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在住院患者的抗菌素耐药性感染

Hannah Wolford¹, Natalie L McCarthy¹, James Baggs¹

¹Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.

JAMA network open

|March 14, 2025

概括

在美国,抗菌素耐药性仍然是一个重大的公共卫生问题. 尽管出现了一些下降,但MRSA和ESCR-EK等耐药性感染的发生率仍然很高,需要加强减少的战略.

科学领域:

公共卫生公共卫生
传染性疾病传染性疾病
流行病学流行病学

背景情况:

抗菌素耐药性 (AMR) 在美国构成了重大公共卫生挑战.
估计由耐药病原体引起的医疗保健相关感染 (HAI) 的全国率对于有针对性的干预至关重要.

研究的目的:

确定2012年至2022年6种主要耐药病原体的国家发病率.
为了追踪甲素耐药黄金葡萄球菌 (MRSA) 的趋势,抗万科胺素耐药Enterococcus spp. (VRE),以及其他随着时间的推移.

主要方法:

一项队列研究分析了2012年至2022年住院患者住院数据.
利用PINC-AI和Becton Dickinson Insights数据库的数据,包括临床培养和抗菌素敏感性测试 (AST).
对于六种特定的抗菌素耐药性病原体,定义了社区发病和医院发病病例.

主要成果:

在2022年,估计有569,749例抗菌素耐药性感染病例发生,每10,000例住院病例中病例率为179.6.
耐MRSA和扩展频谱的抗氨酸的埃舍里希亚大肠杆菌和克莱布西拉spp. (ESCR-EK) 是最常见的病原体.
虽然一些医院发病的耐药性感染最初下降,但大多数在2020-2021年增加;社区发病的ESCR-EK在整个研究期间增加.

结论:

美国的抗菌素耐药性率在2012年至2022年之间呈现不均的下降,造成了相当大的持续负担.
这些发现强调了需要更有效的策略来打击抗微生物药物耐药性日益增长的威胁.

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