约旦成人和儿科患者临床分离物的体外抗菌药物敏感性:2010-2021 年抗菌药物测试领导和监测(ATLAS)

Dima Al Jammal, Julia Bachir, Jihane A. Moussa, Jamal Wadi Al Ramahi
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引用次数: 0

摘要

约旦的医疗中心在 2010 年至 2021 年间从有明确感染源的住院患者中收集细菌分离物(2014 年未收集分离物)。抗菌药敏感性采用 CLSI 标准进行解释。对替加环素采用了 FDA 批准的断点。在收集到的鲍曼不动杆菌中,超过 92% 对多种药物耐药 (MDR) 和/或碳青霉烯耐药 (CR),仅对米诺环素的敏感性大于 50%(在 MDR 和 CR 分离物中均为 62.2%)。MDR和CR铜绿假单胞菌的比例分别为14.3%和20.5%,在从成人中收集的所有铜绿假单胞菌中,对头孢唑肟/阿维菌素的敏感率为95.3%,对头孢羟氨苄/他唑巴坦的敏感率为88.4%。成人大肠埃希菌和耐药大肠埃希菌对头孢他啶/阿维菌素、头孢唑烷/他唑巴坦、亚胺培南、美罗培南和美罗培南/伐硼巴坦的敏感率为 92.1%-98.7%。成人、儿科和重症监护室患者(所有年龄段)中的肺炎克雷伯菌对替加环素的敏感性大于 94%。在大肠杆菌和肺炎克雷伯菌中,CTX-M-15 是最常发现的 β-内酰胺酶基因。携带 CTX-M-15、CTX-M-9 型、NDM-5 和/或 OXA-48 β-内酰胺酶基因的肺炎双球菌对大多数抗菌药物的敏感性低于 50%。收集到的所有金黄色葡萄球菌都对替考拉宁、万古霉素、达托霉素、利奈唑胺和替加环素敏感,96.1%的成人金黄色葡萄球菌对头孢他啶敏感。总体而言,58.8% 的金黄色葡萄球菌为 MRSA。这项研究提供了有关 2010 年至 2021 年约旦抗菌药物敏感性的宝贵信息。继续监测体外抗菌药敏感性对抗击抗菌药耐药性至关重要。
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In vitro antimicrobial susceptibility of clinical isolates from adult and paediatric patients in Jordan: Antimicrobial Testing Leadership and Surveillance (ATLAS) 2010–2021
To evaluate the in vitro antimicrobial susceptibilities of Gram-positive and Gram-negative isolates from patients in Jordan between 2010 and 2021, through the Antimicrobial Testing Leadership and Surveillance (ATLAS) programme.Medical centres in Jordan collected bacterial isolates from hospitalised patients with defined infection sources between 2010 and 2021 (no isolates collected in 2014). Antimicrobial susceptibility was interpreted using CLSI standards. FDA-approved breakpoints were applied for tigecycline. The identification of β-lactamase genes was performed for a proportion of isolates using multiplex PCR assays.More than 92% of Acinetobacter baumannii collected were multidrug-resistant (MDR) and/or carbapenem-resistant (CR), and > 50% susceptibility was reported only to minocycline (62.2% among both MDR and CR isolates). Rates of MDR and CR Pseudomonas aeruginosa were 14.3% and 20.5%, respectively, and among all P. aeruginosa collected from adults, susceptibility to ceftazidime/avibactam was 95.3% and to ceftolozane/tazobactam was 88.4%. For Escherichia coli from adults and MDR E. coli, susceptibility to ceftazidime/avibactam, ceftolozane/tazobactam, imipenem, meropenem and meropenem/vaborbactam was 92.1%–98.7%. Susceptibility to tigecycline was > 94% among Klebsiella pneumoniae from adult, paediatric, and ICU patients (all ages). CTX-M-15 was the most frequently identified β-lactamase gene among E. coli and K. pneumoniae. Susceptibility to most antimicrobial agents was < 50% among K. pneumoniae carrying CTX-M-15, CTX-M-9-type, NDM-5, and/or OXA-48 β-lactamase genes. All S. aureus collected were susceptible to teicoplanin, vancomycin, daptomycin, linezolid and tigecycline, with 96.1% of S. aureus from adults were susceptible to ceftaroline. Overall, 58.8% of Staphylococcus aureus were MRSA.This study provides valuable information regarding antimicrobial susceptibility in Jordan between 2010 and 2021. Continued monitoring of in vitro antimicrobial susceptibility is critical in the fight against antimicrobial resistance.
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