Geographic and Temporal Patterns of Antimicrobial Resistance in Pseudomonas aeruginosa Over 20 Years From the SENTRY Antimicrobial Surveillance Program, 1997-2016
Geographic and Temporal Patterns of Antimicrobial Resistance in Pseudomonas aeruginosa Over 20 Years From the SENTRY Antimicrobial Surveillance Program, 1997-2016
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DOI：
10.1093/ofid/ofy343
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发表时间：
2019-03-01
影响因子：
4.2
通讯作者：
Jones, Ronald N.
中科院分区：
文献类型：
--
作者：
Shortridge, Dee;Gales, Ana C.;Jones, Ronald N.
背景SENTRY抗菌素监测计划成立于1997年，涵盖了来自全球≥ 400个医疗中心的75万多个细菌分离株。在检测的病原体中，铜绿假单胞菌仍然是住院患者多重耐药（MDR）血流感染和肺炎的常见原因。在本研究中，我们回顾了SENTRY计划20年来铜绿假单胞菌耐药表型的地理和时间趋势。方法。从1997年到2016年，从代表亚太地区、欧洲、拉丁美洲和北美的>= 200个医学中心提交了52022个具有临床意义的连续分离株。每例患者每次感染事件仅提交1株分离株。通过标准算法和/或基质辅助激光解吸电离-飞行时间质谱法鉴定分离株。通过临床和实验室标准化研究所（CLSI）方法进行药敏试验，并在JMI制药厂使用CLSI和欧洲抗菌药物敏感性试验委员会2018标准进行解释。铜绿假单胞菌最常见的感染是住院患者的肺炎（44.6%），其次是血流感染（27.9%），肺炎的MDR率（27.7%）略高于血流感染（23.7%）。MDR表型百分比最高的地区是拉丁美洲（41.1%），其次是欧洲（28.4%）。MDR率在2005-2008年最高，最近一段时间有所下降。多粘菌素敏感率最高（99.4%），其次为阿米卡星（90.5%）。在SENTRY计划监测的20年中，MDR铜绿假单胞菌感染率有所下降，特别是在拉丁美洲。铜绿假单胞菌耐药性下降的趋势是否保持将记录在未来的SENTRY计划和其他监测报告中。
Background. The SENTRY Antimicrobial Surveillance Program was established in 1997 and encompasses over 750 000 bacterial isolates from >= 400 medical centers worldwide. Among the pathogens tested, Pseudomonas aeruginosa remains a common cause of multidrug-resistant (MDR) bloodstream infections and pneumonia in hospitalized patients. In the present study, we reviewed geographic and temporal trends in resistant phenotypes of P. aeruginosa over 20 years of the SENTRY Program.Methods. From 1997 to 2016, 52 022 clinically significant consecutive isolates were submitted from >= 200 medical centers representing the Asia-Pacific region, Europe, Latin America, and North America. Only 1 isolate per patient per infection episode was submitted. Isolates were identified by standard algorithms and/or matrix-assisted laser desorption ionization-time of flight mass spectrometry. Susceptibility testing was performed by Clinical and Laboratory Standards Institute (CLSI) methods and interpreted using CLSI and European Committee on Antimicrobial Susceptibility Testing 2018 criteria at JMI Laboratories.Results. The most common infection from which P. aeruginosa was isolated was pneumonia in hospitalized patients (44.6%) followed by bloodstream infection (27.9%), with pneumonia having a slightly higher rate of MDR (27.7%) than bloodstream infections (23.7%). The region with the highest percentage of MDR phenotypes was Latin America (41.1%), followed by Europe (28.4%). The MDR rates were highest in 2005-2008 and have decreased in the most recent period. Colistin was the most active drug tested (99.4% susceptible), followed by amikacin (90.5% susceptible).Conclusions. Over the 20 years of SENTRY Program surveillance, the rate of MDR P. aeruginosa infections has decreased, particularly in Latin America. Whether the trend of decreasing resistance in P. aeruginosa is maintained will be documented in future SENTRY Program and other surveillance reports.