Department of Medicine, Division of Infectious Diseases, Brigham and Women's Hospital , Boston, MA, USA.
Department of Medicine, Harvard Medical School , Boston, MA, USA.
Expert Rev Anti Infect Ther. 2020 Oct;18(10):1055-1062. doi: 10.1080/14787210.2020.1776114. Epub 2020 Jun 18.
This study presents trends in organism isolation and antimicrobial resistance in routine microbiology test results from acute-care hospital microbiology laboratories in Vermont.
Organism identifications and antimicrobial susceptibility test results were captured from acute-care hospital laboratories to monitor geographic and temporal trends in resistance and emerging microbial threats with the free WHONET software.
Data were provided from 12 acute care hospital laboratories from 2011 through 2018 for 318,833 isolates from 148,994 patients (70% female, 74% outpatient, and 63% urine). Significant differences (p < 0.05) in age, gender, and antimicrobial susceptibility results (e.g. and levofloxacin) between outpatient and inpatient isolates were identified with temporal increases in certain species (e.g. ) and resistance (e.g. and erythromycin). The use of multi-resistance phenotypes demonstrated significant heterogeneity (p < 0.05) in MRSA strains between facilities, for example resistant to six priority antimicrobials were found in no critical access hospitals (fewer than 25 inpatient beds) but in all non-critical access hospitals.
Comprehensive electronic surveillance of antimicrobial resistance utilizing routine clinical microbiology data with free software tools offers early recognition and tracking of emerging community and healthcare resistance threats at the local and state level.
本研究介绍了佛蒙特州急性护理医院微生物学实验室常规微生物学检测结果中病原体分离和抗菌药物耐药性的趋势。
使用免费的 WHONET 软件，从急性护理医院实验室中获取病原体鉴定和抗菌药物敏感性测试结果，以监测耐药性的地域和时间趋势以及新出现的微生物威胁。
2011 年至 2018 年期间，从 148994 名患者的 318833 株分离物中，提供了来自 12 家急性护理医院实验室的数据（70%为女性，74%为门诊患者，63%为尿液）。门诊和住院分离物的年龄、性别和抗菌药物敏感性结果（例如 克林霉素和左氧氟沙星）存在显著差异（p<0.05），某些物种（例如 屎肠球菌）和耐药性（例如 耐甲氧西林金黄色葡萄球菌和红霉素）随着时间的推移而增加。多耐药表型的使用表明，各医疗机构之间 MRSA 菌株存在显著的异质性（p<0.05），例如，所有非关键访问医院都发现了对 6 种优先抗菌药物耐药的菌株，但在没有关键访问医院（少于 25 张住院病床）中则没有发现。
利用常规临床微生物学数据和免费软件工具对抗菌药物耐药性进行全面的电子监测，可以在本地和州级及早发现和跟踪新出现的社区和医疗机构耐药威胁。
