黄金葡萄球菌 (Staphylococcus aureus) 和白球菌 (Enterococcus spp.) 的抗菌耐药性. 澳大利亚儿童血液感染的分离物,2013-2021年
Anita Williams1, Geoffrey W Coombs2,3,4, Jan M Bell5
1Wesfarmers Centre of Vaccines and Infectious Diseases, The Kids Research Institute Australia, Nedlands, Western Australia, Australia.
Journal of the Pediatric Infectious Diseases Society
|October 29, 2024
概括
在澳大利亚儿童中,黄金葡萄球菌和菌血流感染 (BSI) 的抗菌素耐药性 (AMR) 显示出显著的转变. 根据年龄分层报告对于理解儿科AMR监测中抗药性模式的演变至关重要.
科学领域:
- 儿童传染病 儿童传染病
- 抗微生物耐药性的流行病学.
- 临床微生物学 临床微生物学
背景情况:
- 抗菌素耐药性 (AMR) 的上升对金黄色葡萄球菌和菌菌种都越来越令人担忧.
- 了解儿科患者的耐药性趋势对于有效的治疗策略至关重要.
研究的目的:
- 分析澳大利亚儿童引起血流感染 (BSI) 的金黄色葡萄球菌和菌菌种的流行病学和抗菌素耐药性模式.
- 突出 AMR 监测中年龄分层数据的重要性.
主要方法:
- 利用了澳大利亚抗菌素耐药性监测计划研究小组 (9年) 的数据.
- 分析了来自18岁以下儿童的血液培养分离物的临床和微生物学数据.
- 通过EUCAST 2022指南和R软件进行分析来解释数据.
主要成果:
- 在儿童中观察到2091种金黄色细菌和534种肠球菌BSI. 黄金菌的BSI主要是社区发病的 (78.3%),而肠球菌的BSI主要是医院发病的 (56.9%).
- 甲素耐药黄金葡萄球菌 (MRSA) 占隔离物的15%. 在金黄色菌中,对青素 (85.3%),红素 (12.5%) 和克林达胺素 (10.3%) 发现了高耐药率,随着时间的推移,青素的耐药性下降,克林达胺素的耐药性增加.
- 肠球菌的耐药性主要存在于肠球菌 (Enterococcus faecium) 中 (73%对安培耐药,25.5%对万科米辛耐药[VREfm],8.8%对提科普拉宁耐药). 甲状腺肠球菌 (Enterococcus faecalis) 的耐药性较低.
结论:
- 在澳大利亚儿童中发现了S. aureus和Enterococcus BSIs的流行病学和耐药性概况的显著变化.
- 年龄分层报告对于准确解释和管理儿科AMR数据至关重要.
- 持续监测是必要的,以监测儿科血液感染中不断变化的耐药性趋势.
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