美国近20 年主要食源性致病菌的分布及耐药性分析——对我国细菌耐药性监控工作的启示
摘要
Systemic analyses were conducted on the major groups of pathogenic bacteria and antimicrobial resistance patterns during 1996—2016 from the dataset of the USA National Antimicrobial Resistance Monitoring System. Potential links between consumption of antimicrobials and patterns of antimicrobial resistance were discussed. Bacterial pathogens of patients and antimicrobial resistance data in 2016 from CHINET (China Antimicrobial Resistance Surveillance Network) were also retrieved for comparative purpose and correlated with consumption of antimicrobials in China. Of 190 365 strains in the USA database, 29% were from human patients, and 71% were from animals and their meat samples. Percentage of isolates from animals and meat was further attributed from high to low as follows: chicken 41%, cattle 13%, turkey 9% and pig 8%. The pathogen of highest prevalence in animals and human patients was Salmonella (45% and 66%, respectively). Animal meat was dominated by Enterococcus spp. (42%). Salmonella was the main pathogen in animals and humans in the United States. Of the pathogens from human patients in 2016 in China, pathogenic Escherichia coli and Staphylococcus aureus were predominant. Resistance data suggested that high resistance was seen in commonly used drugs in six classes of antimicrobials in the United States and four classes of antimicrobials in China. High resistance rate was also observed in aminoglycosides that were not commonly used in both countries. Nevertheless, such comparison appears to be farfetched due to lack of long-term systemic surveillance data in China. Integration of resources from the national health departments, agricultural departments and food administrations, therefore, is highly recommended for coordinated efforts to monitor resistant bacterial species via food-chain from food animals, meats, human patients. Such data could be linked with the use of antimicrobials in human clinical settings and food animal for policy makers to propose guidel