在日本住院患者中隔离的WHO优先病原体的抗菌素耐药性模式:第三级中心观察性研究
Tania Tabassum Nisa1, Daisaku Nakatani1, Fumie Kaneko1
1Department of Global and Innovative Medicine, Osaka University Graduate School of Medicine, Yamadaoka, Suita, Osaka, Japan.
抗菌素耐药性 (AMR) 在日本的WHO优先病原体中正在增加,特别是Pseudomonas aeruginosa的卡巴胺耐药性和E. coli和K. pneumoniae的脑菌素耐药性. 患有并发症的高风险患者面临临关键优先AMR的死亡率增加.
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:
- 世界卫生组织 (WHO) 确定了优先病原体,以指导抗微生物研究和开发.
- 了解局部抗菌素耐药性 (AMR) 流行病学对于有效的干预至关重要.
- 这项研究分析了日本一家三级医院的世卫组织优先生物.
研究的目的:
- 在日本一家三级医院评估世卫组织优先病原体的流行病学.
- 为了比较2010-2015年和2016-2021年之间的AMR趋势.
- 评估AMR对住院死亡率的影响,考虑到患者的并发病.
主要方法:
- 来自大阪大学医院 (2010-2021) 的电子病历的回顾性分析.
- 根据世卫组织优先清单 (危急,高,中等) 划分病原体的分类.
- 在早期 (2010-2015年) 和晚期 (2016-2021年) 阶段之间的抗菌药物耐药性率和住院死亡率的比较.
主要成果:
- 在52 130个培养阳性标本中的18.9%中发现了世卫组织优先分离物.
- 在后期阶段观察到 Pseudomonas aeruginosa 的卡巴因耐药性增加和 Escherichia coli 和 Klebsiella pneumoniae 的头类菌耐药性增加.
- 在WHO优先病原体类别中,住院死亡率是可比的,但在关键优先AMR和慢性病和糖尿病等并发症之间注意到了显著的相互作用.
结论:
- 当地抗菌素耐药性流行病学,特别是关于世卫组织优先病原体的流行病学,需要持续监测.
- 识别患有并发病的"高风险"患者对于有针对性的干预措施至关重要.
- 定期评估是更新抗微生物药物管理政策和实践所必需的.
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