Carbapenem Susceptibility Rate Against Gram-Positive and Gram-Negative Bacteria and Its Correlation with Consumption

George Arthur Mantiri, Rheza Paleva Uyanto, M. Hendrianingtyas
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Abstract

Antibiotic susceptibility is significant in patient management and needs close monitoring. This study aims to evaluate the Carbapenem susceptibility profiles and correlation between Carbapenem consumption and susceptibility of the most frequent isolates from blood, sputum, and urine in 2020–2022 from the non-intensive inpatients. The proportion of males and females was 54% and 46%, with the median age group of males and females both being 65-74 years. Higher Meropenem susceptibility was shown in urine isolates of female patients. Lower susceptibility to Meropenem was shown in 2021 compared to 2020 and 2022. Lower susceptibility was shown in isolates from sputum compared to blood and urine. The three-year susceptibility of Carbapenem was decreased compared to 3 years before. The susceptibility of E.coli and S.aureus to Meropenem showed relatively high proportions 95% and 88%, compared to K.pneumoniae (46%), A.baumanii (30%), P.aeruginosa (29%), and others.  The susceptibility of isolates from non-intensive-care inpatients in 2020-2022 showed lower rates compared to the hospital-wide and the previous three years' rates. Meropenem consumption was highest compared to Imipenem with inhibitor and Doripenem. The susceptibility of Gram-negative rods to Meropenem showed higher proportions (58.9%) compared to Gram-positive cocci (26.2%). Carbapenem susceptibility was decreased, along with increased Carbapenem consumption but no significant statistical correlation between the susceptibility rates and the monthly defined daily dose.
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革兰氏阳性和革兰氏阴性细菌对碳青霉烯类抗生素的敏感率及其与消费量的关系
抗生素敏感性对患者管理意义重大,需要密切监测。本研究旨在评估 2020-2022 年非重症住院患者血液、痰液和尿液中最常见分离菌株对碳青霉烯类抗生素的敏感性谱以及碳青霉烯类抗生素用量与敏感性之间的相关性。男性和女性的比例分别为 54% 和 46%,男性和女性的年龄中位数均为 65-74 岁。女性患者的尿液分离物对美罗培南的敏感性较高。2021 年对美罗培南的敏感性低于 2020 年和 2022 年。与血液和尿液相比,痰中分离物对美罗培南的敏感性较低。与三年前相比,卡巴培南的三年药敏率有所下降。大肠杆菌和金黄色葡萄球菌对美罗培南的药敏率相对较高,分别为 95% 和 88%,而肺炎双球菌(46%)、鲍曼痢疾杆菌(30%)、铜绿假单胞菌(29%)和其他细菌对美罗培南的药敏率相对较低。 2020-2022 年非重症监护住院患者分离菌株的药敏率低于全院和前三年的药敏率。与带抑制剂的亚胺培南和多尼培南相比,美罗培南的消耗量最大。革兰氏阴性杆菌对美罗培南的敏感率(58.9%)高于革兰氏阳性球菌(26.2%)。随着卡巴培南用量的增加,对卡巴培南的敏感率也随之降低,但敏感率与每月规定的日剂量之间没有明显的统计学相关性。
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