2007-2016年芬兰西南部耐甲氧西林金黄色葡萄球菌耐药性上升趋势：菌株动态变化及新出现的危险因素分析

IF 3.7 3区医学 Q2 INFECTIOUS DISEASES

Journal of global antimicrobial resistance Pub Date : 2025-01-01 DOI:10.1016/j.jgar.2024.11.015

Jaakko Silvola , Kirsi Gröndahl-Yli-Hannuksela , Tiina Hirvioja , Kaisu Rantakokko-Jalava , Mari Kanerva , Kari Auranen , Harri Marttila , Jenna Junnila , Jaana Vuopio

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引用次数: 0

摘要

目的：2007-2016年间，芬兰西南部耐甲氧西林金黄色葡萄球菌（MRSA）的年发病率大幅上升（12.4至24.9/10万人）。为了了解这些变化对MRSA管理的影响，我们试图分析MRSA的抗微生物药物耐药性（AMR）趋势与患者特征的关系。方法：对10种临床相关抗菌药物进行药敏试验。对≥2种抗菌素耐药的菌株为多重耐药菌株。分离株为spa型和聚类。通过将耐药表型与患者人口统计学相关联，确定了AMR趋势和危险因素。结果：2007-2016年共发现新发MRSA病例983例。结论：2007-2016年芬兰西南部地区MRSA分离株AMR呈显著上升趋势，耐药比例从13.9%上升至31.5%。患者人口统计数据向年轻年龄组的转变和社区获得促成了多重耐药菌株的增加。移民、接触国外医院环境和接触家畜是多重耐药的主要危险因素。自2016年以来，共同耐药性的增加一直持续下去。

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Increasing trend of antimicrobial resistance among methicillin-resistant Staphylococcus aureus strains in Southwest Finland, 2007–2016: An analysis of shifting strain dynamics and emerging risk factors

Objective

Substantial rise in the annual incidence of methicillin-resistant Staphylococcus aureus (MRSA) was reported in Southwest Finland (12.4–24.9/100,000 people) between 2007 and 2016. To understand the implications of these changes to the management of MRSA, we sought to analyse the antimicrobial resistance (AMR) trends of MRSA in relation with patient characteristics.

Methods

Antimicrobial susceptibility was determined for 10 clinically relevant antimicrobials. Strains with resistance to ≥2 antimicrobials were defined multi-resistant. The isolates were spa-typed and clustered. AMR trends and risk factors were identified by associating resistant phenotypes with patient demographics.

Results

A total of 983 new MRSA cases were identified between 2007 and 2016. After 2011, significant increasing trends were observed in the proportion of isolates resistant to clindamycin (13.9%–31.5%, P < 0.001), erythromycin (19.4%–35.4%, P < 0.001) and tetracycline (16.7%–32%, P < 0.001). The proportion of multi-resistant isolates more than doubled from 14.8% to 39.2%. The increasing AMR trend was reflected in the increase of new strain types and the decrease of previously dominant, non-multi-resistant strains. Patient risk factors associated with (P < 0.001) the acquisition of multi-resistant strains included community acquisition, livestock contact, hospital care abroad and immigrant status.

Conclusions

Notable increasing AMR trends among MRSA isolates were observed in Southwest Finland, 2007–2016. The shift in patient demographics to younger age groups and community acquisition contributed to the increase in multi-resistant strains. Immigration, contact with hospital environment abroad and contact with livestock were identified as essential risk factors of multi-resistance. The increased level of co-resistance has persisted after 2016.

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来源期刊

Journal of global antimicrobial resistance INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY

CiteScore

8.70

自引率

2.20%

发文量

285

审稿时长

34 weeks

期刊介绍： The Journal of Global Antimicrobial Resistance (JGAR) is a quarterly online journal run by an international Editorial Board that focuses on the global spread of antibiotic-resistant microbes. JGAR is a dedicated journal for all professionals working in research, health care, the environment and animal infection control, aiming to track the resistance threat worldwide and provides a single voice devoted to antimicrobial resistance (AMR). Featuring peer-reviewed and up to date research articles, reviews, short notes and hot topics JGAR covers the key topics related to antibacterial, antiviral, antifungal and antiparasitic resistance.