Abu Dhabi Public Health Center, Abu Dhabi, United Arab Emirates.
Department of Pathology and Infectious Diseases, Khalifa University, Abu Dhabi, United Arab Emirates.
Front Public Health. 2024 Jan 4;11:1245131. doi: 10.3389/fpubh.2023.1245131. eCollection 2023.
spp., in particular , are opportunistic pathogens linked to nosocomial pneumonia (particularly ventilator-associated pneumonia), central-line catheter-associated blood stream infections, meningitis, urinary tract infections, surgical-site infections, and other types of wound infections. is able to acquire or upregulate various resistance determinants, making it frequently multidrug-resistant, and contributing to increased mortality and morbidity. Data on the epidemiology, levels, and trends of antimicrobial resistance of spp. in clinical settings is scarce in the Gulf Cooperation Council (GCC) and Middle East and North Africa (MENA) regions.
A retrospective 12-year analysis of 17,564 non-duplicate diagnostic spp. isolates from the United Arab Emirates (UAE) was conducted. Data was generated at 317 surveillance sites by routine patient care during 2010-2021, collected by trained personnel and reported by participating surveillance sites to the UAE National AMR Surveillance program. Data analysis was conducted with WHONET.
Species belonging to the complex were mostly reported (86.7%). They were most commonly isolated from urine (32.9%), sputum (29.0%), and soft tissue (25.1%). Resistance trends to antibiotics from different classes during the surveillance period showed a decreasing trend. Specifically, there was a significant decrease in resistance to imipenem, meropenem, and amikacin. Resistance was lowest among species to both colistin and tigecycline. The percentages of multidrug-resistant (MDR) and possibly extensively drug-resistant (XDR) isolates was reduced by almost half between the beginning of the study in 2010 and its culmination in 2021. Carbapenem-resistant spp. (CRAB) was associated with a higher mortality (RR: 5.7), a higher admission to ICU (RR 3.3), and an increased length of stay (LOS; 13 excess inpatient days per CRAB case), as compared to Carbapenem-susceptible spp.
Carbapenem-resistant spp. are associated with poorer clinical outcomes, and higher associated costs, as compared to carbapenem-susceptible spp. A decreasing trend of MDR spp., as well as resistance to all antibiotic classes under surveillance was observed during 2010 to 2021. Further studies are needed to explore the reasons and underlying factors leading to this remarkable decrease of resistance over time.
种属，尤其是机会性病原体，与医院获得性肺炎（尤其是呼吸机相关性肺炎）、中央导管相关血流感染、脑膜炎、尿路感染、手术部位感染和其他类型的伤口感染有关。能够获得或上调各种耐药决定因素，使其经常成为多药耐药菌，并导致死亡率和发病率增加。在海湾合作委员会（GCC）和中东和北非（MENA）地区，关于种属的流行病学、水平和趋势的数据在临床环境中非常缺乏。
对 2010 年至 2021 年期间阿联酋（UAE）的 17564 例非重复诊断种属分离株进行了回顾性的 12 年分析。数据由 317 个监测点通过常规患者护理生成，由经过培训的人员收集，并由参与监测的地点报告给阿联酋国家抗菌素耐药性监测计划。数据分析使用了 WHONET。
种属复合体的物种报告最多（86.7%）。它们最常从尿液（32.9%）、痰液（29.0%）和软组织（25.1%）中分离出来。在监测期间，不同类别抗生素的耐药趋势呈下降趋势。具体来说，对亚胺培南、美罗培南和阿米卡星的耐药性显著下降。种属对黏菌素和替加环素的耐药率最低。2010 年研究开始时和 2021 年研究结束时，多药耐药（MDR）和可能广泛耐药（XDR）分离株的百分比几乎减少了一半。耐碳青霉烯肠杆菌科（CRAB）与更高的死亡率（RR：5.7）、更高的 ICU 入院率（RR 3.3）和更长的住院时间（LOS；每例 CRAB 病例增加 13 天住院时间）相关，与碳青霉烯敏感肠杆菌科（CSAB）相比。
与碳青霉烯敏感肠杆菌科相比，耐碳青霉烯肠杆菌科与更差的临床结局和更高的相关成本相关。在 2010 年至 2021 年期间，观察到 MDR 种属呈下降趋势，以及所有监测抗生素类别的耐药性呈下降趋势。需要进一步研究探索导致这种耐药性随时间显著下降的原因和潜在因素。
