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首页> 外文期刊>International journal of antimicrobial agents >Epidemiology and antimicrobial susceptibility profiles of Gram-negative bacteria causing urinary tract infections in the Asia-Pacific region: 2009-2010 results from the Study for Monitoring Antimicrobial Resistance Trends (SMART)
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Epidemiology and antimicrobial susceptibility profiles of Gram-negative bacteria causing urinary tract infections in the Asia-Pacific region: 2009-2010 results from the Study for Monitoring Antimicrobial Resistance Trends (SMART)

机译：亚太地区引起尿路感染的革兰氏阴性细菌的流行病学和抗菌素敏感性分布：2009-2010年监测抗菌素耐药性趋势研究（SMART）的结果

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摘要

In 2009, the Study for Monitoring Antimicrobial Resistance Trends (SMART) was expanded to include surveillance of Gram-negative pathogens causing urinary tract infections (UTIs) in the Asia-Pacific region. A total of 1762 isolates were collected from 38 centers in 11 countries from patients with UTIs in 2009 and 2010. In vitro susceptibilities were determined by the broth microdilution method and susceptibility profiles were determined using minimum inhibitory concentration (MIC) interpretive criteria, as recommended by the Clinical and Laboratory Standards Institute (CLSI) in 2010 (M100-S20), in 2011 (M100-S21), and in 2012 (M100-S22). Enterobacteriaceae comprised 86.0 of the isolates, of which Escherichia coli (56.5) and Klebsiella pneumoniae (13.8) were the two most common species. Amikacin was the most effective antibiotic (91.7), followed by ertapenem (86.9), imipenem (86.6), and piperacillin-tazobactam (84.9). Rates of susceptibility were 50.3 for cefoxitin and ranged from 50.3 to 74.2 for the third- and fourth-generation cephalosporins. For ciprofloxacin and levofloxacin, the susceptibility rates were 51.4 and 54.4, respectively. Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae comprised 28.2 of all isolates. We also found a high rate of resistance to carbapenems among Acinetobacter baumannii and Pseudomonas aeruginosa causing UTI. Interestingly, according to 2012 CLSI breakpoints, approximately 33.4 of ESBL producers were still susceptible to ceftazidime. However, this in vitro efficacy of ceftazidime needs to be validated in vivo by clinical data. The lowered CLSI interpretive breakpoints for piperacillin-tazobactam, carbapenems, and some cephalosporins in 2011-2012 for Enterobacteriaceae resulted in an approximate 5 drop in susceptibility rates for each drug, with the exception of imipenem for which the susceptibility rate dropped from 99.4 according to 2010 criteria to 91.2 according to 2011 criteria. With the updated CLSI criteria, the antimicrobial resistance threat from UTI pathogens in the Asia Pacific area was revealed to be more prominent.
机译：在2009年，监测抗菌素耐药性趋势研究（SMART）进行了扩展，包括对亚太地区引起尿路感染（UTI）的革兰氏阴性病原体的监测。 2009年和2010年，从11个国家/地区的38个中心收集了来自UTI病人的1762株分离株。通过肉汤微量稀释法确定了体外药敏性，并使用最低抑菌浓度（MIC）解释标准确定了药敏性状，分别于2010年（M100-S20），2011年（M100-S21）和2012年（M100-S22）进入临床和实验室标准协会（CLSI）。肠杆菌科细菌包括86.0种分离物，其中大肠杆菌（56.5）和肺炎克雷伯菌（13.8）是最常见的两种。阿米卡星是最有效的抗生素（91.7），其次是厄他培南（86.9），亚胺培南（86.6）和哌拉西林-他唑巴坦（84.9）。头孢西丁的敏感性为50.3，第三代和第四代头孢菌素的敏感性为50.3至74.2。环丙沙星和左氧氟沙星的药敏率分别为51.4和54.4。产广谱β-内酰胺酶（ESBL）的肠杆菌科细菌占所有分离株的28.2。我们还发现引起泌尿道感染的鲍曼不动杆菌和铜绿假单胞菌对碳青霉烯类的耐药率很高。有趣的是，根据2012年CLSI的断点，大约33.4的ESBL生产商仍然容易受到头孢他啶的影响。但是，头孢他啶的这种体外功效需要通过临床数据在体内进行验证。 2011-2012年，对肠杆菌科的哌拉西林-他唑巴坦，碳青霉烯类药物和某些头孢菌素的CLSI解释性断裂点降低，导致每种药物的药敏率均下降了约5倍，亚胺培南的药敏率从2010年的99.4下降至99.4根据2011年标准，将标准提高到91.2。通过更新的CLSI标准，揭示了亚太地区来自UTI病原体的抗菌素耐药性威胁更加突出。

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