拉丁美洲监测登记显示，与欧洲基准相比，来自肝硬化患者的侵袭性分离株的抗菌素耐药性更高

IF 4.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology Pub Date : 2025-09-01 DOI:10.1016/j.aohep.2025.101959

Gonzalo Gomez Perdiguero , Maria Dolores Murga , Ana Palazzo , Esteban Gonzalez Ballerga , Ilse Pardo Ivirico , Maria Daniela Perez , Lorena Notari , Josefina Pages , Manuel Mendizabal , Camila Maria Briz , Agustin Di Santo , Julia Brutti , Brenda Osso Sanchez , Margarita Anders , Pablo Calzetta , Alina Raquel Zerega , Angelo Z. Mattos , Astrid Smud , Laura R. Maboni , Maximiliano Castro , Sebastian Marciano

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引用次数: 0

摘要

鉴于抗菌素耐药性（AMR）的负担日益加重，我们旨在报告拉丁美洲肝硬化患者中主要AMR模式的流行情况，并将其与欧洲抗菌素耐药性监测网络（ear - net）数据进行比较。材料和方法对拉丁美洲监测登记处（ClinicalTrials.gov: NCT0634940）登记的成年肝硬化患者的侵袭性分离物（血液、腹水或胸膜液）进行横断面研究。报告了主要病原体的抗菌素耐药性模式：大肠杆菌、肺炎克雷伯菌、金黄色葡萄球菌、不动杆菌、粪肠杆菌和铜绿假单胞菌。结果2020年12月至2025年5月，在阿根廷、乌拉圭、巴西和秘鲁共分离到908株细菌。其中226个（25%）来自入侵点，与分析中预先确定的流行病学兴趣细菌相对应。分离株39%是医院感染，38%是社区获得，23%是卫生保健相关。主要感染为自发性菌血症（38%）和收缩压（32%）。拉丁美洲的肺炎克雷伯菌（56%对34%）和大肠杆菌（46%对24%）对喹诺酮类药物的耐药性高于欧洲。肺炎克雷伯菌对碳青霉烯的耐药性为46% (vs. 13%)，大肠杆菌为5.3% （vs. 0.3%）。金黄色葡萄球菌对甲氧西林的耐药性在拉丁美洲（32%）高于欧洲（16%）。其他病原体也表现出更高的耐药性（表）。结论拉丁美洲肝硬化患者耐药率升高值得关注。在一个多个层面的监管缺口可能导致抗生素滥用的地区，这些发现呼吁采取紧急行动，加强抗生素的合理使用并实施有效的管理战略。

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LATIN AMERICAN SURVEILLANCE REGISTRY REVEALS HIGHER ANTIMICROBIAL RESISTANCE IN INVASIVE ISOLATES FROM PATIENTS WITH CIRRHOSIS COMPARED TO EUROPEAN BENCHMARKS

Introduction and Objectives

Given the growing burden of antimicrobial resistance (AMR), we aimed to report the prevalence of key AMR patterns in Latin American patients with cirrhosis and compare them with the European Antimicrobial Resistance Surveillance Network (EARS-Net) data

Materials and Methods

Cross-sectional study of invasive isolates (blood, ascitic or pleural fluid) from adults with cirrhosis enrolled in the Latin American surveillance registry (ClinicalTrials.gov: NCT0634940). AMR patterns were reported for key pathogens: E. coli, K. pneumoniae, S. aureus, Acinetobacter spp., E. faecium, and P. aeruginosa.

Results

Between December 2020 and May 2025, 908 bacterial isolates were collected from Argentina, Uruguay, Brazil, and Peru. Of these, 226 (25%) were obtained from invasive sites and correspond to predefined bacteria of epidemiological interest included in the analysis. Isolates were 39% nosocomial, 38% community-acquired, and 23% healthcare-associated. The main infections were spontaneous bacteremia (38%) and SBP (32%). Quinolone resistance was higher in Latin American vs. Europe for K. pneumoniae (56% vs. 34%) and E. coli (46% vs. 24%). Carbapenem resistance in K. pneumoniae was 46% (vs. 13%), and in E. coli, 5.3% (vs. 0.3%). Methicillin resistance among S. aureus was higher in Latin American (32%) than in Europe (16%). Other pathogens also showed higher resistance (Table).

Conclusions

The elevated resistance rates observed in Latin American patients with cirrhosis demand attention. In a region where regulatory gaps at multiple levels may contribute to antibiotic misuse, these findings call for urgent action to strengthen rational antibiotic use and implement effective stewardship strategies.

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来源期刊

Annals of hepatology 医学-胃肠肝病学

CiteScore

7.90

自引率

2.60%

发文量

183

审稿时长

4-8 weeks

期刊介绍： Annals of Hepatology publishes original research on the biology and diseases of the liver in both humans and experimental models. Contributions may be submitted as regular articles. The journal also publishes concise reviews of both basic and clinical topics.