Kannian Priya, Mahanathi Pasuvaraj, Ashwini Veeraraghavan, Vaishnavi Muthu, Priya Chandran
Department of Clinical Research, VHS Hospital, Chennai, India.
Microb Drug Resist. 2021 Aug;27(8):1057-1062. doi: 10.1089/mdr.2020.0294. Epub 2021 Jan 8.
Carbapenems, although originally introduced against multidrug-resistant (MDR) Gram negative bacilli (GNB), are now advocated for initial empiric use resulting in increasing carbapenem-resistant (CR) GNB. In this study, we analyzed the frequencies of CR-GNB and compared their resistance patterns against other antibiotics. Overall, 42% (1,014/2,420) of CR-GNB were isolated (range: 29-59%), with similar frequencies among hospitalized and community-acquired infections. However, the CR frequencies in were significantly higher in the hospitalized patients (>50%). In addition, the CR-GNB isolates showed significantly higher resistance to the other antibiotics-fluoroquinolones, aminoglycosides, sulfonamides, and ureidopenicillins compared to carbapenem-sensitive isolates, thereby limiting further treatment options. Majority of CR-GNB isolates were extended spectrum β-lactamase producers (38-72%) and MDR (19-61%). Pan-drug resistant (PDR) frequencies among these MDR isolates ranged from 21% ( spp.) to 100% (). Overall, CR-GNB are predominantly MDR or PDR and so warrant continuous antibiotic surveillance to provide better management of the infectious diseases.
碳青霉烯类药物最初用于对抗多重耐药(MDR)革兰氏阴性杆菌(GNB),但现在提倡将其用于初始经验性治疗,这导致耐碳青霉烯(CR)GNB的数量不断增加。在本研究中,我们分析了CR-GNB的发生率,并比较了它们对其他抗生素的耐药模式。总体而言,分离出42%(1014/2420)的CR-GNB(范围:29%-59%),在医院感染和社区获得性感染中的发生率相似。然而,住院患者中的CR发生率显著更高(>50%)。此外,与碳青霉烯敏感菌株相比,CR-GNB分离株对其他抗生素(氟喹诺酮类、氨基糖苷类、磺胺类和脲基青霉素类)的耐药性显著更高,从而限制了进一步的治疗选择。大多数CR-GNB分离株是超广谱β-内酰胺酶产生菌(38%-72%)和MDR(19%-61%)。这些MDR分离株中的泛耐药(PDR)发生率从21%( 菌属)到100%( 菌属)不等。总体而言,CR-GNB主要为MDR或PDR,因此需要持续进行抗生素监测,以便更好地管理传染病。