ABSTRACT

Objective

This study presents trends in organism isolation and antimicrobial resistance in routine microbiology test results from acute-care hospital microbiology laboratories in Vermont.

Methods

Organism identifications and antimicrobial susceptibility test results were captured from acute-care hospital laboratories to monitor geographic and temporal trends in resistance and emerging microbial threats with the free WHONET software.

Results

Data were provided from 12 acute care hospital laboratories from 2011 through 2018 for 318,833 isolates from 148,994 patients (70% female, 74% outpatient, and 63% urine). Significant differences (p < 0.05) in age, gender, and antimicrobial susceptibility results (e.g. Escherichia coli and levofloxacin) between outpatient and inpatient isolates were identified with temporal increases in certain species (e.g. Aerococcus urinae) and resistance (e.g. Streptococcus pneumoniae and erythromycin). The use of multi-resistance phenotypes demonstrated significant heterogeneity (p < 0.05) in MRSA strains between facilities, for example Staphylococcus aureus resistant to six priority antimicrobials were found in no critical access hospitals (fewer than 25 inpatient beds) but in all non-critical access hospitals.

Conclusions

Comprehensive electronic surveillance of antimicrobial resistance utilizing routine clinical microbiology data with free software tools offers early recognition and tracking of emerging community and healthcare resistance threats at the local and state level.

中文翻译：

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佛蒙特州抗菌素耐药性和进化微生物种群的监测：2011-2018。

摘要

客观的

本研究展示了佛蒙特州急诊医院微生物实验室常规微生物学检测结果中生物体分离和抗菌素耐药性的趋势。

方法

生物体鉴定和抗菌药物敏感性测试结果是从急诊医院实验室获取的，以使用免费的 WHONET 软件监测耐药性和新出现的微生物威胁的地理和时间趋势。

结果

从 2011 年到 2018 年，来自 12 个急诊医院实验室的数据来自 148,994 名患者（70% 女性，74% 门诊患者和 63% 尿液）的 318,833 株分离株。门诊和住院分离株在年龄、性别和抗菌素敏感性结果（例如大肠杆菌和左氧氟沙星）方面的显着差异（p < 0.05）被确定为某些物种（例如尿气球菌）和耐药性（例如肺炎链球菌和红霉素）的时间增加. 多耐药表型的使用证明了设施之间 MRSA 菌株的显着异质性 (p < 0.05)，例如金黄色葡萄球菌 在所有非关键通道医院（少于 25 张住院床位）中都没有发现对六种优先抗微生物药物的耐药性。

结论

利用常规临床微生物学数据和免费软件工具对抗菌素耐药性进行全面电子监测，可在地方和州一级对新兴社区和医疗保健耐药性威胁进行早期识别和跟踪。