Patient age as a factor of antibiotic resistance in methicillin-resistant Staphylococcus aureus
Patient age as a factor of antibiotic resistance in methicillin-resistant Staphylococcus aureus
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DOI：
10.1099/jmm.0.000635
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发表时间：
2017-12-01
影响因子：
3
通讯作者：
Nasr, Payman
中科院分区：
文献类型：
--
作者：
Garcia, Alexander;Delorme, Thierry;Nasr, Payman
目的。耐甲氧西林金黄色葡萄球菌（MRSA）是医院感染的主要原因之一。深入了解MRSA的流行病学和分布，有助于制定更好的预防措施，并有助于控制或降低普通人群的感染率。回顾性调查了511例MRSA感染的住院、门诊和养老院人口在12个月的时间。为了研究两个连续定量变量（患者年龄与耐药百分比）之间的关系，对每种抗生素计算简单线性回归，以预测抗生素耐药百分比与患者年龄的关系。结果/重要发现。与患者年龄相关的抗生素耐药模式取决于抗生素的作用方式。以DNA合成为目标的抗生素（如氟喹诺酮类药物）与患者年龄直接相关，在老年人群中耐药率较高，而以核糖体功能（如氨基糖苷类）或细胞壁合成（如头孢菌素）为目标的抗生素不表现出年龄依赖模式，并且在所有年龄组中具有一致的耐药程度。以DNA合成为目标的抗生素导致老年人群中越来越多的耐药分离株。结果强调了患者年龄对抗生素选择的重要性，作为一种预防措施，以减少每个易感人群的耐药感染率。这一模式提示医生在确定最佳抗生素治疗方案时应将患者年龄作为另一个考虑因素，以减少未来出现新的耐药表型。
Purpose. Methicillin-resistant Staphylococcus aureus (MRSA) is one of the leading causes of nosocomial infections. A thorough understanding of the epidemiology and distribution of MRSA allows the development of better preventive measures and helps to control or reduce the rate of infection among the general population.Methodology. A retrospective survey was performed on 511 cases of MRSA infections from inpatient, outpatient and nursing home populations over a 12-month period. To study the relationships between two continuous quantitative variables (patient age vs resistance percentage), a simple linear regression was calculated for each antibiotic to predict the antibiotic resistance percentage with respect to patient age.Results/Key findings. The pattern of antibiotic resistance with respect to the age of patients depended on the antibiotic mode of action. Antibiotics that target DNA synthesis (i.e. fluoroquinolones) display a direct correlation with the age of patients, with higher rates of resistance among the older population, while antibiotics that target ribosomal functions (i.e. aminoglycosides) or cell wall synthesis (i.e. cephalosporin) do not display an age-dependent pattern and have a consistent degree of resistance across all age classes.Conclusion. Antibiotics that target DNA synthesis result in a progressively higher number of resistant isolates among the older population. The results emphasize the importance of patient age on antibiotic selection as a preventive measure to reduce the rate of resistant infections in each susceptible population. This pattern suggests that physicians should take into consideration patient age as another factor in determining the best antibiotic regiment with the aim of curtailing the emergence of newer resistant phenotypes in the future.