Vodianyk Arkadii, Holovnia Oksana, Diomin Eugene, Letourneau Alyssa R, Poznansky Mark C, Shenoy Erica S, Turbett Sarah E
Service Delivery Department, WHO Country Office for Ukraine, Kyiv, Ukraine.
Department of Bacteriology, National Children's Specialized Hospital Okhmatdyt, Kyiv, Ukraine.
JAC Antimicrob Resist. 2024 Oct 9;6(5):dlae156. doi: 10.1093/jacamr/dlae156. eCollection 2024 Oct.
Antimicrobial resistance is a global health threat resulting in significant morbidity and mortality worldwide. Until recently, in Ukraine, cumulative antibiograms (CuAbgms) have never been available.
To describe the first CuAbgm developed in Ukraine.
We developed a CuAbgm for the Okhmatdyt National Specialized Children's Hospital using data from WHONET. Antimicrobial susceptibility testing was performed per EUCAST guidelines. The CuAbgm was developed using guidance from CLSI.
For , 66% and 69% of isolates were susceptible to ceftazidime and ceftriaxone, respectively, and 99% were susceptible to meropenem. For , 26% and 27% of isolates were susceptible to ceftazidime and ceftriaxone, respectively, and only 59% were susceptible to meropenem. Of the carbapenem-resistant isolates that underwent additional susceptibility testing, only 38% were susceptible to ceftazidime/avibactam. For , only 53% were susceptible to meropenem. Of those that were resistant to meropenem and underwent additional susceptibility testing, only 12% were susceptible to ceftazidime/avibactam. Similarly, for spp., only 37% of isolates were susceptible to meropenem. Susceptibility to ampicillin/sulbactam was also low at 45%. The oxacillin susceptibility rate for was 99%.
In this first-ever CuAbgm developed in Ukraine, high levels of resistance were demonstrated among Gram-negative bacteria. CuAbgms should be prioritized in laboratories in Ukraine to guide empirical antimicrobial therapy, infection control and antimicrobial stewardship policies. This is of heightened relevance during wartime, when there is a need for healthcare systems to treat complex and infected penetrating and blast-related injuries.
抗菌药物耐药性是一种全球健康威胁，在全球范围内导致了显著的发病率和死亡率。直到最近，乌克兰都从未有过累积抗菌谱（CuAbgms）。
描述乌克兰开发的首个CuAbgm。
我们利用WHONET的数据为奥赫马迪特国立专科医院开发了一个CuAbgm。按照欧盟药敏试验委员会（EUCAST）指南进行抗菌药物敏感性测试。CuAbgm的开发遵循了美国临床和实验室标准协会（CLSI）的指导。
对于[具体细菌种类1]，分别有66%和69%的分离株对头孢他啶和头孢曲松敏感，99%对美罗培南敏感。对于[具体细菌种类2]，分别有26%和27%的分离株对头孢他啶和头孢曲松敏感，只有59%对美罗培南敏感。在接受额外敏感性测试的耐碳青霉烯类[具体细菌种类2]分离株中，只有38%对头孢他啶/阿维巴坦敏感。对于[具体细菌种类3]，只有53%对美罗培南敏感。在那些对美罗培南耐药并接受额外敏感性测试的分离株中，只有12%对头孢他啶/阿维巴坦敏感。同样，对于[具体细菌种类4]，只有37%的分离株对美罗培南敏感。氨苄西林/舒巴坦的敏感性也较低，为45%。[具体细菌种类5]对苯唑西林的敏感率为99%。
在乌克兰开发的首个CuAbgm中，革兰氏阴性菌表现出高水平的耐药性。乌克兰的实验室应优先开展CuAbgms，以指导经验性抗菌治疗、感染控制和抗菌药物管理政策。在战时，当医疗系统需要治疗复杂的、与穿透伤和爆炸相关的感染性损伤时，这一点尤为重要。
