van Hal Sebastiaan J, Jensen Slade O, Tong Stephen Y C, Bentley Stephen, Holden Matthew T
Department of Microbiology and Infectious Diseases, Royal Prince Alfred Hospital, Sydney, Australia.
Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
J Antimicrob Chemother. 2024 Apr 2;79(4):891-896. doi: 10.1093/jac/dkae048.
This study aims to elucidate the genomic dynamics driving the emergence of antimicrobial resistance (AMR), with a specific focus on the interplay between AMR and antimicrobial usage.
We conducted a comprehensive analysis using a ST239 methicillin-resistant Staphylococcus aureus (MRSA) dataset over a continuous 12-year period from a single hospital. Genomic analyses were performed tracking the changes in MRSA populations, particularly the emergence of reduced vancomycin susceptibility, and assessing the impact of glycopeptide use on these emergence events.
Our findings reveal a significant correlation between hospital glycopeptide usage and the selection of MRSA strains with reduced vancomycin susceptibility. Genomic analyses provided insights into the molecular mechanisms driving resistance emergence, including the slowing of the molecular clock rate in response to heightened antimicrobial consumption.
In conclusion, this study the highlights the complex dynamics between AMR and antimicrobial use at the hospital level. The observed correlation between antimicrobial consumption and the development of less susceptible MRSA strains underscores the importance of antimicrobial stewardship programmes and the establishment of optimal consumption thresholds for mitigating AMR effectively.
本研究旨在阐明推动抗菌药物耐药性（AMR）出现的基因组动态变化，特别关注AMR与抗菌药物使用之间的相互作用。
我们使用来自一家医院连续12年的ST239耐甲氧西林金黄色葡萄球菌（MRSA）数据集进行了全面分析。进行基因组分析以追踪MRSA种群的变化，特别是万古霉素敏感性降低的出现情况，并评估糖肽类药物使用对这些出现事件的影响。
我们的研究结果揭示了医院糖肽类药物使用与万古霉素敏感性降低的MRSA菌株选择之间存在显著相关性。基因组分析提供了对抗药性出现的分子机制的见解，包括分子钟速率因抗菌药物消耗增加而减慢。
总之，本研究突出了医院层面AMR与抗菌药物使用之间的复杂动态变化。抗菌药物消耗与较不易感的MRSA菌株发展之间观察到的相关性强调了抗菌药物管理计划以及建立最佳消耗阈值以有效减轻AMR的重要性。
