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2007 年至 2020 年间,纽约兽医诊断实验室分离的犬大肠埃希菌的抗菌药物耐药趋势。

Antimicrobial resistance trends among canine Escherichia coli isolated at a New York veterinary diagnostic laboratory between 2007 and 2020.

机构信息

Cornell Atkinson Center for Sustainability, Cornell University, Ithaca, NY 14853, USA; Department of Public and Ecosystem Health, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.

Department of Public and Ecosystem Health, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.

出版信息

Prev Vet Med. 2022 Nov;208:105767. doi: 10.1016/j.prevetmed.2022.105767. Epub 2022 Sep 23.

Abstract

Dogs are a potential source of drug-resistant Escherichia coli, but very few large-scale antimicrobial resistance surveillance studies have been conducted in the canine population. Here, we assess the antimicrobial susceptibility patterns, identify temporal resistance and minimum inhibitory concentration (MIC) trends, and describe associations between resistance phenotypes among canine clinical E. coli isolates in the northeastern United States. Through a retrospective study design, we collected MICs from 7709 E. coli isolates from canine infections at the Cornell University Animal Health Diagnostic Center between 2007 and 2020. The available clinical data were limited to body site. Isolates were classified as resistant or susceptible to six (urinary) and 22 (non-urinary) antimicrobials based on Clinical and Laboratory Standards Institute breakpoints. We used the Mann-Kendall test (MKT) and Sen's slope to identify the presence of a significant trend in the percent of resistant isolates over the study period. Multivariable logistic regression (MLR) models were built with ceftiofur, enrofloxacin, or trimethoprim-sulfamethoxazole resistance as the outcome and either body site and isolation date, or resistance to other antimicrobials as predictors. MIC trends were characterized with survival analysis models, controlling for body site and year of isolation. Overall, 16.4% of isolates were resistant to enrofloxacin, 14.3% to ceftiofur, and 14% to trimethoprim-sulfamethoxazole. The MKT and Sen's slope revealed a significant decreasing temporal trend for gentamicin and trimethoprim-sulfamethoxazole resistance among non-urinary isolates. No significant temporal resistance trends were detected by MKT for other antimicrobials. However, controlling for body-site in MLR models identified a decrease in resistance rates to enrofloxacin and trimethoprim-sulfamethoxazole after 2010. Similarly, survival analysis data confirmed these findings and showed a decrease in MIC values after 2010 for gentamicin and trimethoprim-sulfamethoxazole, but an increase in cephalosporin MICs. MLR showed that non-urinary isolates were significantly more likely than urinary isolates to demonstrate in vitro resistance to ceftiofur, enrofloxacin, and trimethoprim-sulfamethoxazole after controlling for year of isolation. We identified a higher level of ceftiofur resistance among enrofloxacin resistant isolates from urinary and non-urinary origins. Our findings confirmed that dogs are still a non-negligeable reservoir of drug-resistant E. coli in the northeastern United States. The increase in extended-spectrum cephalosporin MIC values in 2018-2020 compared to 2007-2010 constitutes a particularly worrying issue; the relationship between ceftiofur and enrofloxacin resistance suggests that the use of fluoroquinolones could contribute to this trend. Trimethoprim-sulfamethoxazole may be a good first-line choice for empiric treatment of E. coli infections; it is already recommended for canine urinary tract infections.

摘要

狗是耐药大肠杆菌的潜在来源,但很少有大规模的抗菌药物耐药性监测研究在犬群中进行。在这里,我们评估了美国东北部犬科临床大肠杆菌分离株的抗菌药物敏感性模式,确定了时间耐药性和最小抑菌浓度(MIC)趋势,并描述了耐药表型之间的相关性。通过回顾性研究设计,我们收集了康奈尔大学动物健康诊断中心 2007 年至 2020 年间犬感染的 7709 株大肠杆菌的 MIC。可用的临床数据仅限于身体部位。根据临床和实验室标准协会的临界点,将分离株分为对 6 种(尿液)和 22 种(非尿液)抗菌药物的耐药或敏感。我们使用曼肯德尔检验(MKT)和森斜率来确定研究期间耐药分离株百分比是否存在显著趋势。多变量逻辑回归(MLR)模型以头孢噻肟、恩诺沙星或甲氧苄啶-磺胺甲恶唑耐药作为因变量,以身体部位和分离日期或对其他抗菌药物的耐药性作为预测因子。使用生存分析模型,在控制身体部位和分离年份的情况下,对 MIC 趋势进行了描述。总体而言,16.4%的分离株对恩诺沙星耐药,14.3%对头孢噻肟耐药,14%对甲氧苄啶-磺胺甲恶唑耐药。MKT 和森斜率显示,非尿液分离株的庆大霉素和甲氧苄啶-磺胺甲恶唑耐药性呈显著的时间下降趋势。MKT 未检测到其他抗菌药物的显著时间耐药趋势。然而,在 MLR 模型中控制身体部位,发现 2010 年后恩诺沙星和甲氧苄啶-磺胺甲恶唑的耐药率下降。同样,生存分析数据证实了这些发现,并显示 2010 年后庆大霉素和甲氧苄啶-磺胺甲恶唑的 MIC 值下降,但头孢菌素的 MIC 值增加。MLR 表明,在控制分离年份后,非尿液分离株比尿液分离株更有可能对头孢噻肟、恩诺沙星和甲氧苄啶-磺胺甲恶唑表现出体外耐药性。我们发现,来自尿液和非尿液来源的恩诺沙星耐药分离株的头孢噻肟耐药水平更高。我们的研究结果证实,狗仍然是美国东北部耐药大肠杆菌的一个不可忽视的储库。2018-2020 年与 2007-2010 年相比,头孢菌素 MIC 值的增加是一个特别令人担忧的问题;头孢噻肟和恩诺沙星耐药之间的关系表明,氟喹诺酮类药物的使用可能导致这一趋势。甲氧苄啶-磺胺甲恶唑可能是治疗大肠杆菌感染的首选经验性药物;它已被推荐用于犬尿路感染。

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