Occurrence and antimicrobial resistance pattern comparisons among bloodstream infection isolates from the SENTRY Antimicrobial Surveillance Program (1997-2002)
Occurrence and antimicrobial resistance pattern comparisons among bloodstream infection isolates from the SENTRY Antimicrobial Surveillance Program (1997-2002)
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DOI：
10.1016/j.diagmicrobio.2004.05.003
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发表时间：
2004-09-01
影响因子：
2.9
通讯作者：
Jones, RN
中科院分区：
文献类型：
--
作者：
Biedenbach, DJ;Moet, GJ;Jones, RN
在抗生素耐药性不断增加的时代，血流感染（BSI）患者的经验性治疗变得更加复杂。自1997年以来，SENTRY抗菌素监测项目一直在全球医疗中心监测患者的BSI。在1997-2002年期间，共对来自北美、拉丁美洲和欧洲的81，213种BSI病原体进行了抗菌药物敏感性测试。S.金黄色葡萄球菌E.大肠杆菌和凝固酶阴性葡萄球菌是这三个地区每年最常见的三种BSI病原体。一些物种的流行率在不同地区存在差异，包括大肠杆菌的分离率较高。欧洲的大肠杆菌、肠球菌属（Enterococcus spp.）在北美，革兰氏阴性肠道和非肠道物种在拉丁美洲。患者年龄分析显示，新生儿中最常见的BSI病原体是凝固酶阴性葡萄球菌，而老年患者中最常见的病原体是E。杆菌BSI病原体的耐药性在医院感染和重症监护病房（ICU）的患者中更为普遍;还注意到年龄差异。地理上，苯唑西林耐药S.金黄色葡萄球菌（39.1%，2002）和万古霉素耐药肠球菌（17.7%，2002）在北美最高，产超广谱β-内酰胺酶克雷伯菌属（Klebsiella spp.）（35.8-46.7%）和多重耐药铜绿假单胞菌（18.7%，2002年）在拉丁美洲最高。在北美，除万古霉素耐药肠球菌（1997年至2002年下降20%）外，常用抗菌药物的活性保持相对稳定。耐苯唑西林沙门氏菌的流行病学调查。在北美的金黄色葡萄球菌中鉴定了10个显著的克隆（核糖体型）和与它们相关的常见抗性模式。需要监测BSI病原体，以确定耐药趋势，并提供有关患者风险因素和地理差异的有用信息。(C)2004爱思唯尔公司All rights reserved.
The empiric treatment of patients with bloodstream infections (BSI) has become more complicated in an era of increasing antimicrobial resistance. The SENTRY Antimicrobial Surveillance Program has monitored BSI from patients in medical centers worldwide since 1997. During 1997-2002, a total of 81,213 BSI pathogens from North America, Latin America, and Europe were tested for antimicrobial susceptibility. S. aureus, E. coli, and coagulase-negative staphylococci were the three most common BSI pathogens in all three regions each year. Prevalence variability was noted in regions for some species, including higher rates of isolation of E. coli in Europe, Enterococcus spp. in North America, and Gram-negative enteric and nonenteric species in Latin America. Patient age analysis showed the most common BSI pathogen among neonates was coagulase-negative staphylococci and among elderly patients, E. coli. Resistance among BSI pathogens was much more prevalent in nosocomial infections and in patients in intensive care units (ICUs); age differences were also noted. Geographically, oxacillin-resistant S. aureus (39.1%, 2002) and vancomycin-resistant enterococci (17.7%, 2002) were highest in North America, and extended-spectrum beta-lactamase-producing Klebsiella spp. (35.8-46.7%) and multidrug-resistant P. aeruginosa (18.7%, 2002) were highest in Latin America. Activity of commonly used antimicrobial agents remained relatively stable in North America, except in the case of vancomycin-resistant enterococci (20% decline between 1997 and 2002). An epidemiologic investigation of oxacillin-resistant S. aureus in North America identified 10 significant clones (ribotypes) and the common resistance patterns associated with them. Surveillance of BSI pathogens is needed to determine trends of resistance and provide useful information regarding patient risk factors and geographic differences. (C) 2004 Elsevier Inc. All rights reserved.