氨基糖苷类对禽肠道细菌的耐药判定标准研究进展

Establishment on the resistant standards for aminoglycosides against digestive tract bacteria in chickens

禽消化道细菌病是危害养禽业的主要问题之一,沙门菌病、大肠埃希菌病等家禽肠道细菌病的流行日趋复杂,越来越难以控制,且不断出现新的流行与致病特点,不仅会造成严重肠道疾病而且会产生死亡。氨基糖苷类抗生素是高效、广谱抗生素,在临床上广泛应用,但是养殖业用药的不合理导致细菌的氨基糖苷耐药性日趋严重,这在很大程度上降低了其临床应用的潜力。而耐药监测需要判定标准,目前我国并没有相关标准,主要参考美国临床和实验室标准化协会(CLSI)和欧盟抗菌药物敏感性试验委员会(EUCAST)中的折点。当前CLSI和欧盟EUCAST标准中氨基糖苷类抗生素对禽消化道细菌病折点的制定并不完全,所以要全面建立符合我国国情的流行病学临界值和药效学临界值,为折点的制定工作提供科学数据,以监测耐药性的产生,分析耐药现状和发展规律,更科学地指导临床用药和新药开发。

Bacterial disease of poultry digestive tract is one of the major problems that endanger poultry industry. Salmonellosis, colibacillosis and other poultry intestinal bacterial epidemic were increasingly complex and more and more difficult to control. The emergence of new epidemic and disease characteristics can cause serious intestinal disease and death. Aminoglycoside antibiotics are highly effective, broad-spectrum antibiotics, and are widely used in clinical practice, However, the irrational use of aquaculture led to the growing resistance of bacteria against aminoglycoside, which greatly reduced the potential of its clinical application.Thus, drug resistance monitoring is necessary and urgent. The standard of drug resistance monitoring needs to be referenced. At present, China does not have the relevant standards. The main references Clinical and Laboratory Standards Institute （CLSI） and The European Committee on Antimicrobial Susceptibility Testing （EUCAST）were used to establish the breakpoint. According to current CLSI and the EUCAST standard, aminoglycoside antibiotics on the poultry digestive tract bacterial disease point is not complete. Therefore, we should establish a comprehensive line with China＇s national conditions of the epidemiological cut-off values （ECOFFs） breakpoints and pharmacodynamic breakpoints, to provide scientific data for the development of breakpoints to monitor the emergence of drug resistance, to analyze the status quo and the development of drug resistance, and to provide more scientific guidance for the clinical usageand drug development.