抗药性就是现实:乌克兰首个累积抗生素图谱的发现。

IF 3.7 Q2 INFECTIOUS DISEASES JAC-Antimicrobial Resistance Pub Date : 2024-10-09 eCollection Date: 2024-10-01 DOI:10.1093/jacamr/dlae156
Arkadii Vodianyk, Oksana Holovnia, Eugene Diomin, Alyssa R Letourneau, Mark C Poznansky, Erica S Shenoy, Sarah E Turbett
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引用次数: 0

摘要

背景:抗菌药耐药性是一个全球性的健康威胁,在全球范围内造成了严重的发病率和死亡率。直到最近,乌克兰才有了累积抗生素图谱(CuAbgms):描述乌克兰开发的首个累积抗生素图谱:我们利用 WHONET 的数据为 Okhmatdyt 国立儿童专科医院开发了累积抗生素图谱。抗菌药物药敏试验是根据 EUCAST 指南进行的。CuAbgm 是在 CLSI 的指导下制定的:对于大肠埃希菌,分别有 66% 和 69% 的分离株对头孢他啶和头孢曲松敏感,99% 的分离株对美罗培南敏感。至于肺炎克雷伯氏菌,分别有 26% 和 27% 的分离株对头孢他啶和头孢曲松敏感,只有 59% 的分离株对美罗培南敏感。在经过额外药敏试验的耐碳青霉烯类肺炎双球菌分离物中,只有 38% 对头孢他啶/阿维巴坦敏感。铜绿假单胞菌中,只有 53% 对美罗培南敏感。在对美罗培南耐药并接受了额外药敏试验的假单胞菌中,只有 12% 对头孢他啶/阿维巴坦敏感。同样,对于醋酸杆菌属,只有 37% 的分离物对美罗培南敏感。对氨苄西林/舒巴坦的敏感性也很低,仅为 45%。金黄色葡萄球菌对奥沙西林的敏感率为 99%:在乌克兰首次开发的 CuAbgm 中,革兰氏阴性菌的耐药性水平很高。乌克兰的实验室应优先考虑 CuAbgm,以指导经验性抗菌治疗、感染控制和抗菌药物管理政策。在战时,医疗保健系统需要治疗复杂的感染性穿透伤和与爆炸有关的伤害,因此这一点显得尤为重要。
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Resistance is reality: findings from the first Ukrainian cumulative antibiogram.

Background: Antimicrobial resistance is a global health threat resulting in significant morbidity and mortality worldwide. Until recently, in Ukraine, cumulative antibiograms (CuAbgms) have never been available.

Objectives: To describe the first CuAbgm developed in Ukraine.

Methods: We developed a CuAbgm for the Okhmatdyt National Specialized Children's Hospital using data from WHONET. Antimicrobial susceptibility testing was performed per EUCAST guidelines. The CuAbgm was developed using guidance from CLSI.

Results: For Escherichia coli, 66% and 69% of isolates were susceptible to ceftazidime and ceftriaxone, respectively, and 99% were susceptible to meropenem. For Klebsiella pneumoniae, 26% and 27% of isolates were susceptible to ceftazidime and ceftriaxone, respectively, and only 59% were susceptible to meropenem. Of the carbapenem-resistant K. pneumoniae isolates that underwent additional susceptibility testing, only 38% were susceptible to ceftazidime/avibactam. For Pseudomonas aeruginosa, only 53% were susceptible to meropenem. Of those that were resistant to meropenem and underwent additional susceptibility testing, only 12% were susceptible to ceftazidime/avibactam. Similarly, for Acinetobacter spp., only 37% of isolates were susceptible to meropenem. Susceptibility to ampicillin/sulbactam was also low at 45%. The oxacillin susceptibility rate for Staphylococcus aureus was 99%.

Conclusions: In this first-ever CuAbgm developed in Ukraine, high levels of resistance were demonstrated among Gram-negative bacteria. CuAbgms should be prioritized in laboratories in Ukraine to guide empirical antimicrobial therapy, infection control and antimicrobial stewardship policies. This is of heightened relevance during wartime, when there is a need for healthcare systems to treat complex and infected penetrating and blast-related injuries.

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CiteScore
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