High prevalence of antimicrobial resistance among Shigella isolates in the United States tested by the National Antimicrobial Resistance Monitoring System from 1999 to 2002
High prevalence of antimicrobial resistance among Shigella isolates in the United States tested by the National Antimicrobial Resistance Monitoring System from 1999 to 2002
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DOI：
10.1128/aac.50.1.49-54.2006
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发表时间：
2006-01-01
影响因子：
4.9
通讯作者：
Mintz, ED
中科院分区：
文献类型：
--
作者：
Sivapalasingam, S;Nelson, JM;Mintz, ED
志贺菌在美国，每年大约有450，000人感染，导致6，000多人住院治疗。自1999年以来，国家肠道细菌耐药性监测系统（NARMS）对来自16个州或地方公共卫生实验室的每10株志贺氏菌分离株进行了15种抗菌药物敏感性测试。从1999年到2002年，NARMS检测了1，604个分离株。在1，598株鉴定到种水平的分离株中，1，278株（80%）为宋内志贺菌，295株（18%）为福氏志贺菌，18株（1%）为鲍氏志贺菌，7株（0.4%）为志贺菌。总体而言，1，251例（78%）对氨苄青霉素耐药，744例（46%）对甲氧苄啶-磺胺甲恶唑（TMP-SMX）耐药。耐TMP-SMX或氨苄青霉素和TMP-SMX宋内志贺菌分离株的流行率因地理区域而异，南部和中西部地区的流行率较低（TMP-SMX耐药率分别为27%和30%;氨苄青霉素和TMP-SMX耐药率分别为25%和22%），东部和西部地区的比例较高（TMP-SMX抗性，分别为66%和80%;氨苄青霉素和TMP-SMX抗性，分别为54%和65%）。19株（1%）对萘啶酸耐药（1%）。sonnei和S.这些分离株中有12株（63%）对环丙沙星的敏感性降低。一个S。福氏杆菌对环丙沙星耐药。所有分离株均对头孢曲松敏感。自1986年以来，对氨苄青霉素和TMP-SMX的耐药性急剧增加。美国的志贺氏菌分离株对环丙沙星和头孢曲松敏感。
Shigella spp. infect approximately 450,000 persons annually in the United States, resulting in over 6,000 hospitalizations. Since 1999, the National Antimicrobial Resistance Monitoring System (NARMS) for Enteric Bacteria has tested every 10th Shigella isolate from 16 state or local public health laboratories for susceptibility to 15 antimicrobial agents. From 1999 to 2002, NARMS tested 1,604 isolates. Among 1,598 isolates identified to species level, 1,278 (80%) were Shigella sonnei, 295 (18%) were Shigella flexneri, 18 (1%) were Shigella boydii, and 7 (0.4%) were Shigella dysenteriae. Overall, 1,251 (78%) were resistant to ampicillin and 744 (46%) were resistant to trimethoprim-sulfamethoxazole (TMP-SMX). Prevalence of TMP-SMX- or ampicillin- and TMP-SMX-resistant Shigella sonnei isolates varied by geographic region, with lower rates in the South and Midwest regions (TMP-SMX resistance, 27% and 30%, respectively; ampicillin and TMP-SMX resistance, 25% and 22%, respectively) and higher rates in the East and West regions (TMP-SMX resistance, 66% and 80%, respectively; ampicillin and TMP-SMX resistance, 54% and 65%, respectively). Nineteen isolates (1%) were resistant to nalidixic acid (1% of S. sonnei and 2% of S. flexneri isolates); 12 (63%) of these isolates had decreased susceptibility to ciprofloxacin. One S. flexneri isolate was resistant to ciprofloxacin. All isolates were susceptible to ceftriaxone. Since 1986, resistance to ampicillin and TMP-SMX has dramatically increased. Shigella isolates in the United States remain susceptible to ciprofloxacin and ceftriaxone.