加泰罗尼亚成人和儿科人群抗菌药物敏感性的综合监测：来自社区、医院和长期护理机构设置的见解

IF 2.6 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica Pub Date : 2025-01-13 DOI:10.1016/j.eimc.2024.12.003

Nieves Larrosa , Montserrat Giménez , Mónica Ballestero-Téllez , Sergi Hernández , Alexander Almendral , Juan P. Horcajada , Susana Melendo , M Pilar García , Albert Boada , Enric Limón , Miquel Pujol , on behalf of the microbiologists of the participating laboratories in VINCat-PROA

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引用次数: 0

摘要

背景：本研究提供了西班牙加泰罗尼亚医疗环境和年龄组抗菌药物敏感性的综合数据。方法收集2020 - 2022年社区获得性感染（CAIs）和2021 - 2022年医院和长期护理机构（ltcf）的药敏数据。根据感药菌株占总菌株的比例计算药敏度。结果：社区获得性感染（CAIs）：尿路感染（uti）中，广谱β -内酰胺酶生成（ESBL-P）大肠杆菌占3.8%；肺炎链球菌对青霉素高度敏感（97.5%）。社区获得性耐甲氧西林金黄色葡萄球菌占6.8%。医院获得性感染（HAIs）： ESBL-P在大肠杆菌和肺炎克雷伯菌中分别为6.7%和9.4%。阴沟肠杆菌复合体对碳青霉烯类药物的耐药性小于1%。极耐药铜绿假单胞菌占1.6%。成人感染：在尿路感染中，大肠杆菌对磷霉素（>95%）和ESBL-P具有高敏感性。在呼吸道感染中，化脓性链球菌对大环内酯类药物（67%）和克林霉素（75.1%）的敏感性降低，而流感嗜血杆菌和肺炎链球菌对青霉素类药物仍然敏感（78%和96%）。HAIs：大肠杆菌ESBL-P检出率12.8%，肺炎克雷伯菌检出率20%。碳青霉烯类耐药菌株主要为阴沟肠杆菌（2.8%）和肺炎克雷伯菌（2.2%）。铜绿假单胞菌对美罗培南敏感性高（87%）。22%的金黄色葡萄球菌耐甲氧西林。长期护理机构（ltcf）：大肠杆菌引起的UTI对碳青霉烯类（99%）、呋喃托因（96%）和磷霉素（93%）高度敏感，对esblp的敏感性为25.8%。肺炎克雷伯菌对ESBL-P的耐药性为40%，对碳青霉烯类的耐药性为2.9%。P. aeruginosa对喹诺酮类药物的敏感性较低（69.5%），对美罗培南的敏感性较高（88.5%）。结论这些数据强调了按环境、感染类型和年龄分层易感报告的必要性。

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Comprehensive surveillance of antimicrobial susceptibility across adult and pediatric populations in Catalonia: Insights from community, hospital, and long-term care facility settings

Background

This study presents comprehensive data on antimicrobial susceptibility across healthcare settings and age groups in Catalonia, Spain.

Methods

Susceptibility data were collected from 37 microbiology laboratories between 2020 and 2022 for community-acquired infections (CAIs), and 2021 and 2022 for hospital and long-term care facilities (LTCFs). Susceptibility was calculated based on the proportion of susceptible strains among the total strains.

Results

Pediatrics: Community-acquired infections (CAIs): in urinary tract infections (UTIs), extended-spectrum beta-lactamase production (ESBL-P) Escherichia coli was 3.8%. Streptococcus pneumoniae was highly susceptible to penicillins (97.5%). Community-acquired methicillin-resistant Staphylococcus aureus was 6.8%. Hospital-acquired infections (HAIs): ESBL-P in E. coli and Klebsiella pneumoniae were 6.7% and 9.4%. Carbapenem resistance in Enterobacter cloacae complex was less than 1%. Extremely drug-resistant Pseudomonas aeruginosa was 1.6%.

Adults

CAIs: In UTIs, E. coli showed high susceptibility to fosfomycin (>95%) and 9% of ESBL-P. In respiratory tract infections, Streptococcus pyogenes exhibited reduced susceptibility to macrolides (67%) and clindamycin (75.1%), while Haemophilus influenzae and S. pneumoniae remained susceptible to penicillins (78% and 96%). HAIs: E. coli showed 12.8% of ESBL-P and K. pneumoniae 20%. Carbapenem resistance was mainly identified in E. cloacae (2.8%) and K. pneumoniae (2.2%). P. aeruginosa showed high susceptibility to meropenem (87%). Methicillin-resistance was detected in 22% of S. aureus.

Long-term care facilities (LTCFs): E. coli causing UTI was highly susceptible to carbapenems (99%), nitrofurantoin (96%), and fosfomycin (93%) with 25.8% of ESBL-P. K. pneumoniae showed 40% ESBL-P and 2.9% of carbapenem resistance. P. aeruginosa exhibited decreased susceptibility to quinolones (69.5%) and highly susceptibility to meropenem (88.5%).

Conclusion

The data underscore the necessity of stratified susceptibility reports by setting, type of infection, and age.

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来源期刊

Enfermedades infecciosas y microbiologia clinica 医学-传染病学

CiteScore

2.10

自引率

8.00%

发文量

194

审稿时长

29 days

期刊介绍： Hoy está universalmente reconocida la renovada y creciente importancia de la patología infecciosa: aparición de nuevos agentes patógenos, de cepas resistentes, de procesos con expresión clínica hasta ahora desconocida, de cuadros de una gran complejidad. Paralelamente, la Microbiología y la Infectología Clínicas han experimentado un gran desarrollo como respuesta al reto planteado por la actual patología infecciosa. Enfermedades Infecciosas y Microbiología Clínica es la Publicación Oficial de la Sociedad Española SEIMC. Cumple con la garantía científica de esta Sociedad, la doble función de difundir trabajos de investigación, tanto clínicos como microbiológicos, referidos a la patología infecciosa, y contribuye a la formación continuada de los interesados en aquella patología mediante artículos orientados a ese fin y elaborados por autores de la mayor calificación invitados por la revista.