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2018 年至 2021 年来自国家数据库的冈山地区抗生素耐药现状。

Current Prevalence of Antimicrobial Resistance in Okayama from a National Database between 2018 and 2021.

机构信息

Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.

Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.

出版信息

Acta Med Okayama. 2023 Jun;77(3):255-262. doi: 10.18926/AMO/65490.

Abstract

Antimicrobial resistance is an emerging global threat that must be addressed using a multidisciplinary approach. This study aimed to raise awareness of high-level antimicrobial-resistant (AMR) pathogens in Japan by comparing their recent prevalences among prefectures, particularly Okayama. Data for the isolation proportions of meropenem-resistant Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus faecium, cefotaxime-resistant Escherichia coli and Klebsiella pneumoniae, and levofloxacin-resistant E. coli and K. pneumoniae were collected from the Japan Nosocomial Infections Surveillance, a national database sponsored by the Japanese Ministry of Health, Labour, and Welfare, between 2018 and 2021. The average isolated proportions of the seven AMR pathogens were higher in Okayama compared to other prefectures: the worst (19.9%) was meropenem-resistant P. aeruginosa, the sixth worst (57.2%) was methicillin-resistant S. aureus, the eighth worst (3.3%) was vancomycin-resistant E. faecium, the second (37.8%) and fifth worst (17.6%) were cefotaxime-resistant E. coli and K. pneumoniae, respectively, and the fourth (49.9%) and third worst (8.7%) were levofloxacin-resistant E. coli and K. pneumoniae, respectively. Our study highlights the notably high prevalences of representative AMR pathogens in Okayama, suggesting the need for fundamental infection prevention and control by healthcare professionals, promoting antimicrobial stewardship, and educating undergraduates and postgraduates in Okayama.

摘要

抗微生物药物耐药性是一个新出现的全球威胁,必须采用多学科方法来应对。本研究旨在通过比较日本各地区(特别是冈山县)近期高耐药性(AMR)病原体的流行情况,提高对其的认识。从日本厚生劳动省资助的全国医院感染监测数据库中收集了 2018 年至 2021 年美罗培南耐药铜绿假单胞菌、耐甲氧西林金黄色葡萄球菌、万古霉素耐药粪肠球菌、头孢噻肟耐药大肠埃希菌和肺炎克雷伯菌以及左氧氟沙星耐药大肠埃希菌和肺炎克雷伯菌的分离比例数据。与其他县相比,冈山县这七种 AMR 病原体的平均分离比例更高:最严重的是美罗培南耐药铜绿假单胞菌(19.9%),第六严重的是耐甲氧西林金黄色葡萄球菌(57.2%),第八严重的是万古霉素耐药粪肠球菌(3.3%),其次是头孢噻肟耐药大肠埃希菌和肺炎克雷伯菌(分别为 37.8%和 17.6%),第四和第三严重的是左氧氟沙星耐药大肠埃希菌和肺炎克雷伯菌(分别为 49.9%和 8.7%)。我们的研究强调了冈山县代表性 AMR 病原体的流行率显著较高,这表明需要医疗保健专业人员进行基本的感染预防和控制,促进抗菌药物管理,并对冈山县的本科生和研究生进行教育。

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