在过去 12 年(2010-2021 年)中,阿拉伯海湾地区铜绿假单胞菌的抗生素耐药性分析。

Antimicrobial Resistance Profiles of Pseudomonas aeruginosa in the Arabian Gulf Region Over a 12-Year Period (2010-2021).

机构信息

National Reference Laboratory, Abu Dhabi, UAE.

Department of Pathology and Laboratory Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, UAE.

出版信息

J Epidemiol Glob Health. 2024 Sep;14(3):529-548. doi: 10.1007/s44197-024-00191-y. Epub 2024 Jun 10.

Abstract

OBJECTIVES

To evaluate literature from a 12-year period (2010-2021) on the antimicrobial resistance profile of Pseudomonas aeruginosa from the Arabian Gulf countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates).

METHODS

An electronic literature search was conducted for articles on antimicrobial resistance in P. aeruginosa and associated phenotypes, covering the period of 1st January 2010 to 1st December 2021.

RESULTS

Antimicrobial resistance in the Arabian Gulf was highest to meropenem (10.3-45.7%) and lowest to colistin (0.0-0.8%), among the agents tested. Annual data showed that ceftazidime resistance (Kuwait), piperacillin-tazobactam non-susceptibility (Qatar), and aztreonam, imipenem, and meropenem resistance (Saudi Arabia) increased by 12-17%. Multiple mechanisms of carbapenem resistance were identified and multiple clones were detected, including high-risk clones such as ST235. The most common carbapenemases detected were the VIM-type metallo-β-lactamases.

CONCLUSIONS

Among P. aeruginosa in the Arabian Gulf countries, resistance to meropenem was higher than to the other agents tested, and meropenem resistance increased in Saudi Arabia during the study period. Resistance to colistin, a classic antibiotic used to treat Pseudomonas spp. infections, remained low. The VIM-type β-lactamase genes were dominant. We recommend local and regional antimicrobial resistance surveillance programs to detect the emergence of resistance genes and to monitor antimicrobial resistance trends in P. aeruginosa.

摘要

目的

评估 2010 年至 2021 年期间来自阿拉伯海湾国家(巴林、科威特、阿曼、卡塔尔、沙特阿拉伯和阿拉伯联合酋长国)的铜绿假单胞菌的抗菌药物耐药性研究文献。

方法

对 2010 年 1 月 1 日至 2021 年 12 月 1 日期间发表的关于铜绿假单胞菌的抗菌药物耐药性及相关表型的文章进行电子文献检索。

结果

在所测试的药物中,阿拉伯海湾地区铜绿假单胞菌的抗菌药物耐药率最高的是美罗培南(10.3%-45.7%),最低的是黏菌素(0.0%-0.8%)。年度数据显示,头孢他啶耐药(科威特)、哌拉西林-他唑巴坦不敏感(卡塔尔)以及阿佐培南、亚胺培南和美罗培南耐药(沙特阿拉伯)增加了 12%-17%。确定了多种碳青霉烯类耐药机制,检测到多种克隆,包括 ST235 等高危克隆。最常见的碳青霉烯酶是 VIM 型金属β-内酰胺酶。

结论

在阿拉伯海湾国家的铜绿假单胞菌中,对美罗培南的耐药性高于其他测试药物,并且在研究期间沙特阿拉伯的美罗培南耐药性有所增加。对黏菌素的耐药性,一种用于治疗铜绿假单胞菌感染的经典抗生素,仍然较低。VIM 型β-内酰胺酶基因占主导地位。我们建议开展本地和区域抗菌药物耐药性监测计划,以检测耐药基因的出现,并监测铜绿假单胞菌的抗菌药物耐药趋势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e30d/11442796/5eec70c2eb92/44197_2024_191_Fig1_HTML.jpg

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