全国细菌耐药监测网2014—2019年临床分离非发酵革兰阴性杆菌耐药性变迁  

Change in antimicrobial resistance of clinically isolated non-fermentative Gram-negative bacilli: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70-76,共7页Chinese Journal of Infection Control

摘　　要：目的了解全国临床分离非发酵革兰阴性杆菌的耐药性变迁。方法按照全国细菌耐药监测技术方案要求开展耐药监测工作,参考美国临床实验室标准化协会(CLSI)标准对2014—2019年全国1000余家医院上报至全国细菌耐药监测网的非发酵革兰阴性杆菌的临床资料进行总结和分析。结果非发酵革兰阴性杆菌主要分离自呼吸道标本(痰和支气管肺泡灌洗液)、尿、脓液和血,分别占83.6%,6.5%,4.0%和3.6%。铜绿假单胞菌、鲍曼不动杆菌、嗜麦芽窄食单胞菌和洋葱伯克霍尔德菌占分离细菌的比率分别为8.8%,7.3%,2.1%和0.5%。铜绿假单胞菌对多粘菌素B、阿米卡星和庆大霉素的敏感率分别为96.9%~98.2%,89.1%~94.0%和80.1%~86.4%;对哌拉西林和氨曲南的敏感率分别为66.7%~72.8%和58.8%~62.4%;对其余抗菌药物的敏感率维持在70.4%~81.7%。鲍曼不动杆菌对多粘菌素B、阿米卡星和米诺环素的敏感率分别为96.2%~98.0%,51.0%~58.0%和59.4%~63.4%,对其余抗菌药物的敏感率为35.8%~50.0%。嗜麦芽窄食单胞菌对米诺环素、复方磺胺甲口恶唑和左氧氟沙星的敏感率分别为93.0%~95.3%,89.3%~91.4%和85.0%~86.6%,对替卡西林/克拉维酸和氯霉素的敏感率为37.4%~50.3%和46.6%~51.1%。洋葱伯克霍尔德菌对替卡西林/克拉维酸和氯霉素的敏感率分别为18.5%~37.0%和54.4%~62.2%,对其余抗菌药物的敏感率维持在64.7%~86.8%。耐碳青霉烯类铜绿假单胞菌检出率呈下降趋势,而耐碳青霉烯类鲍曼不动杆菌检出率呈现先上升后下降的变化趋势。结论非发酵革兰阴性杆菌对常用抗菌药物的敏感性无明显变化,耐碳青霉烯类铜绿假单胞菌和鲍曼不动杆菌检出率呈下降趋势。Objective To understand the change in antimicrobial resistance of clinical non-fermentative Gram-negative bacilli in China.Methods Surveillance on antimicrobial resistance was carried out according to the requirements of China Antimicrobial Resistance Surveillance System(CARSS),referring to Clinical&Laboratory Stan-dards Institute(CLSI)standard,clinical data of non-fermentative Gram-negative bacilli reported to CARSS by more than 1000 hospitals in China from 2014 to 2019 were summarized and analyzed.Results Non-fermentative Gram-negative bacilli were mainly isolated from respiratory tract specimens(sputum and bronchoalveolar lavage fluid),urine,pus,and blood,accounting for 83.6%,6.5%,4.0%and 3.6%respectively.Isolation rates of Pseudomonas aeruginosa,Acinetobacter baumannii,Stenotrophomonas maltophilia,and Burkholderia cepacia were 8.8%,7.3%,2.1%and 0.5%respectively.Susceptibility rates of Pseudomonas aeruginosa to polymyxin B,amikacin and gentamicin were 96.9%-98.2%,89.1%-94.0%and 80.1%-86.4%respectively;susceptibility rates to piperacillin and aztreonam were 66.7%-72.8%and 58.8%-62.4%respectively;susceptibility rates to other antimicrobial agents were 70.4%-81.7%.Susceptibility rates of Acinetobacter baumannii to polymyxin B,amikacin and minocycline were 96.2%-98.0%,51.0%-58.0%and 59.4%-63.4%respectively,to other antimicrobial agents were 35.8%-50.0%.Susceptibility rates of Stenotrophomonas maltophilia to minocycline,sulfamethoxazole and levofloxacin were 93.0%-95.3%,89.3%-91.4%and 85.0%-86.6%respectively,susceptibility rates to ticarcillin/clavulanic acid and chloramphenicol were 37.4%-50.3%and 46.6%-51.1%respectively.Susceptibility rates of Burkholderia cepacia to ticarcillin/clavulanic acid and chloramphenicol were 18.5%-37.0%and 54.4%-62.2%respectively,susceptibility rates to other antimicrobial agents maintained 64.7%-86.8%.Isolation rate of carbapenem-resistant Pseudomonas aeruginosa decreased,while isolation rate of carbapenem-resis-tant Acinetobacter baumannii increased first and then decreased.Conclusio

关 键 词：非发酵革兰阴性杆菌 抗菌药物 耐药性 非发酵菌 铜绿假单胞菌 鲍曼不动杆菌 嗜麦芽窄食单胞菌 全国细菌耐药监测 

分 类 号：R181.3+2[医药卫生—流行病学]