一个嵌套队列为期5年的加拿大监测格兰氏阴性抗菌素耐药性,以优化抗菌素治疗
Joseph Blondeau1, Marthe Kenny Charles2, Vivian Loo3
1Clinical Microbiology, Royal University Hospital and the Saskatchewan Health Authority, and the Departments of Pathology and Laboratory Medicine, Microbiology, Immunology and Biochemistry, and Ophthalmology, University of Saskatchewan, Saskatoon, SK, Canada.
Scientific reports
|August 29, 2023
概括
在加拿大成年人中抗微生物耐药性 (AMR) 的格兰氏阴性感染表明大肠杆菌,P. aeruginosa和K. pneumoniae作为主要的病原体. 塞夫托洛赞/塔扎巴克坦对P. aeruginosa具有很高的敏感性,有助于抗菌管理.
科学领域:
- 传染性疾病 传染性疾病
- 微生物学 微生物学
- 公共卫生 公共卫生
背景情况:
- 抗菌素耐药性 (AMR) 对全球健康构成重大威胁.
- 了解医疗保健机构中的AMR模式对于有效治疗至关重要.
- 加拿大监测数据提供了关于格拉姆阴性感染的宝贵见解.
研究的目的:
- 分析2016-2020年在加拿大医疗保健机构成年人格兰氏阴性感染中的病原体占主导地位和AMR模式.
- 识别关键病原体及其耐药性概况,以指导抗菌药物管理.
- 为了补充现有的加拿大公共监控计划.
主要方法:
- 通过监测抗菌素耐药性趋势研究 (SMART) 来分析来自加拿大医疗保健机构的6853种格拉姆阴性细菌分离物 (2016-2020年).
- 分离物被按临床来源 (呼吸道,腹腔内,尿道,血液) 和单位类型 (医疗,外科,ICU,急诊) 分类.
- 进行了病原体鉴定和抗微生物敏感性测试.
主要成果:
- 大肠杆菌 (36%), Pseudomonas aeruginosa (18%) 和 Klebsiella pneumoniae (12%) 是最常见的分离物.
- P. aeruginosa是主要的呼吸道病原体,10%的病原体表现出多药性耐药性 (MDR).
- 观察到P. aeruginosa对塞夫托拉/塔扎巴克坦和胆固醇素的高度敏感性 (>95%),而对其他药物的敏感性则有所不同 (58-74%). 18%的肠道细菌是ESBL阳性的.
结论:
- 国家监测数据揭示了加拿大成人医疗保健中关键的格拉姆阴性病原体和AMR趋势.
- 塞夫托洛赞/塔扎巴克坦对P. aeruginosa,包括MDR菌株,显示出显著的疗效.
- 这些发现支持制定有针对性的抗菌药物管理策略和治疗指南.
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