2019冠状病毒病疫情期间及疫情后(2017-2023年)波兰某地区医院产esbl肠杆菌科细菌耐药性变化趋势:基于地方视角的耐药性变化分析

Q3 Medicine
Przeglad epidemiologiczny Pub Date : 2025-10-03 Epub Date: 2025-07-02 DOI:10.32394/pe/205497
Rafał Kuczma, Szymon Barwiński, Barbara Symula, Katarzyna Jermakow
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引用次数: 0

摘要

背景:抗菌素耐药性是一个主要的公共卫生威胁,来自肠杆菌科的广谱β-内酰胺酶(ESBL)产生细菌被世卫组织列为关键优先病原体。2019冠状病毒病大流行影响了全球抗生素消费模式,可能影响ESBL(+)菌株的耐药性和医院细菌感染的频率。目的:本研究旨在分析下西里西亚省某地区医院产esbl细菌(肠杆菌科)感染流行趋势,并评估抗生素使用与耐药性变化之间的关系。材料和方法:一项回顾性队列研究使用了Oława医疗保健中心的微生物学和药理学数据。分析了77,829例住院患者的34,629例临床培养标本。该研究的重点是大肠杆菌、肺炎克雷伯菌和具有ESBL耐药机制的肠杆菌。对解剖治疗化学(ATC)分类系统J01C和J01D组β-内酰胺类抗生素的消耗量进行评估。应用统计趋势和相关分析。结果:ESBL(+)细菌感染发生率无明显变化趋势。流行前ESBL(+)株流行率较低(6.42% ~ 24.49%),2020年上升至56.25%,2021 ~ 2022年达到100%的峰值。到2023年,耐药菌株下降到77.50%。2020年β-内酰胺类抗生素(J01D,主要是头孢菌素)的消费量增加了50.2%。ESBL(+)感染比例最高的是非手术病房(40.97%)和长期护理设施(25.88%)。结论:2017-2023年的数据分析显示,ESBL(+)感染发生率无显著趋势,但β-内酰胺耐药性增加。2020年,ESBL(+)菌株的流行率和抗生素(特别是头孢菌素)的消费量增加。然而,抗生素消耗与耐药性之间缺乏显著相关性表明,其他因素,如耐药菌株传播或持续定植,起着至关重要的作用。这些发现强调需要加强耐药性监测和合理的抗生素管理策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Trends in Resistance of ESBL-Producing Bacteria Belonging to the Enterobacteriaceae Family in a Polish District Hospital during the COVID-19 Pandemic and Post-Pandemic Period (2017-2023): Analysis of Resistance Changes from a Local Perspective.

Background: Antimicrobial resistance is a major public health threat, with extended-spectrum β-lactamase (ESBL)-producing bacteria from the Enterobacteriaceae family classified by the WHO as critical priority pathogens. The COVID-19 pandemic affected global antibiotic consumption patterns, potentially influencing the resistance of ESBL(+) strains and the frequency of bacterial infections in hospitals.

Objective: This study aimed to analyze the trends in the prevalence of infections caused by ESBL-producing bacteria (Enterobacteriaceae family) in a district hospital in the Lower Silesian Voivodeship during the peri-pandemic period (2017-2023) and assess the relationship between antibiotic consumption and changes in resistance.

Material and methods: A retrospective cohort study was conducted using microbiological and pharmacological data from the Healthcare Complex in Oława. 34,629 clinical specimen cultures from 77,829 hospitalized patients were analyzed. The study focused on Escherichia coli, Klebsiella pneumoniae, and Enterobacter spp. with an ESBL resistance mechanism. The consumption of β-lactam antibiotics from Anatomical Therapeutic Chemical (ATC) Classification System groups J01C and J01D was assessed. Statistical trend and correlation analysis was applied.

Results: The incidence of ESBL(+) bacterial infections showed no significant trends. The pre-pandemic prevalence of ESBL(+) strains was low (6.42%-24.49%), rising to 56.25% in 2020 and peaking at 100% in 2021-2022. In 2023, resistant isolates declined to 77.50%. A 50.2% increase in β-lactam antibiotic consumption (J01D, mainly cephalosporins) was recorded in 2020. The highest proportion of ESBL(+) infections occurred in non-surgical wards (40.97%) and long-term care facilities (25.88%).

Conclusions: Data analysis from 2017-2023 revealed no significant trends in incidence of ESBL(+) infections but an increase in β-lactam resistance. In 2020, the prevalence of ESBL(+) strains and antibiotic consumption, especially cephalosporins, increased. However, the lack of a significant correlation between antibiotic consumption and resistance suggests that other factors, such as resistant strain transmission or persistent colonization, play a crucial role. These findings highlight the need for enhanced resistance monitoring and rational antibiotic stewardship strategies.

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Przeglad epidemiologiczny
Przeglad epidemiologiczny Medicine-Medicine (all)
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