全国细菌耐药监测网2014—2019年脑脊液标本细菌耐药监测报告  

Antimicrobial resistance of bacteria from cerebrospinal fluid specimens:surveillance report from China Antimicrobial Resistance Surveillance System in 2014-2019

作　　者：无 无(China Antimicrobial Resistance Surveillance System)

机构地区：[1]全国细菌耐药监测网

出　　处：《中国感染控制杂志》2021年第1期44-52,共9页Chinese Journal of Infection Control

摘　　要：目的了解全国脑脊液标本分离细菌的分布及耐药性变迁。方法按照全国细菌耐药监测网(CARSS)方案,应用WHONET 5.6软件对2014—2019年所有CARSS成员单位上报的脑脊液标本分离细菌及药敏结果数据进行分析。结果2014—2019年脑脊液共分离细菌99741株,前五位依次为凝固酶阴性葡萄球菌(49902株,50.0%)、鲍曼不动杆菌(7692,7.7%)、大肠埃希菌(5561株,5.6%)、肺炎克雷伯菌(4653株,4.7%)、金黄色葡萄球菌(4295株,4.3%)。耐甲氧西林金黄色葡萄球菌(MRSA)的检出率由2014年的48.2%下降至2019年的39.9%;耐青霉素肺炎链球菌(PRSP)检出率一直在70%以上;屎肠球菌对多数测试药物的耐药率高于粪肠球菌;大肠埃希菌对头孢曲松的耐药率多数>60%,对碳青霉烯类抗生素的耐药率较低,但有上升趋势:对美罗培南的耐药率从2.6%上升至4.6%,对亚胺培南的耐药率从1.7%上升至4.5%;肺炎克雷伯菌对头孢曲松的耐药率>50%,对碳青霉烯类的耐药率快速增长:对美罗培南耐药率从13.1%上升至30.9%,对亚胺培南耐药率从12.6%上升至30.4%。鲍曼不动杆菌和铜绿假单胞菌对美罗培南耐药率均呈下降趋势,分别从74.2%下降至71.7%,32.6%下降至27.8%。结论脑脊液临床常见分离细菌的耐药性仍较强,耐药监测对中枢神经系统感染的有效治疗十分重要。Objective To investigate the change in distribution and antimicrobial resistance of bacteria isolated from cerebrospinal fluid(CSF)specimens in China.Methods According to China Antimicrobial Resistance Surveillance System(CARSS)technical program,data of bacteria isolated from CSF specimens and antimicrobial susceptibility testing results reported by CARSS member hospitals in 2014-2019 were analyzed with WHONET 5.6 software.Results From 2014 to 2019,a total of 99741 strains of bacteria were isolated from CSF,the top 5 were coagulase negative Staphylococcus(49902 strains,50.0%),Acinetobacter baumannii(7692 strains,7.7%),Escherichia coli(5561 strains,5.6%),Klebsiella pneumoniae(4653 strains,4.7%),and Staphylococcus aureus(4295 strains,4.3%).Isolation rate of methicillin-resistant Staphylococcus aureus(MRSA)decreased from 48.2%in 2014 to 39.9%in 2019;isolation rates of penicillin-resistant Streptococcus pneumoniae(PRSP)maintained above 70%;resistance rates of Enterococcus faecium to most tested antimicrobial agents were higher than Enterococcus faecalis;resistance rates of most Escherichia coli strains to ceftriaxone were>60%,to carbapenems were low,but with an upward trend:resistance rates to meropenem and imipenem increased from 2.6%to 4.6%and from 1.7%to 4.5%respectively;resistance rate of Klebsiella pneumoniae to ceftriaxone was>50%,and to carbapenems increased rapidly:resistance rates to meropenem and imipenem increased from 13.1%to 30.9%and from 12.6%to 30.4%respectively.Resistance rates of Acinetobacter baumannii and Pseudomonas aeruginosa to meropenem had decreased tendency,from 74.2%to 71.7%and 32.6%to 27.8%respectively.Conclusion Antimicrobial resistance of clinical isolates of CSF is still high,surveillance on antimicrobial resistance is very important for the effective treatment of central nervous system infection.

关 键 词：脑脊液 耐药性 耐甲氧西林金黄色葡萄球菌 耐青霉素肺炎链球菌 耐碳青霉烯类革兰阴性菌 中枢神经系统感染 病原体 全国细菌耐药监测网 

分 类 号：R181.3+2[医药卫生—流行病学]