Estimated Incidence of Antimicrobial Drug-Resistant Nontyphoidal Salmonella Infections, United States, 2004-2012.
Estimated Incidence of Antimicrobial Drug-Resistant Nontyphoidal Salmonella Infections, United States, 2004-2012.
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DOI：
10.3201/eid2301.160771
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发表时间：
2016-01
影响因子：
11.8
通讯作者：
Hoekstra RM
中科院分区：
文献类型：
--
作者：
Medalla F;Gu W;Mahon BE;Judd M;Folster J;Griffin PM;Hoekstra RM
沙门氏菌感染是美国疾病的主要原因。用于治疗严重感染的抗微生物剂包括头孢曲松、环丙沙星和氨苄青霉素。抗菌药物耐药性与不良临床结局相关。为了估计耐药培养证实的非伤寒沙门氏菌感染的发生率，我们使用了来自疾病控制和预防中心国家抗菌素耐药性监测系统和基于实验室的肠道疾病监测的2004-2012年数据的贝叶斯分层模型。我们根据敏感性测试的3个相互排斥的耐药类别：头孢曲松和氨苄青霉素耐药，环丙沙星不敏感，但头孢曲松敏感，氨苄青霉素耐药，但头孢曲松和环丙沙星敏感。我们估计，仅氨苄青霉素耐药的耐药感染总发生率为1.07/100，000人年，头孢曲松和氨苄青霉素耐药为0.51/100，000人年，环丙沙星不敏感为0.35/100，000人年，或每年106，200例经培养确认的耐药感染。这些国家估计数有助于确定抗药性问题的严重程度，以便能够适当地针对控制措施。
Salmonella infections are a major cause of illness in the United States. The antimicrobial agents used to treat severe infections include ceftriaxone, ciprofloxacin, and ampicillin. Antimicrobial drug resistance has been associated with adverse clinical outcomes. To estimate the incidence of resistant culture-confirmed nontyphoidal Salmonella infections, we used Bayesian hierarchical models of 2004–2012 data from the Centers for Disease Control and Prevention National Antimicrobial Resistance Monitoring System and Laboratory-based Enteric Disease Surveillance. We based 3 mutually exclusive resistance categories on susceptibility testing: ceftriaxone and ampicillin resistant, ciprofloxacin nonsusceptible but ceftriaxone susceptible, and ampicillin resistant but ceftriaxone and ciprofloxacin susceptible. We estimated the overall incidence of resistant infections as 1.07/100,000 person-years for ampicillin-only resistance, 0.51/100,000 person-years for ceftriaxone and ampicillin resistance, and 0.35/100,000 person-years for ciprofloxacin nonsusceptibility, or ≈6,200 resistant culture-confirmed infections annually. These national estimates help define the magnitude of the resistance problem so that control measures can be appropriately targeted.