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Abstract：
Pseudomonas is a group of ubiquitous non-fermenting Gram-negative bacteria (NFGNB). Of the several species associated with humans, Pseudomonas aeruginosa (PA) can acclimate to diverse environments. The global frequency of PA infections is rising and is complicated by this organism\'s high intrinsic and acquired resistance to several clinically relevant antibiotics. Data on the epidemiology, levels, and trends of antimicrobial resistance of PA in clinical settings in the MENA/GCC region is scarce.
A retrospective 12-year analysis of 56,618 non-duplicate diagnostic Pseudomonas spp. from the United Arab Emirates (UAE) was conducted. Data was generated at 317 surveillance sites by routine patient care during 2010-2021, collected by trained personnel and reported by participating surveillance sites to the UAE National antimicrobial resistance (AMR) Surveillance program. Data analysis was conducted with WHONET (https://whonet.org/).
Among the total isolates (N = 56,618), the majority were PA (95.6%). Data on nationality revealed 44.1% were UAE nationals. Most isolates were from soft tissue (55.7%), followed by respiratory tract (26.7%). PA was more commonly found among inpatients than among outpatients, followed by ICUs. PA showed a horizontal trend for resistance to fluoroquinolones, 3rd- and 4th-generation cephalosporins, and decreasing trends of resistance for aminoglycosides and meropenem. The highest percentage of multidrug resistant (MDR) isolates was reported in 2011 at 35.6%. As an overall trend, the percentage of MDR, extensively drug-resistant (XDR), and possible pandrug-resistant (PDR) isolates generally declined over the study period. Carbapenem-resistant PA (CRPA) were associated with a higher mortality (RR: 2.7), increased admission to ICU (RR: 2.3), and increased length of stay (LOS) (12 excess inpatient days per case), as compared to carbapenem-susceptible PA (CSPA).
The resistance trends in Pseudomonas species in the UAE indicated a decline in AMR and in percentages of Pseudomonas isolates with MDR and XDR profiles. The sustained Pseudomonas spp. circulation particularly in the hospital settings highlights the importance of surveillance techniques, infection control strategies, and stewardship to limit the continued dissemination. This data also shows that CRPA are associated with higher mortality, increased ICU admission rates, and a longer hospitalization, thus higher costs due to increased number of in-hospital and ICU days.
A retrospective 12-year analysis of 56,618 non-duplicate diagnostic Pseudomonas spp. from the United Arab Emirates (UAE) was conducted. Data was generated at 317 surveillance sites by routine patient care during 2010-2021, collected by trained personnel and reported by participating surveillance sites to the UAE National antimicrobial resistance (AMR) Surveillance program. Data analysis was conducted with WHONET (https://whonet.org/).
Among the total isolates (N = 56,618), the majority were PA (95.6%). Data on nationality revealed 44.1% were UAE nationals. Most isolates were from soft tissue (55.7%), followed by respiratory tract (26.7%). PA was more commonly found among inpatients than among outpatients, followed by ICUs. PA showed a horizontal trend for resistance to fluoroquinolones, 3rd- and 4th-generation cephalosporins, and decreasing trends of resistance for aminoglycosides and meropenem. The highest percentage of multidrug resistant (MDR) isolates was reported in 2011 at 35.6%. As an overall trend, the percentage of MDR, extensively drug-resistant (XDR), and possible pandrug-resistant (PDR) isolates generally declined over the study period. Carbapenem-resistant PA (CRPA) were associated with a higher mortality (RR: 2.7), increased admission to ICU (RR: 2.3), and increased length of stay (LOS) (12 excess inpatient days per case), as compared to carbapenem-susceptible PA (CSPA).
The resistance trends in Pseudomonas species in the UAE indicated a decline in AMR and in percentages of Pseudomonas isolates with MDR and XDR profiles. The sustained Pseudomonas spp. circulation particularly in the hospital settings highlights the importance of surveillance techniques, infection control strategies, and stewardship to limit the continued dissemination. This data also shows that CRPA are associated with higher mortality, increased ICU admission rates, and a longer hospitalization, thus higher costs due to increased number of in-hospital and ICU days.
