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门诊病人的抗菌素耐药性模式 黄金葡萄球菌 隔离物
Margaret Carrel1, Matthew Smith2,3, Qianyi Shi2
1Department of Geographical and Sustainability Sciences, University of Iowa, Iowa City.
JAMA network open
|June 14, 2024
概括
甲素耐药黄金葡萄球菌 (MRSA) 的患病率有所下降,但MRSA分离体对四环素和三甲胺-硫甲醇 (TMP-SMX) 的耐药性呈现上升. 地理分析显示,两种药物耐药性较高的县没有重叠.
科学领域:
- 传染性疾病 传染性疾病
- 抗微生物耐药性 抗微生物耐药性
- 公共卫生 公共卫生
背景情况:
- 口服非β-乳糖抗生素对于治疗金黄色葡萄球菌感染至关重要,特别是在门诊环境中.
- 关于美国S. aureus对这些抗生素耐药性的地理变异和时间趋势的数据有限.
研究的目的:
- 分析S. aureus对非β-乳酸抗生素的耐药性的时间空间趋势.
- 描述耐药率和多药耐药性的区域差异.
主要方法:
- 来自退伍军人卫生管理局数据的S. aureus感染 (2010-2019) 成年门诊患者的横截面研究.
- 对克林达米辛,四环素,三甲烯-硫甲醇 (TMP-SMX) 和宏化物耐药性的分析.
- 根据MRSA/MSSA和美国地区进行分层;采用趋势测试和双变异映射.
主要成果:
- MRSA 的比例从53.6% (2010) 降至38.8% (2019).
- MRSA分离体对四环素 (3.6%至12.8%) 和TMP-SMX (2.6%至9.2%) 的耐药性增加.
- 在MSSA分离物中,克林达米辛,四环素和TMP-SMX的耐药性呈上升趋势.
结论:
- 虽然MRSA的患病率下降,但对关键的非β-乳酸盐的耐药性在MRSA分离物中增加.
- 地理分析没有发现对四环素和TMP-SMX的高耐药性重叠区域.
- 了解区域抗生素耐药性模式对于实证治疗和跟踪耐药性演变至关重要.
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