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一所三级大学医院9年期间某菌属血流感染的实验室监测

Laboratory Surveillance of spp. Bloodstream Infections in a Tertiary University Hospital during a 9-Year Period.

作者信息

Spiliopoulou Anastasia, Giannopoulou Ioanna, Assimakopoulos Stelios F, Jelastopulu Eleni, Bartzavali Christina, Marangos Markos, Paliogianni Fotini, Kolonitsiou Fevronia

机构信息

Department of Microbiology, University Hospital of Patras, 265 04 Rio, Greece.

Department of Infectious Diseases, University Hospital of Patras, 265 04 Rio, Greece.

出版信息

Trop Med Infect Dis. 2023 Nov 19;8(11):503. doi: 10.3390/tropicalmed8110503.

Abstract

Multidrug-resistant infections have become a threat for public health worldwide. The aim of the present study was to follow-up resistance patterns of spp. bloodstream isolates in a Tertiary University Hospital over the last nine years, from 2014 to 2022. Susceptibility patterns were followed for the following antimicrobial agents: amikacin, gentamicin, tobramycin, ciprofloxacin, levofloxacin, imipenem, meropenem, tigecycline, trimethoprim/sulfamethoxazole, and colistin. Minimal inhibitory concentration (MIC) values to ampicillin/sulbactam, cefepime, ceftazidime, minocycline, piperacillin/tazobactam were evaluated from 2020 to 2023. During the study period, 853 spp. bloodstream infections (BSIs) were recorded, accounting for 5.36% of all BSIs. . was isolated in 795 cases (93.2%), during the study period. Most BSIs were recorded in adult intensive care units (ICU) (46.2%) and medical wards (42%). Among isolates, 4.5% were multidrug-resistant, 84.7% were extensively drug-resistant, and 8.5% were pandrug-resistant. Resistance to carbapenems was over 95%. Resistance to tigecycline increased significantly during the last years of the study (2020-2022); isolates with MIC ≤ 2 μg/mL accounted for 28.5% of all isolates. Resistance to colistin exhibited an increasing pattern up to 42.2% in 2022. Increasing resistance rates and the evolution of pandrug-resistant isolates call for the urgent application of preventive and response actions.

摘要

多重耐药感染已成为全球公共卫生的一大威胁。本研究的目的是追踪2014年至2022年这过去九年里一所三级大学医院中某菌属血流分离株的耐药模式。对以下抗菌药物的药敏模式进行了追踪:阿米卡星、庆大霉素、妥布霉素、环丙沙星、左氧氟沙星、亚胺培南、美罗培南、替加环素、甲氧苄啶/磺胺甲恶唑和黏菌素。对2020年至2023年期间氨苄西林/舒巴坦、头孢吡肟、头孢他啶、米诺环素、哌拉西林/他唑巴坦的最低抑菌浓度(MIC)值进行了评估。在研究期间,记录了853例某菌属血流感染(BSIs),占所有BSIs的5.36%。在研究期间,795例(93.2%)分离出了该菌。大多数BSIs记录在成人重症监护病房(ICU)(46.2%)和内科病房(42%)。在分离株中,4.5%为多重耐药,84.7%为广泛耐药,8.5%为全耐药。对碳青霉烯类的耐药率超过95%。在研究的最后几年(2020 - 2022年),对替加环素的耐药性显著增加;MIC≤2μg/mL的分离株占所有分离株的28.5%。对黏菌素的耐药率呈上升趋势,到2022年达到42.2%。耐药率的上升和全耐药分离株的演变呼吁紧急采取预防和应对措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/521f/10674392/e266df3bf00f/tropicalmed-08-00503-g001.jpg

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