Neidhöfer Claudio, Berens Christina, Parčina Marijo
Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, University of Bonn, 53127 Bonn, Germany.
Antibiotics (Basel). 2022 Feb 25;11(3):311. doi: 10.3390/antibiotics11030311.
spp. are intrinsically multidrug-resistant environmental microorganisms which are known to cause opportunistic, nosocomial, and sometimes chronic infections. The existing literature yields scarcely any larger datasets, especially with regard to the incidence in patient groups other than those with cystic fibrosis. The aim of this study was to fill this gap. We present a retrospective analysis of 314 clinical and 130 screening isolates detected in our diagnostic unit between 2004 and 2021, combined with patients' demographic and clinical information (ward type and length of hospitalization), and the results of routine diagnostic antibiotic MIC determination. We found the apparent increase in prevalence in our diagnostic unit, in which cystic fibrosis patients are an underrepresented group, in large part to be attributable to an overall increase in the number of samples and, more importantly, changes in the diagnostic setting, such as the introduction of rigorous screening for Gram-negative multidrug-resistant pathogens. We found these spp. to be most commonly detected in urine, stool, wounds and airway samples, and found the resistance rates to vary strongly between different sample types. Intestinal carriage is frequently not investigated, and its frequency is likely underestimated. Isolates resistant to meropenem can hardly be treated.
某些菌种本质上是具有多重耐药性的环境微生物,已知会引发机会性感染、医院感染,有时还会导致慢性感染。现有文献几乎没有提供任何更大规模的数据集,尤其是关于除囊性纤维化患者群体之外其他患者群体中的发病率数据。本研究的目的就是填补这一空白。我们对2004年至2021年间在我们诊断科室检测到的314份临床分离株和130份筛查分离株进行了回顾性分析,并结合了患者的人口统计学和临床信息(病房类型和住院时长)以及常规诊断性抗生素最低抑菌浓度测定结果。我们发现,在我们的诊断科室(其中囊性纤维化患者占比不足),其患病率的明显上升在很大程度上归因于样本数量的总体增加,更重要的是诊断环境的变化,比如对革兰氏阴性多重耐药病原体引入了严格筛查。我们发现这些菌种最常在尿液、粪便、伤口和气道样本中检测到,并且发现不同样本类型之间的耐药率差异很大。肠道携带情况经常未被调查,其发生率可能被低估。对美罗培南耐药的分离株几乎无法治疗。