Department of Microbiology, National Pirogov Memorial Medical University, Vinnytsya, Ukraine.
Department of Emergency and Military Medicine, National Pirogov Memorial Medical University, Vinnytsya, Ukraine.
J Hosp Infect. 2024 Oct;152:99-104. doi: 10.1016/j.jhin.2024.06.011. Epub 2024 Jul 10.
This study continues surveillance of antimicrobial resistance associated with combat injuries in Ukraine.
To compare species composition, antibiotic resistance profiles, and emergence of new resistance genes between 2014-2020 and 2022-2023.
This was a retrospective multi-centre microbiological survey in Ukrainian hospitals. Antibiotic susceptibility, whole-genome sequencing and multi-locus sequence typing were conducted on 154 organisms obtained from 125 casualties between 2022 and 2023.
The data revealed a predominance of Gram-negative bacteria, particularly Acinetobacter baumannii (35.7%), Pseudomonas aeruginosa (14.9%) and Klebsiella pneumoniae (20.7%). High levels of carbapenem resistance were observed among A. baumannii {meropenem 72.2% [39/54, 95% confidence interval (CI) 58.4-83.5]; imipenem 66.7% (36/54, 95% CI 52.5-78.9)}, K. pneumoniae [meropenem 90.6% (29/32, 95% CI 75.0-98.0); imipenem 81.2% (26/32, 95% CI 63.6-92.8)] and P. aeruginosa [meropenem 47.8% (11/23, 95% CI 26.8-69.4); imipenem 60.8% (14/23, 95% CI 38.5-80.3)] strains. A. baumannii sequence type (ST)-78 and ST-400 were prevalent from 2014 to 2020, while five strains of ST-1077 were newly identified in 2022-2023. P. aeruginosa strains showed diversity across 16 STs, with ST-773 increasing in frequency and new STs emerging, but lacking carbapenemase genes. K. pneumoniae exhibited increased genetic diversity over time, with three STs from 2014 to 2020 and six new STs, including bla, bla and bla carriers, in 2022-2023.
The prevalence of multi-drug-resistant isolates with STs associated with a high risk of global dissemination is increasing.
本研究持续监测乌克兰战伤相关的抗菌药物耐药情况。
比较 2014-2020 年与 2022-2023 年之间的物种组成、抗生素耐药谱和新耐药基因的出现情况。
这是一项在乌克兰医院进行的回顾性多中心微生物学调查。对 2022 年至 2023 年间 125 名伤员中获得的 154 株菌进行了抗生素敏感性、全基因组测序和多位点序列分型。
数据显示，革兰氏阴性菌占主导地位，特别是鲍曼不动杆菌（35.7%）、铜绿假单胞菌（14.9%）和肺炎克雷伯菌（20.7%）。鲍曼不动杆菌（美罗培南 72.2%[39/54，95%置信区间（CI）58.4-83.5%；亚胺培南 66.7%（36/54，95%CI 52.5-78.9%]）、肺炎克雷伯菌（美罗培南 90.6%[29/32，95%CI 75.0-98.0%；亚胺培南 81.2%（26/32，95%CI 63.6-92.8%]）和铜绿假单胞菌（美罗培南 47.8%[11/23，95%CI 26.8-69.4%；亚胺培南 60.8%（14/23，95%CI 38.5-80.3%））对碳青霉烯类药物的耐药率较高。2014 年至 2020 年，鲍曼不动杆菌流行株为 ST-78 和 ST-400，2022-2023 年新发现 5 株 ST-1077。铜绿假单胞菌菌株在 16 个 ST 中表现出多样性，ST-773 频率增加，新的 ST 出现，但缺乏碳青霉烯酶基因。肺炎克雷伯菌的遗传多样性随时间增加，2014 年至 2020 年有 3 个 ST，2022-2023 年有 6 个新 ST，包括 bla、bla 和 bla 携带株。
与高全球传播风险相关的多药耐药分离株的流行率正在上升。
