浅析2014~2019年我国主要致病菌“ESKAPE”的耐药性变迁  

Data Analysis of Drug-resistance Trends of Main Pathogenic Bacteria “ESKAPE” during 2014 and 2019 in China

作　　者：王佳 孟现民[1] Wang Jia;Meng Xianmin(Department of Pharmacy,Shanghai Public Health Clinical Center,Shanghai 201508,China)

机构地区：[1]上海市公共卫生临床中心药学部,上海201508

出　　处：《中国药师》2021年第1期99-104,共6页China Pharmacist

摘　　要：目的:浅析我国2014~2019年屎肠球菌、金黄色葡萄球菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌和肠杆菌属6种主要致病菌(以下简称"ESKAPE")的耐药性变迁,为临床抗感染治疗提供参考。方法:检索并下载2014~2019年中国细菌耐药监测网数据,统计分析临床分离的革兰阳性菌、革兰阴性菌和"ESKAPE"的检出率、占比及耐药率变化。结果:2014~2019年,革兰阳性菌与阴性菌分离率变化不大,分别占约30%和70%;"ESKAPE"占比基本维持在50%左右。屎肠球菌检出率变化不大,万古霉素耐药屎肠球菌检出率下降,对万古霉素、替考拉宁、氯霉素耐药率下降。金黄色葡萄球菌检出率略有升高,甲氧西林耐药金葡菌检出率下降,对利福平、左氧氟沙星和庆大霉素的耐药率下降。肺炎克雷伯菌和铜绿假单胞菌的检出率升高,鲍曼不动杆菌检出率有所下降,肠杆菌属检出率波动不大。肺炎克雷伯菌、鲍曼不动杆菌和肠杆菌属耐药趋势较为相似,除对替加环素、多粘菌素B等少数药物耐药率下降外,其余大部分抗菌药物包括亚胺培南和美罗培南在内均呈上升趋势。铜绿假单胞菌对美罗培南耐药率从2014年的24.3%下降至2019年的22.7%,对亚胺培南耐药率维持在27%左右。结论:近6年屎肠球菌和金黄色葡萄球菌耐药性得到了一定程度的遏制,但肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌和肠杆菌属耐药性仍呈上升趋势,医务工作者仍需充分重视"ESKAPE"耐药菌所致的感染及其耐药性问题,并加强抗菌药物使用管理。Objective: To observe and analyze the drug resistance trends of Enterococcus faecium,Staphylococcus aureus,Klebsiella pneumoniae,Acinetobacter baumannii,Pseudomonas aeruginosa and Enterobacter species( "ESKAPE") from 2014 to 2019 in China to provide reference for clinical anti-infection treatment. Methods: The bacterial resistance surveillance in China from 2014 to 2019 were retrieved and downloaded,and the detection rate,proportion and drug resistance rate of gram-positive bacteria,gram-negative bacteria and"ESKAPE"were statistically analyzed. Results: The separation rate of gram-positive bacteria and gram-negative bacteria did not change much,accounting for 30% and 70%,respectively. The proportion of"ESKAPE"was remained at about 50% from 2014 to 2019. The detection rate of Enterococcus faecium changed a little,the detection of vancomycin-resistant Enterococcus decreased,the resistance rates to vancomycin,teicoplanin and chloramphenicol decreased. The detection rate of staphylococcus aureuswas increased slightly,the detection rate of methicillin-resistant Staphylococcus aureus decreased,and the drug resistance rate to rifampicin,levofloxacin and gentamicin decreased. The detection rate of Klebsiella pneumoniae and Pseudomonas aeruginosa increased,while Acinetobacter baumannii decreased,and Enterobacter spp. fluctuated a little. Klebsiella pneumoniae,Acinetobacter baumannii and Enterobacter spp.showed similar trends in drug resistance. In addition to the decrease in drug resistance rate to some drugs such as tigecycline and polymyxin B,many other important antibacterial drugs including imipenem and meropenem all showed an increasing resistance trend. The drug resistance rate of Pseudomonas aeruginosa to meropenem decreased from 24.3% to 22.7%,and the drug resistance rate to imipenem remained at about 27%. Conclusion: In the past 6 years,the drug resistance of Enterococcus faecium and Staphylococcus aureus were effectively inhibited,while the drug resistance of Klebsiella pneumoniae,Acinetobacter baumannii,Pseudom

关 键 词：屎肠球菌 金黄色葡萄球菌 肺炎克雷伯菌 鲍曼不动杆菌 铜绿假单胞菌 肠杆菌属 检出率 抗菌药物 耐药性 

分 类 号：R378[医药卫生—病原生物学]