Barchitta M, Maugeri A, La Rosa M C, La Mastra C, Murolo G, Basile G, Agodi A
Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy.
Regional Health Authority of the Sicilian Region, Palermo, Italy.
Ann Ig. 2021 May-Jun;33(3):289-296. doi: 10.7416/ai.2020.2402. Epub 2020 Dec 11.
The results of the present study highlight the need for comprehensive strategies targeting the appropriate use of antibiotics and infection control measures.
In the last decades, multidrug-resistant gram-negative bacteria have been increasing and they are involved in severe healthcare associated infections. In treating drug-resistant gram-negative bacterial infections, carbapenems are generally administered as a last choice. However, the rate of carbapenemresistant bacteria is constantly increasing the last years. The aim of the present study is to describe the relationship between the rate of carbapenem-resistant gram-negative bacteria and antibiotic consumption intensity.
In 2017, the Sicilian Region implemented a regional surveillance system to describe and analyze consumption of antibiotics in hospital settings, as well as prevalence of antibiotic resistant microorganisms.
Resistance data were retrospectively collected from routinary clinical antimicrobial susceptibility tests. Resistance rates (RRs) of carbapenems were calculated and Spearman's correlation analysis was performed to investigate the relationship between annual antibiotic consumption and rate of carbapenem resistance.
In 2015, the overall prevalence of carbapenem-resistant Klebsiella pneumoniae isolates was 43.9 %, and was positively correlated with beta-lactam consumption (R=0.529, p<0.01), and with carbapenem consumption (R=0.364, p<0.05). In 2016, the overall prevalence of carbapenem-resistant Klebsiella pneumoniae isolates was 53.8 %, and was positively correlated with carbapenem antibiotic consumption (R=0.364, p<0.05). In 2017, the overall prevalence of carbapenem-resistant Klebsiella pneumoniae isolates was 58.7 %, and was significantly positively correlated with carbapenem antibiotic consumption (R=0.427, p<0.05). In 2015, the overall prevalence of carbapenem-resistant Escherichia coli isolates was 6.5 %, and was significantly positively correlated with antibiotic consumption for the ATC class J01 (i.e., antibacterial for systemic use) (R=0.402, p<0.05).
本研究结果凸显了针对抗生素合理使用及感染控制措施制定综合策略的必要性。
在过去几十年中，多重耐药革兰氏阴性菌不断增加，且它们与严重的医疗保健相关感染有关。在治疗耐药革兰氏阴性菌感染时，碳青霉烯类药物通常作为最后选择使用。然而，近年来碳青霉烯类耐药菌的比例持续上升。本研究的目的是描述碳青霉烯类耐药革兰氏阴性菌比例与抗生素消费强度之间的关系。
2017年，西西里岛地区实施了一项区域监测系统，以描述和分析医院环境中抗生素的消费情况以及抗生素耐药微生物的流行情况。
从常规临床抗菌药物敏感性试验中回顾性收集耐药数据。计算碳青霉烯类药物的耐药率（RRs），并进行Spearman相关性分析，以研究年度抗生素消费与碳青霉烯类耐药率之间的关系。
2015年，耐碳青霉烯类肺炎克雷伯菌分离株的总体流行率为43.9%，与β-内酰胺类药物消费呈正相关（R=0.529，p<0.01），与碳青霉烯类药物消费呈正相关（R=0.364，p<0.05）。2016年，耐碳青霉烯类肺炎克雷伯菌分离株的总体流行率为53.8%，与碳青霉烯类抗生素消费呈正相关（R=0.364，p<0.05）。2017年，耐碳青霉烯类肺炎克雷伯菌分离株的总体流行率为58.7%，与碳青霉烯类抗生素消费呈显著正相关（R=0.427，p<0.05）。2015年，耐碳青霉烯类大肠埃希菌分离株的总体流行率为6.5%，与ATC分类J01（即全身用抗菌药）的抗生素消费呈显著正相关（R=0.402，p<0.05）。
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