Detection of Rare Antimicrobial Resistance Profiles by Active and Passive Surveillance Approaches.
Detection of Rare Antimicrobial Resistance Profiles by Active and Passive Surveillance Approaches.
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DOI：
10.1371/journal.pone.0158515
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Reid SW
中科院分区：
文献类型：
--
作者：
Mather AE;Reeve R;Mellor DJ;Matthews L;Reid-Smith RJ;Dutil L;Haydon DT;Reid SW
抗微生物药物耐药性（AMR）监测系统通常不是专门为发现新出现的耐药性而设计的，通常主要关注对个别药物的耐药性。利用生态指标评估抗性的多样性，可以评估关于检测罕见表型（包括抗性组合）的采样方案。利用加拿大家禽海德堡沙门氏菌和猪鼠伤寒沙门氏菌变种5-的表型抗菌素耐药性监测数据，对比了主动（来自健康动物的代表性分离株）和被动（诊断分离株）监测数据，并评估了它们在检测新出现的耐药模式方面的适用性。尽管在这两个数据集中，对单个抗菌素的耐药性在两个监测系统之间没有显著差异，但对整个耐药表型多样性的分析表明，诊断分离株的被动监测检测到更多独特的表型。虽然最合适的监测方法将取决于相关目标，但在本研究的条件下，诊断分离株的被动监测对于检测罕见且因此可能出现的耐药表型更为有效。
Antimicrobial resistance (AMR) surveillance systems are generally not specifically designed to detect emerging resistances and usually focus primarily on resistance to individual drugs. Evaluating the diversity of resistance, using ecological metrics, allows the assessment of sampling protocols with regard to the detection of rare phenotypes, comprising combinations of resistances. Surveillance data of phenotypic AMR of Canadian poultry Salmonella Heidelberg and swine Salmonella Typhimurium var. 5- were used to contrast active (representative isolates derived from healthy animals) and passive (diagnostic isolates) surveillance and assess their suitability for detecting emerging resistance patterns. Although in both datasets the prevalences of resistance to individual antimicrobials were not significantly different between the two surveillance systems, analysis of the diversity of entire resistance phenotypes demonstrated that passive surveillance of diagnostic isolates detected more unique phenotypes. Whilst the most appropriate surveillance method will depend on the relevant objectives, under the conditions of this study, passive surveillance of diagnostic isolates was more effective for the detection of rare and therefore potentially emerging resistance phenotypes.