for Children and Adolescents, University Hospital Leipzig, Liebigstraße 20a, 04103, Leipzig, Germany.

Institute of Medical Microbiology and Epidemiology of Infectious Diseases, University Hospital Leipzig, Liebigstraße 21, 04103, Leipzig, Germany.

出版信息

BMC Res Notes. 2020 May 13;13(1):242. doi: 10.1186/s13104-020-05065-7.

Abstract

OBJECTIVE

Analyze the changes in antimicrobial drug resistance patterns due to hospital relocation. To this end, we conducted a retrospective analysis of microbiological results, especially minimum inhibitory concentrations (MIC) of all isolates from blood, urine and bronchial secretions, in our pediatric university hospital before and after moving to a new building.

RESULTS

While the number of tests done did not change, the fraction of those positive increased, more MICs were determined and certain microbes (A. baumannii, E. faecalis, Klebsiella spp. and P. mirabilis) were detected more frequently. Most changes in MICs occurred in E. faecium (increases in 8 antimicrobials, decreases only in linezolid and gentamicin). For imipenem and aminopenicillins the MICs commonly rose after relocation, the opposite is true for gentamicin and trimethoprim/sulfamethoxazole. The other factors that alter by moving a hospital such as changes in medical personnel or case severity cannot be corrected for, but using MICs we are able to provide insights into changes down to the individual antimicrobial drug and even small changes usually undetectable to the common categorical reporting of resistance.

摘要

目的

分析医院搬迁导致的抗菌药物耐药模式变化。为此,我们对我院儿科医院搬迁前后血液、尿液和支气管分泌物的所有分离物的微生物学结果(尤其是最低抑菌浓度(MIC))进行了回顾性分析。

结果

虽然检测数量没有变化,但阳性率增加,更多的 MIC 得到了确定,某些微生物(鲍曼不动杆菌、粪肠球菌、克雷伯菌属和奇异变形杆菌)的检出率更高。MIC 变化主要发生在屎肠球菌(8 种抗菌药物增加,仅利奈唑胺和庆大霉素减少)。对于亚胺培南和氨芐西林,搬迁后 MIC 通常升高,而庆大霉素和甲氧苄啶/磺胺甲恶唑则相反。医院搬迁等因素改变了医务人员或疾病严重程度,无法纠正,但使用 MIC,我们能够深入了解到单个抗菌药物的变化,甚至可以发现通常无法通过常见的耐药类别报告检测到的微小变化。

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