摘要：
■假单胞菌是一组普遍存在的非发酵革兰氏阴性菌(NFGNB)。在与人类相关的几种物种中，铜绿假单胞菌（PA）可以适应多种环境。PA感染的全球频率正在上升，并且由于该生物体对几种临床相关抗生素的高内在和获得性耐药性而变得复杂。流行病学数据，levels,在MENA/GCC地区的临床环境中，PA的耐药性趋势很少。
■对56,618个非重复诊断假单胞菌属的回顾性12年分析。从阿拉伯联合酋长国（阿联酋）进行。数据是在2010-2021年期间由常规患者护理在317个监测点产生的，由训练有素的人员收集，并由参与监测点向阿联酋国家抗菌素耐药性（AMR）监测计划报告。使用WHONET（https://whonet.org/）进行数据分析。
■在总分离株中（N=56,618），大多数是PA（95.6％）。国籍数据显示，阿联酋国民占44.1％。大多数分离株来自软组织（55.7％），其次是呼吸道(26.7%)。PA在住院患者中比门诊患者中更常见，其次是ICUs。PA对氟喹诺酮类药物的耐药性呈水平趋势，第3代和第4代头孢菌素，氨基糖苷类和美罗培南耐药性呈下降趋势。2011年报告的多重耐药（MDR）分离株比例最高，为35.6％。作为一个整体趋势,MDR的百分比，广泛耐药(XDR)，在研究期间，可能的耐pandrug（PDR）分离株普遍下降。耐碳青霉烯PA（CRPA）与较高的死亡率相关（RR：2.7），ICU住院人数增加（RR：2.3），并增加住院时间（LOS）（每例超过12个住院天数），与碳青霉烯易感PA（CSPA）相比。
■阿联酋假单胞菌属的耐药性趋势表明AMR和具有MDR和XDR谱的假单胞菌属分离株的百分比下降。持续的假单胞菌属。特别是在医院环境中的循环突出了监控技术的重要性，感染控制策略，和管理以限制持续传播。该数据还表明，CRPA与较高的死亡率相关，ICU入院率增加，和更长的住院时间，因此，由于住院和ICU天数增加，费用增加。
■对56,618个非重复诊断假单胞菌属的回顾性12年分析。从阿拉伯联合酋长国（阿联酋）进行。数据是在2010-2021年期间由常规患者护理在317个监测点产生的，由训练有素的人员收集，并由参与监测点向阿联酋国家抗菌素耐药性（AMR）监测计划报告。使用WHONET（https://whonet.org/）进行数据分析。
■在总分离株中（N=56,618），大多数是PA（95.6％）。国籍数据显示，阿联酋国民占44.1％。大多数分离株来自软组织（55.7％），其次是呼吸道(26.7%)。PA在住院患者中比门诊患者中更常见，其次是ICUs。PA对氟喹诺酮类药物的耐药性呈水平趋势，第3代和第4代头孢菌素，氨基糖苷类和美罗培南耐药性呈下降趋势。2011年报告的多重耐药（MDR）分离株比例最高，为35.6％。作为一个整体趋势,MDR的百分比，广泛耐药(XDR)，在研究期间，可能的耐pandrug（PDR）分离株普遍下降。耐碳青霉烯PA（CRPA）与较高的死亡率相关（RR：2.7），ICU住院人数增加（RR：2.3），并增加住院时间（LOS）（每例超过12个住院天数），与碳青霉烯易感PA（CSPA）相比。
■阿联酋假单胞菌属的耐药性趋势表明AMR和具有MDR和XDR谱的假单胞菌属分离株的百分比下降。持续的假单胞菌属。特别是在医院环境中的循环突出了监控技术的重要性，感染控制策略，和管理以限制持续传播。该数据还表明，CRPA与较高的死亡率相关，ICU入院率增加，和更长的住院时间，因此，由于住院和ICU天数增加，费用增加。
