Facultad de Medicina, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico.
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
PeerJ. 2023 Jan 17;11:e14411. doi: 10.7717/peerj.14411. eCollection 2023.
Antimicrobial resistance is a global concern. Analysis of sterile fluids is essential because microorganisms are defined as significant in most cases. Blood, cerebrospinal, and pleural fluids are frequently received in the microbiology lab because they are associated with considerable rates of morbi-mortality. Knowledge of epidemiology in these samples is needed to choose proper empirical treatments due to the importance of reducing selection pressure.
We used retrospective laboratory data of blood, CSF, and pleural fluid collected from patients in Mexico between 2019 and 2020. Each laboratory identified the strains and tested susceptibility using its routine methods. For , a comparative analysis was performed with data from the broth microdilution method.
Forty-five centers participated in the study, with 30,746 clinical isolates from blood, 2,429 from pleural fluid, and 2,275 from CSF. For blood and CSF, was the most frequent. For blood, among gram negatives, the most frequent was . Among , 9.8% of were carbapenem-resistant For , similar resistance percentages were observed for levofloxacin, cefotaxime, and vancomycin. For CSF, the most frequent gram-negative was In , carbapenem resistance was 71.4%. The most frequent species detected for pleural fluid was ; in , carbapenem resistance was 96.3%.
Gram-negative bacteria, with most prevalent, are frequently recovered from CSF, blood, and pleural fluid. In , the routine, conventional methods showed good agreement in detecting resistance percentages for erythromycin, levofloxacin, and vancomycin.
抗菌药物耐药性是一个全球性问题。分析无菌体液至关重要,因为微生物在大多数情况下被定义为重要病原体。由于与较高的病死率相关,血、脑脊髓和胸腔积液经常被送到微生物实验室进行检测。由于降低选择压力的重要性,了解这些样本中的流行病学知识有助于选择适当的经验性治疗方法。
我们使用了 2019 年至 2020 年期间从墨西哥患者中收集的血、CSF 和胸腔积液的回顾性实验室数据。每个实验室都使用其常规方法鉴定菌株并测试药敏性。对于 ,与肉汤微量稀释法的数据进行了比较分析。
45 个中心参与了这项研究,共检测了 30746 株血培养分离株、2429 株胸腔积液分离株和 2275 株脑脊液分离株。对于血和脑脊液,最常见的病原体是 。在革兰氏阴性菌中,最常见的是 。对于血,9.8%的 对碳青霉烯类耐药。对于 ,左氧氟沙星、头孢噻肟和万古霉素的耐药率相似。对于 CSF,最常见的革兰氏阴性菌是 ,碳青霉烯类耐药率为 71.4%。胸腔积液中最常见的革兰氏阴性菌是 ,碳青霉烯类耐药率为 96.3%。
革兰氏阴性菌,以 最常见,经常从 CSF、血液和胸腔积液中分离出来。对于 ,常规的传统方法在检测红霉素、左氧氟沙星和万古霉素的耐药率方面具有良好的一致性。