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血培养分离株的抗菌药物耐药性和病原学变化:哥伦比亚北部地区十年(2010 - 2019年)监测结果

Changes in Antimicrobial Resistance and Etiology of Blood Culture Isolates: Results of a Decade (2010-2019) of Surveillance in a Northern Region of Colombia.

作者信息

Robledo Jaime, Maldonado Natalia, Robledo Carlos, Ceballos Naranjo Laura, Hernández Galeano Valentín, Pino Juan Jose

机构信息

Laboratorio Médico de Referencia, Medellín, Colombia.

Escuela de Ciencias de la Salud, Universidad Pontificia Bolivariana, Medellín, Colombia.

出版信息

Infect Drug Resist. 2022 Oct 20;15:6067-6079. doi: 10.2147/IDR.S375206. eCollection 2022.

Abstract

BACKGROUND

Bloodstream infections (BSI) are important causes of morbidity and mortality worldwide. Antimicrobial surveillance is essential for identifying emerging resistance and generating empirical treatment guides, the purpose of this study is to analyze trends in antimicrobial susceptibility of BSI from 2010 to 2019 in healthcare institutions from Medellin and nearby towns in Colombia.

METHODS

A Whonet database was analyzed from the GERMEN antimicrobial surveillance network; frequency and antibiotic susceptibility trends were calculated on more frequent microorganisms using Mann Kendall and Sen's Slope Estimator Test.

RESULTS

61,299 isolates were included; the three microorganisms more frequent showed a significant increasing trend through time (Sen's Slope estimator = 0.7 p = <0.01) (Sen's Slope estimator = 0.60 p = <0.01) and (Sen's Slope estimator = 0.30 p = <0.01). showed a significant increase trend in cefepime and ceftazidime resistance, while showed a significant increase in resistance to cefepime, ciprofloxacin, and gentamicin. increases its susceptibility to all analyzed antibiotics and to oxacillin. No increasing trend was observed for carbapenem resistance.

CONCLUSION

An upward trends was observed in more frequent microorganisms and resistance to third and fourth-generation cephalosporins for and ; in contrast, not increasing trends in antibiotic resistance was observed for and . The essential role of AMR-surveillance programs is to point out and identify these trends, which should improve antibiotic resistance control.

摘要

背景

血流感染(BSI)是全球发病和死亡的重要原因。抗菌药物监测对于识别新出现的耐药性和制定经验性治疗指南至关重要,本研究旨在分析2010年至2019年哥伦比亚麦德林及周边城镇医疗机构中血流感染的抗菌药物敏感性趋势。

方法

对来自GERMEN抗菌药物监测网络的Whonet数据库进行分析;使用Mann Kendall和Sen斜率估计检验计算更常见微生物的频率和抗生素敏感性趋势。

结果

纳入61299株分离菌;三种最常见的微生物随时间呈显著上升趋势(Sen斜率估计值=0.7,p<0.01)(Sen斜率估计值=0.60,p<0.01)和(Sen斜率估计值=0.30,p<0.01)。在头孢吡肟和头孢他啶耐药性方面呈显著上升趋势,而在头孢吡肟、环丙沙星和庆大霉素耐药性方面呈显著上升趋势。对所有分析的抗生素和苯唑西林的敏感性增加。碳青霉烯类耐药性未观察到上升趋势。

结论

观察到常见微生物以及[未提及具体微生物名称]对第三代和第四代头孢菌素的耐药性呈上升趋势;相比之下,[未提及具体微生物名称]和[未提及具体微生物名称]的抗生素耐药性未观察到上升趋势。抗菌药物耐药性监测计划的重要作用是指出并识别这些趋势,这应有助于改善抗生素耐药性控制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfab/9581729/728ff6e0573e/IDR-15-6067-g0001.jpg

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