1Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA.
2Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA.
J Am Vet Med Assoc. 2023 Mar 1;261(7):1-7. doi: 10.2460/javma.22.12.0545. Print 2023 Jul 1.
To create antibiograms for commonly cultured organisms in a small animal tertiary care hospital following Clinical and Laboratory Standards Institute guidelines and to compare these local resistance patterns to published first-tier antimicrobial recommendations.
Urine (n = 429), respiratory (41), and skin (75) isolates cultured from dogs between January 1, 2019, and December 31, 2020, at the Tufts University Foster Hospital for Small Animals.
MIC and susceptibility interpretations were recorded for multiple sites for 2 years. Sites with greater than 30 isolates for at least 1 organism were included. Urinary, respiratory, and skin antibiograms were created using Clinical and Laboratory Standards Institute breakpoints and guidelines.
Urinary Escherichia coli had a higher susceptibility percentage for amoxicillin-clavulanate (80% [221/275]) than amoxicillin alone (64% [175/275]). Respiratory E coli were greater than 80% susceptible to only 2 antimicrobials (imipenem, amikacin). Of skin Staphylococcus pseudintermedius isolates, 40% (30/75) were methicillin-resistant and frequently also displayed resistance to non-beta lactam antimicrobials. Susceptibility to recommended first-line antimicrobials varied and was greatest for gram-negative urinary isolates and lowest for methicillin-resistant S pseudintermedius skin isolates and respiratory E coli.
Local antibiogram creation identified frequent resistance that may preclude the use of guideline-recommended first-line therapy. High levels of resistance identified in methicillin-resistant S pseudintermedius isolates supports growing concern for methicillin-resistant staphylococci in veterinary patients. This project highlights the need for population-specific resistance profiles to be used in conjunction with national guidelines.
根据临床和实验室标准协会的指南，为一家小动物三级护理医院中常见培养的生物体创建抗生素图，并将这些本地耐药模式与已发表的一线抗菌建议进行比较。
2019 年 1 月 1 日至 2020 年 12 月 31 日期间，在塔夫茨大学福斯特动物医院培养的来自狗的尿液（n = 429）、呼吸道（41）和皮肤（75）分离物。
在 2 年内记录了多个部位的 MIC 和药敏解释。纳入了至少有 1 种生物体的 30 个以上分离物的部位。使用临床和实验室标准协会的临界点和指南创建了尿液、呼吸道和皮肤的抗生素图。
尿液大肠杆菌对阿莫西林-克拉维酸的敏感性百分比（80%[221/275]）高于阿莫西林单独使用（64%[175/275]）。呼吸道大肠杆菌仅对 2 种抗生素（亚胺培南、阿米卡星）的敏感性大于 80%。40%（30/75）的皮肤中间葡萄球菌分离物为耐甲氧西林，且经常对非β-内酰胺类抗生素也有耐药性。对推荐的一线抗生素的敏感性不同，革兰氏阴性尿液分离物的敏感性最高，耐甲氧西林中间葡萄球菌皮肤分离物和呼吸道大肠杆菌的敏感性最低。
本地抗生素图的创建确定了频繁的耐药性，这可能会排除指南推荐的一线治疗方法的使用。耐甲氧西林中间葡萄球菌分离物中鉴定出的高水平耐药性支持了兽医患者中耐甲氧西林葡萄球菌日益增多的担忧。该项目强调需要使用特定于人群的耐药谱与国家指南结合使用。
