Emerging importance of multidrug-resistant Acinetobacter species and Stenotrophomonas maltophilia as pathogens in seriously ill patients:: Geographic patterns, epidemiological features, and trends in the SENTRY Antimicrobial Surveillance Program (1997-1999)
Emerging importance of multidrug-resistant Acinetobacter species and Stenotrophomonas maltophilia as pathogens in seriously ill patients:: Geographic patterns, epidemiological features, and trends in the SENTRY Antimicrobial Surveillance Program (1997-1999)
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DOI：
10.1086/320183
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发表时间：
2001-05-15
影响因子：
11.8
通讯作者：
Verhoef, J
中科院分区：
文献类型：
--
作者：
Gales, AC;Jones, RN;Verhoef, J
作为 SENTRY 抗菌监测计划的一部分，1997 年 1 月至 1999 年 12 月期间，从 5 个地理区域（加拿大、美国、拉丁美洲、欧洲和亚太地区）总共收集了 1078 种不动杆菌和 842 种嗜麦芽寡养单胞菌分离株。评估了感染频率（按地理区域和身体部位），包括由耐亚胺培南不动杆菌属和耐甲氧苄氨嘧啶-磺胺甲恶唑（TMP-SMZ）的嗜麦芽糖链球菌引起的感染频率。研究了不动杆菌属引起的血流感染季节性变化的可能性，以及几种治疗性抗菌药物对所有菌株的活性。不动杆菌属和嗜麦芽糖链球菌最常与肺部感染相关，与评估的区域无关。相比之下，不同地理区域的抗菌药物耐药性模式存在显着差异，尤其是院内分离株。尽管碳青霉烯类药物是针对不动杆菌属最有效的抗菌药物，但在这两个地区，近 11.0% 的医院分离株对该药物组具有耐药性。 TMP-SMZ、替卡西林克拉维酸、加替沙星和曲伐沙星是唯一对嗜麦芽糖链球菌分离株具有一致治疗活性的药物。 TMP-SMZ 的耐药率从加拿大和拉丁美洲的 2% 到欧洲的 10% 不等。本研究中观察到的不动杆菌属和嗜麦芽糖链球菌菌株之间耐药性模式的地理差异强调了当地监测在确定不动杆菌和嗜麦芽糖链球菌感染的最适当治疗方法以及可能发生的克隆性流行性质方面的重要性。
As part of the SENTRY Antimicrobial Surveillance Program, a total of 1078 Acinetobacter species and 842 Stenotrophomonas maltophilia isolates were collected between January 1997 and December 1999 from 5 geographic regions (Canada, the United States, Latin America, Europe, and the Asia-Pacific). The frequency of infections (by geographic region and body site), including those due to imipenem-resistant Acinetobacter species and trimethoprim-sulfamethoxazole (TMP-SMZ)-resistant S. maltophilia, was evaluated. The possibility of seasonal variations in bloodstream infections caused by Acinetobacter species was studied, as was the activity of several therapeutic antimicrobials against all strains. Acinetobacter species and S. maltophilia were most frequently associated with pulmonary infections, independent of the region evaluated. In contrast, patterns of antimicrobial resistance markedly varied among distinct geographic regions, especially for nosocomial isolates. Although the carbapenems were the most active antimicrobials against Acinetobacter species, nearly 11.0% of the nosocomial isolates were resistant to this drug group in both regions. TMP-SMZ, ticarcillin-clavulanic acid, gatifloxacin, and trovafloxacin were the only agents with consistent therapeutic activity against S. maltophilia isolates. Rates of resistance to TMP-SMZ ranged from 2% in Canada and Latin America to 10% in Europe. The geographic differences in resistance patterns among Acinetobacter species and S. maltophilia isolates observed in this study emphasize the importance of local surveillance in determining the most adequate therapy for acinetobacter and S. maltophilia infections and the possible clonal, epidemic nature of occurrence.