University of Illinois at Chicago, Chicago, Illinois.
University of Illinois at Chicago, Rockford, Illinois.
Infect Control Hosp Epidemiol. 2020 Dec;41(12):1409-1418. doi: 10.1017/ice.2020.334. Epub 2020 Sep 4.
To develop a regional antibiogram within the Chicagoland metropolitan area and to compare regional susceptibilities against individual hospitals within the area and national surveillance data.
Multicenter retrospective analysis of antimicrobial susceptibility data from 2017 and comparison to local institutions and national surveillance data.
The analysis included 51 hospitals from the Chicago-Naperville-Elgin Metropolitan Statistical Area within the state of Illinois. Overall, 18 individual collaborator hospitals provided antibiograms for analysis, and data from 33 hospitals were provided in aggregate by the Becton Dickinson Insights Research Database.
All available antibiogram data from calendar year 2017 were combined to generate the regional antibiogram. The final Chicagoland antibiogram was then compared internally to collaborators and externally to national surveillance data to assess its applicability and utility.
In total, 167,394 gram-positive, gram-negative, fungal, and mycobacterial isolates were collated to create a composite regional antibiogram. The regional data represented the local institutions well, with 96% of the collaborating institutions falling within ±2 standard deviations of the regional mean. The regional antibiogram was able to include 4-5-fold more gram-positive and -negative species with ≥30 isolates than the median reported by local institutions. Against national surveillance data, 18.6% of assessed pathogen-antibiotic combinations crossed prespecified clinical thresholds for disparity in susceptibility rates, with notable trends for resistant gram-positive and gram-negative bacteria.
Developing an accurate, reliable regional antibiogram is feasible, even in one of the largest metropolitan areas in the United States. The biogram is useful in assessing susceptibilities to less commonly encountered organisms and providing clinicians a more accurate representation of local antimicrobial resistance rates compared to national surveillance databases.
在芝加哥大都市区内制定区域性药敏图，并比较该地区各医院的区域性药敏结果与国家监测数据。
对 2017 年抗菌药物敏感性数据进行多中心回顾性分析，并与当地机构和国家监测数据进行比较。
该分析包括伊利诺伊州芝加哥-内珀维尔-埃尔金都会统计区的 51 家医院。共有 18 家合作医院提供了药敏图进行分析，Becton Dickinson Insights Research Database 则提供了 33 家医院的汇总数据。
将 2017 年全年所有可用的药敏数据合并生成区域性药敏图。然后，将最终的芝加哥药敏图与合作机构进行内部比较，并与国家监测数据进行外部比较，以评估其适用性和实用性。
共整理了 167394 株革兰阳性菌、革兰阴性菌、真菌和分枝杆菌分离株，以创建复合区域性药敏图。该区域数据很好地代表了当地机构，其中 96%的合作机构落在区域均值的±2 个标准差内。与国家监测数据相比，区域药敏图能够包括 4-5 倍更多的革兰阳性和革兰阴性菌，每种菌的分离株数≥30 株，而当地机构报告的中位数则更少。在评估的病原体-抗生素组合中，有 18.6%的组合药敏率差异超出了预设的临床阈值，革兰阳性和革兰阴性耐药菌的趋势明显。
即使在美国最大的大都市区之一，制定准确、可靠的区域性药敏图也是可行的。与国家监测数据库相比，药敏图可用于评估较少见病原体的药敏情况，并为临床医生提供更准确的当地抗菌药物耐药率的代表性。
