氨基糖苷类药物对副猪嗜血杆菌的流行折点

Establishment on aminoglycoside epidemiological cut-off values of Haemophilus parasuis

目的副猪嗜血杆菌(HPS)严重危害养猪业,抗菌药滥用导致该菌耐药率升高,建立流行折点(epidemiology cutoff values,ECV)对副猪嗜血杆菌的防治具有重要意义。方法目前美国临床和实验室标准协会(CLSI)和欧盟抗微生物药物敏感性检测委员会(EUCAST)并没有建立关于副猪嗜血杆菌的敏感性ECV,为减少药物滥用和更好地精准用药,本研究在NCBI、知网等网站上搜索大量文献,查找近10年来中国和欧洲不同地区和不同来源的、关于各种氨基糖苷类药物对副猪嗜血杆菌的最小抑菌浓度(minimum inhibitory concentration,MIC)数据。将这些MIC数据进行汇总,运用ECOFFinder软件进行统计分析,拟合出不同氨基糖苷类药物对副猪嗜血杆菌MIC分布图。结果分析并建立了95%置信区间下阿米卡星(中国)、安普霉素(中国)、庆大霉素(中国)、卡那霉素(中国)、链霉素(中国)、奇霉素(中国)、庆大霉素(欧洲部分国家)、链霉素(欧洲部分国家)、奇霉素(欧洲部分国家)、新霉素(欧洲部分国家)对副猪嗜血杆菌的敏感性ECV,分别为64、32、16、32、64、32、4、64、8和16μg/mL。结论为临床合理用药,减少副猪嗜血杆菌的耐药性的发生,提升精准用药的可行性,缩短临床用药周期等一系列监测、防控、治疗工作提供理论基础与支持。

Objective Haemophilus parasuis(HPS)is a kind of pathogenic bacteria which is harmful to swine industry.Its drug resistance to aminoglycosides is becoming more and more serious.It is very important to establish epidemiology cutoff values(ECV)for the control of HPS.Methods At present,Clinical and Laboratory Standards Institute(CLSI)and European Committee on Antimicrobial Susceptibility Testing(EUCAST)have not established ECV for HPS.Therefore,in order to reduce the abuse of drugs and to give better advice on the rationality of precise drug use,this study searched a large number of literatures on NCBI and CNKI.Results We have collected the minimum inhibitory concentration data on the effects of various aminoglycosides on HPS from different regions and sources over the past decade.Then the MIC data were collected and analyzed by ECOFFinder to fit the MIC curve of the original data of HPS with different aminoglycosides and the standard MIC curve,and the ECV of aminoglycosides to HPS was analyzed and established.Next,we obtained the drug resistance rates of HPS to amikacin(China),apramycin(China),gentamicin(China),kanamycin(China),streptomycin(China),spectinomycin(China),gentamicin(Europe),streptomycin(Europe),spectinomycin(Europe),neomycin(Europe)at 95%confidence interval.Conclusion The drug resistance rates were 64,32,16,32,64,32,4,64,8 and 16μg/mL,respectively.This study provides the theoretical basis and support for rational clinical drug use,reducing the drug resistance of HPS,improving the feasibility of precise drug use,and shortening the period of clinical drug use.