PDF(Pubmed)
Abstract：
Antibiotics are often used to treat severe Vibrio infections, with third-generation cephalosporins and tetracyclines combined or fluoroquinolones alone being recommended by the US Centers for Disease Control and Prevention. Increases in antibiotic resistance of both environmental and clinical vibrios are of concern; however, limited longitudinal data have been generated among environmental isolates to inform how resistance patterns may be changing over time. Hence, we evaluated long-term trends in antibiotic resistance of vibrios isolated from Chesapeake Bay waters (Maryland) across two 3-year sampling periods (2009-2012 and 2019-2022). Vibrio parahaemolyticus (n = 134) and Vibrio vulnificus (n = 94) toxR-confirmed isolates were randomly selected from both sampling periods and tested for antimicrobial susceptibility against eight antibiotics using the Kirby-Bauer disk diffusion method. A high percentage (94%-96%) of V. parahaemolyticus isolates from both sampling periods were resistant to ampicillin and only 2%-6% of these isolates expressed intermediate resistance or resistance to third-generation cephalosporins, amikacin, tetracycline, and trimethoprim-sulfamethoxazole. Even lower percentages of resistant V. vulnificus isolates were observed and those were mostly recovered from 2009 to 2012, however, the presence of multiple virulence factors was observed. The frequency of multi-drug resistance was relatively low (6%-8%) but included resistance against antibiotics used to treat severe vibriosis in adults and children. All isolates were susceptible to ciprofloxacin, a fluoroquinolone, indicating its sustained efficacy as a first-line agent in the treatment of severe vibriosis. Overall, our data indicate that antibiotic resistance patterns among V. parahaemolyticus and V. vulnificus recovered from the lower Chesapeake Bay have remained relatively stable since 2009.IMPORTANCEVibrio spp. have historically been susceptible to most clinically relevant antibiotics; however, resistance and intermediate-resistance have been increasingly recorded in both environmental and clinical isolates. Our data showed that while the percentage of multi-drug resistance and resistance to antibiotics was relatively low and stable across time, some Vibrio isolates displayed resistance and intermediate resistance to antibiotics typically used to treat severe vibriosis (e.g., third-generation cephalosporins, tetracyclines, sulfamethoxazole-trimethoprim, and aminoglycosides). Also, given the high case fatality rates observed with Vibrio vulnificus infections, the presence of multiple virulence factors in the tested isolates is concerning. Nevertheless, the continued susceptibility of all tested isolates against ciprofloxacin, a fluoroquinolone, is indicative of its use as an effective first-line treatment of severe Vibrio spp. infections stemming from exposure to Chesapeake Bay waters or contaminated seafood ingestion.
摘要：
抗生素通常用于治疗严重的弧菌感染，美国疾病控制和预防中心推荐使用第三代头孢菌素和四环素类药物或单独使用氟喹诺酮类药物。环境和临床弧菌的抗生素耐药性增加令人担忧；然而，有限的纵向数据已在环境隔离物之间生成，以告知电阻模式如何随时间变化。因此，我们在2个3年的采样期(2009-2012年和2019-2022年)评估了从切萨皮克湾水域(马里兰州)分离的弧菌的抗生素耐药性的长期趋势.从两个采样期随机选择副溶血性弧菌（n=134）和创伤弧菌（n=94），并使用Kirby-Bauer圆盘扩散法测试了对八种抗生素的抗菌敏感性。来自两个采样期的高百分比（94％-96％）的副溶血性弧菌分离株对氨苄西林耐药，这些分离株中只有2％-6％对第三代头孢菌素表示中等耐药或耐药，阿米卡星，四环素,和甲氧苄啶-磺胺甲恶唑.观察到甚至更低百分比的耐药创伤弧菌分离株，并且这些分离株大多从2009年至2012年恢复，然而，观察到多种毒力因子的存在。多重耐药性的频率相对较低（6％-8％），但包括对用于治疗成人和儿童严重弧菌病的抗生素的耐药性。所有分离株均对环丙沙星敏感,一种氟喹诺酮,表明其作为治疗严重弧菌病的一线药物的持续疗效。总的来说,我们的数据表明,自2009年以来,从切萨皮克湾下游恢复的副溶血性弧菌和创伤弧菌的抗生素耐药模式相对稳定.重要弧菌属。历史上对大多数临床相关抗生素敏感；然而，在环境和临床分离株中，耐药性和中等耐药性的记录越来越多。我们的数据显示，尽管多重耐药性和抗生素耐药性的百分比相对较低且随时间稳定，一些弧菌分离株对通常用于治疗严重弧菌病的抗生素表现出抗性和中等抗性(例如，第三代头孢菌素,四环素,磺胺甲恶唑-甲氧苄啶，和氨基糖苷类）。此外，鉴于创伤弧菌感染的高病死率，受试分离株中多种毒力因子的存在令人担忧。然而，所有测试分离株对环丙沙星的持续敏感性，一种氟喹诺酮,表明其用作严重弧菌属的有效一线治疗。由于接触切萨皮克湾水域或摄入受污染的海鲜而引起的感染。
