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尿病原体抗菌敏感性模式的转变:20年尿液培养分析
Shinichi Takebe1,2, Masami Endo3, Nanaho Demizu1
1Department of Urology, International Goodwill Hospital, Yokohama, Kanagawa, Japan.
概括
尿路感染中的抗菌素耐药性正在增加,特别是大肠杆菌中的化诺耐药性. 持续监测对于有效的治疗和抗菌药物管理至关重要.
科学领域:
- 医学微生物学 医学微生物学
- 传染性疾病 传染性疾病
- 临床药房 临床药房
背景情况:
- 泌尿病原体的抗菌素耐药性 (AMR),特别是扩展谱β-乳糖酶 (ESBL) 生产和诺 (FQ) 耐药性,对治疗尿路感染 (UTIs) 构成重大挑战.
- 了解长期耐药性趋势对于有效的抗菌药物管理和患者管理至关重要.
研究的目的:
- 为了分析日本一家二级医院关键尿路分离物的抗微生物敏感性模式的20年趋势.
- 为了确定扩展光谱β-乳糖酶 (ESBL) 生产和化 (FQ) 耐药率的时间变化.
主要方法:
- 从2004年1月到2023年12月对18873个尿液培养分离物的回顾性分析.
- 根据CLSI指南进行的细菌鉴定和抗微生物敏感性测试.
- 后勤回归用于分析ESBL生产和FQ抗性的时间趋势.
主要成果:
- 在大肠杆菌 (Escherichia coli),肺炎菌 (Klebsiella pneumoniae) 和神奇蛋白 (Proteus mirabilis) 中观察到ESBL产量的显著增加.
- 在大肠杆菌,对甲素敏感的黄金葡萄球菌 (MSSA) 和B组链球菌 (GBS) 中,诺醇耐药性显著增加.
- 在Enterococcus faecalis和Pseudomonas aeruginosa中,诺基诺隆耐药性下降;最近,大肠杆菌中的ESBL和FQ耐药性已经稳定下来.
结论:
- 二十年的监测揭示了尿病原体中复杂的,特定物种的AMR模式.
- 大肠杆菌的高FQ耐药性需要局部敏感性数据来进行实证抗生素选择.
- 持续的设施级监测对于抗微生物药物管理和优化患者护理至关重要.
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