Linam Matthew, Goldstein Madeleine, Huang Tracy, Westbrook Adrianna, Jerris Robert C, Gonzalez Mark D
Division of Pediatric Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA.
Children's Healthcare of Atlanta, Atlanta, GA, USA.
Antimicrob Steward Healthc Epidemiol. 2025 Feb 12;5(1):e37. doi: 10.1017/ash.2025.32. eCollection 2025.
Antibiograms monitor antibiotic resistance trends and help guide empiric antibiotic treatment. A statewide pediatric antibiogram can help inform stewardship efforts.
Annual pediatric antibiograms for the five children's hospitals in Georgia from 2014-2023 were collected. All sites used the Clinical and Laboratory Standards Institute guidelines for antibiogram development. Antibiogram data were combined, and the most common bacteria were included: Staphylococcus aureus, Streptococcus pneumoniae, Enterococcus faecalis, Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae complex and Pseudomonas aeruginosa. Interhospital differences were compared for methicillin-susceptible S. aureus (MSSA), methicillin-resistant S. aureus (MRSA), E. coli and K. pneumoniae. The combined data from 2014 and 2023 were compared to demonstrate antibiotic susceptibility changes over time.
Data in 2023 for MSSA and MRSA showed clindamycin susceptibility was 78% and 82%, respectively. S. pneumoniae susceptibility to amoxicillin/clavulanate was 96%. E. faecalis resistance to ampicillin and vancomycin was rare. For all included gram-negative bacteria, susceptibility remained high to 3 generation cephalosporins (90%-92%) and meropenem (95%-99%). From 2014 to 2023, the rate of MRSA decreased from 49% to 33.5%. S. pneumoniae susceptibility to amoxicillin/clavulanate and clindamycin significantly increased. For E. coli, there was a significant decrease in susceptibility for cefazolin (90% to 84%), ceftriaxone (95% to 92%), and meropenem (100% to 99%). There were nonsignificant decreases in susceptibility for K. pneumoniae.
Over the past 10 years, MRSA rates decreased, S. pneumoniae antibiotic susceptibility increased, and gram-negative bacilli susceptibility was stable to slightly decreased. Georgia antibiogram data support the recommended antibiotic treatment for common pediatric infections.
抗菌谱监测抗生素耐药趋势，并有助于指导经验性抗生素治疗。全州范围的儿科抗菌谱有助于指导管理工作。
收集了2014年至2023年佐治亚州五家儿童医院的年度儿科抗菌谱。所有机构均采用临床和实验室标准协会的抗菌谱制定指南。将抗菌谱数据合并，并纳入最常见的细菌：金黄色葡萄球菌、肺炎链球菌、粪肠球菌、大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌复合体和铜绿假单胞菌。比较了耐甲氧西林金黄色葡萄球菌（MSSA）、耐甲氧西林金黄色葡萄球菌（MRSA）、大肠埃希菌和肺炎克雷伯菌的医院间差异。比较了2014年和2023年的合并数据，以显示抗生素敏感性随时间的变化。
2023年MSSA和MRSA的数据显示，克林霉素敏感性分别为78%和82%。肺炎链球菌对阿莫西林/克拉维酸的敏感性为96%。粪肠球菌对氨苄西林和万古霉素的耐药性罕见。对于所有纳入的革兰氏阴性菌，对第三代头孢菌素（90%-92%）和美罗培南（95%-99%）的敏感性仍然很高。从2014年到2023年，MRSA的发生率从49%降至33.5%。肺炎链球菌对阿莫西林/克拉维酸和克林霉素的敏感性显著增加。对于大肠埃希菌，头孢唑林（90%至84%）、头孢曲松（95%至92%）和美罗培南（100%至99%）的敏感性显著降低。肺炎克雷伯菌的敏感性有非显著性降低。
在过去10年中，MRSA发生率下降，肺炎链球菌抗生素敏感性增加，革兰氏阴性杆菌敏感性稳定至略有下降。佐治亚州抗菌谱数据支持常见儿科感染的推荐抗生素治疗。
