The present and the future of antimicrobial resistance surveillance in Catalonia (Spain), 2024: from manual to automatic notification.

IF 5.2 2区 医学 Q1 INFECTIOUS DISEASES
Marc Bach-Griera, Helios Gayà, Aurora Sabrià, Luca Basile, Nieves Larrosa, Cristina Pitart, Alba Rivera, Guillem López de Egea, Yuliya Poliakova, Mónica Ballestero-Téllez, Jun Hao Wang-Wang, Antonio Casabella-Pernas, Sandra Esteban-Cucó, Frederic Gómez-Bertomeu, Esther Clapés, Alba Bellés-Bellés, Inés Valle T-Figueras, José Domenico Stavola, Isabel Pujol-Bajador, Glòria Trujillo, Anna Vilamala, Araceli González-Cuevas, Mayuli Armas-Cruz, Mariona Xercavins, Virginia Plasencia, Natàlia Roca-Bau, Manel Monsónis, Núria Torrellas-Bertran, Karolina Romero-Vanegas, Esther Sanfeliu, Ester Comellas, Gemma Flores-Mateo, Fina Guimerà, Anna Llimós-Fàbregas, Maria Font-Font, Carles Alonso-Tarrés, Jacobo Mendioroz, Pilar Ciruela
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引用次数: 0

Abstract

Background: Antimicrobial resistance (AMR) remains a major global public health concern requiring coordinated surveillance and technological innovation. In Catalonia, AMR surveillance is conducted through the Microbiological Reporting System of Catalonia (MRSC) and will be integrated into the Epidemiological Surveillance Information System (SIVEC), enabling automated and real-time monitoring. This study aimed to evaluate the current landscape of AMR surveillance and laboratory capacity across clinical microbiology laboratories (CMLs).

Methods: All CMLs participating in the MRSC were invited to complete a structured survey assessing diagnostic capacity, resistance mechanism (RM) detection, laboratory information systems (LIS), and reporting practices. Surveillance data from invasive isolates (one per patient and episode) collected between 2016 and 2023 were analysed. CMLs were classified by complexity (L1-L3) according to phenotypic, molecular and genomic capabilities. Temporal trends in resistance were assessed using logistic regression models.

Results: By 2023, 53 CMLs participated compared with 28 in 2016, reflecting a marked increase in coverage. A total of 87,556 invasive isolates and 694,289 susceptibility tests were reported. Escherichia coli was the most frequently notified microorganism (37,999 isolates), followed by Klebsiella pneumoniae (12,626) and methicillin-susceptible Staphylococcus aureus (10,464). All laboratories followed EUCAST criteria, although only 56.6% had implemented the 2023 version. Most CMLs (92.5%) detected RMs and 73.6% monitored multidrug resistance. Based on complexity, 18.9% were L1, 66.0% L2, and 15.1% L3; most notifications were reported by L2 (57.4%) and L3 laboratories (39.4%). Carbapenem resistance decreased in Pseudomonas aeruginosa (21.7 to 12.9%) and K. pneumoniae (6.3% to 3.2%), whereas E. coli increased (0.07 to 0.52%). Vancomycin resistance increased in Enterococcus faecium (0.27 to 2.30%) and remained low in E. faecalis. Third-generation cephalosporin resistance increased in E. coli (14.4 to 17.8%) and decreased in K. pneumoniae (36.0 to 26.6%), while MRSA declined (33.1 to 20.6%).

Conclusions: AMR surveillance in Catalonia provides robust and representative data across a heterogeneous network. Further efforts are needed to ensure consistent EUCAST implementation and expand RM detection. The implementation of SIVEC will enable integrated, real-time surveillance and support timely, evidence-based public health decision-making.

2024年加泰罗尼亚(西班牙)抗菌素耐药性监测的现状和未来:从手动通知到自动通知。
背景:抗菌素耐药性(AMR)仍然是一个主要的全球公共卫生问题,需要协调监测和技术创新。在加泰罗尼亚,抗生素耐药性监测是通过加泰罗尼亚微生物报告系统(MRSC)进行的,并将整合到流行病学监测信息系统(SIVEC)中,实现自动化和实时监测。本研究旨在评估AMR监测的现状和临床微生物实验室(cml)的实验室能力。方法:邀请所有参与MRSC的cml完成一项结构化调查,评估诊断能力、耐药机制(RM)检测、实验室信息系统(LIS)和报告实践。分析了2016年至2023年收集的侵袭性分离株(每例患者和发作一次)的监测数据。根据表型、分子和基因组能力将cml按复杂性(L1-L3)进行分类。使用逻辑回归模型评估耐药性的时间趋势。结果:到2023年,参与cml的cml从2016年的28个增加到53个,覆盖率明显提高。共报告侵袭性分离株87,556株,药敏试验694,289例。大肠杆菌是最常见的通报微生物(37,999株),其次是肺炎克雷伯菌(12,626株)和甲氧西林敏感金黄色葡萄球菌(10,464株)。所有实验室都遵循EUCAST标准,尽管只有56.6%的实验室实施了2023年版本。大多数cml(92.5%)检测到均方根,73.6%监测到多药耐药。从复杂性来看,L1占18.9%,L2占66.0%,L3占15.1%;报告最多的是二级实验室(57.4%)和三级实验室(39.4%)。铜绿假单胞菌(21.7% ~ 12.9%)和肺炎克雷伯菌(6.3% ~ 3.2%)对碳青霉烯类药物的耐药性下降,大肠杆菌(0.07% ~ 0.52%)的耐药性上升。粪便肠球菌对万古霉素的耐药性升高(0.27% ~ 2.30%),粪肠球菌对万古霉素的耐药性维持在较低水平。第三代头孢菌素耐药性在大肠杆菌中呈上升趋势(14.4% ~ 17.8%),在肺炎克雷伯菌中呈下降趋势(36.0% ~ 26.6%),MRSA呈下降趋势(33.1% ~ 20.6%)。结论:加泰罗尼亚的抗菌素耐药性监测提供了跨异构网络的可靠且具有代表性的数据。需要进一步努力确保EUCAST的一致性实施并扩大RM检测。SIVEC的实施将使综合实时监测成为可能,并支持及时、循证的公共卫生决策。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Antimicrobial Resistance and Infection Control
Antimicrobial Resistance and Infection Control PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES
CiteScore
9.70
自引率
3.60%
发文量
140
审稿时长
13 weeks
期刊介绍: Antimicrobial Resistance and Infection Control is a global forum for all those working on the prevention, diagnostic and treatment of health-care associated infections and antimicrobial resistance development in all health-care settings. The journal covers a broad spectrum of preeminent practices and best available data to the top interventional and translational research, and innovative developments in the field of infection control.
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