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从血培养中分离出的病原体的抗菌药物耐药性:意大利一项为期两年的多中心医院监测研究

Antimicrobial Resistance in Pathogens Isolated from Blood Cultures: A Two-Year Multicenter Hospital Surveillance Study in Italy.

作者信息

Licata Francesca, Quirino Angela, Pepe Davide, Matera Giovanni, Bianco Aida

机构信息

Department of Health Sciences, School of Medicine, University of Catanzaro "Magna Græcia", Viale Europa, Germaneto, 88100 Catanzaro, Italy.

出版信息

Antibiotics (Basel). 2020 Dec 24;10(1):10. doi: 10.3390/antibiotics10010010.

Abstract

BACKGROUND

Antimicrobial resistance (AMR) is one of the most concerning issues in medicine today. The objectives of this study were to investigate the AMR distribution of the blood-borne pathogens isolated over a two-year period in an Italian region.

METHODS

A retrospective electronic record review of laboratory-confirmed bloodstream infections (BSIs) was done, and data from three major diagnostic laboratories were used. Twelve invasive clinically important bacteria species were included in the sample.

RESULTS

During the study period, 1228 positive BSIs were collected. The most common pathogens were (CoNS) (29.7%), (19.1%) and (15.9%). With regard to the AMR pattern, 31.7% of CoNS and 28.1% of were oxacillin-resistant, and almost half of the Enterococci showed resistance to high-level gentamicin. Among Gram-negative species, 11.7% of and 39.5% of were carbapenem-resistant. Among the non-fermentative Gram-negative bacteria, the most frequently combined AMR pattern was aminoglycosides and fluoroquinolones (48.4% in and 14.6% in ).

CONCLUSION

The results display an alarming prevalence of AMR among hospital isolated pathogens, consistently higher than the European average. Information from surveillance systems to better characterize the trend in the incidence of AMR at local and national levels is needed.

摘要

背景

抗菌药物耐药性(AMR)是当今医学领域最令人担忧的问题之一。本研究的目的是调查意大利某地区两年内分离出的血源性病原体的AMR分布情况。

方法

对实验室确诊的血流感染(BSIs)进行回顾性电子记录审查,并使用来自三个主要诊断实验室的数据。样本中包括12种具有临床重要性的侵袭性细菌。

结果

在研究期间,共收集到1228例阳性BSIs。最常见的病原体是凝固酶阴性葡萄球菌(CoNS)(29.7%)、金黄色葡萄球菌(19.1%)和肠球菌(15.9%)。关于AMR模式,31.7%的CoNS和28.1%的金黄色葡萄球菌对苯唑西林耐药,近一半的肠球菌对高水平庆大霉素耐药。在革兰氏阴性菌中,11.7%的大肠埃希菌和39.5%的肺炎克雷伯菌对碳青霉烯类耐药。在非发酵革兰氏阴性菌中,最常见的联合AMR模式是氨基糖苷类和氟喹诺酮类(铜绿假单胞菌中为48.4%,鲍曼不动杆菌中为14.6%)。

结论

结果显示医院分离病原体中AMR的流行率令人担忧,一直高于欧洲平均水平。需要来自监测系统的信息,以更好地描述地方和国家层面AMR发病率的趋势。

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