Vlad Madalina Alexandra, Dan Maria, Catana Andreea Nicoleta, Dumitriu Sebastian, Tuchilus Cristina Gabriela
Department of Microbiology, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iași, Romania.
Medical Analysis Laboratory, "St. Spiridon" County Clinical Emergency Hospital, 700111 Iași, Romania.
Molecules. 2025 Jul 12;30(14):2950. doi: 10.3390/molecules30142950.
Colistin has re-emerged as a last-resort antibiotic for treating infections caused by multidrug-resistant (MDR) Gram-negative bacilli (GNB). However, increasing resistance threatens its efficacy. This study aimed to evaluate colistin resistance trends among clinical isolates of Gram-negative bacilli isolated over a five-year period at a large Emergency Hospital in North-Eastern Romania. A total of 23,143 GNB strains were isolated during the study period, including 14,531 and 8294 non-fermenting Gram-negative bacilli. The percentage of colistin-resistant strains among those analyzed was 3.98%. Species-specific analysis focused on spp., , spp., spp., spp., and spp. spp. exhibited the highest prevalence of colistin resistance, accounting for over 80% of all colistin-resistant strains, with annual resistance rates fluctuating between 12.97% and 21.64%. Colistin resistance among was low (0.18-1.25%). spp. showed no resistance in the last three years of the study, and spp. maintained relatively stable resistance (3-5%). Resistance in spp. remained below 1%, while spp. showed a resistance rate of 5.43%. Several distinct resistance phenotypes were identified among spp., spp., and spp. strains, reflecting both endemic and sporadic circulation patterns. The study highlights a persistent presence of colistin resistance, especially in spp., underlining the importance of ongoing surveillance. Despite low resistance in other species, the emergence of resistant strains underscores the need for robust antimicrobial stewardship and infection control policies.
黏菌素已重新成为治疗多重耐药（MDR）革兰氏阴性杆菌（GNB）引起感染的最后一道抗生素防线。然而，不断增加的耐药性威胁着其疗效。本研究旨在评估罗马尼亚东北部一家大型急诊医院在五年期间分离出的革兰氏阴性杆菌临床分离株中黏菌素的耐药趋势。在研究期间共分离出23143株GNB菌株，其中包括14531株发酵型和8294株非发酵型革兰氏阴性杆菌。在所分析的菌株中，黏菌素耐药菌株的比例为3.98%。种属特异性分析集中在大肠埃希菌属、肺炎克雷伯菌属、铜绿假单胞菌属、鲍曼不动杆菌属、嗜麦芽窄食单胞菌属和阴沟肠杆菌属。鲍曼不动杆菌属表现出最高的黏菌素耐药率，占所有黏菌素耐药菌株的80%以上，年耐药率在12.97%至21.64%之间波动。大肠埃希菌属中的黏菌素耐药率较低（0.18 - 1.25%）。在研究的最后三年中，嗜麦芽窄食单胞菌属未表现出耐药性，而阴沟肠杆菌属的耐药性保持相对稳定（3 - 5%）。肺炎克雷伯菌属的耐药率仍低于1%，而铜绿假单胞菌属的耐药率为5.43%。在大肠埃希菌属、肺炎克雷伯菌属和鲍曼不动杆菌属菌株中鉴定出了几种不同的耐药表型，反映了地方流行和散发传播模式。该研究强调了黏菌素耐药性的持续存在，尤其是在鲍曼不动杆菌属中，凸显了持续监测的重要性。尽管其他菌种的耐药性较低，但耐药菌株的出现强调了强有力的抗菌药物管理和感染控制政策的必要性。
