2018—2020年多中心腹腔感染分离菌分布及耐药性分析  

Distribution and drug resistance analysis of bacteria from abdominal specimens of multicenters from 2018 to 2020

作　　者：刘平娟 黄彬[1] 廖康[1] 喻华[2] 蓝锴[3] 贾伟[4] 刘家云 单斌[6] 王晓明[7] 耿荣华[8] 谢小芳[9] 季萍[10] 鲍春梅 Liu Ping-juan;Huang Bin;Liao Kang;Yu Hua;Lan Kai;Jia Wei;Liu Jia-yun;Shan Bin;Wang Xiao-ming;Geng Rong-hua;Xie Xiao-fang;Ji Ping;Bao Chun-mei(The First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080;Sichuan Provincial People’s Hospital,Chengdu 610072;Guangdong Provincial Hospital of Traditional Chinese Medicine,The Second Clinical College of Guangzhou University of Traditional Chinese Medicine,Guangzhou 510120;General Hospital of Ningxia Medical University,Yinchuan 750004;The First Affiliated Hospital of Air Force Military Medical University,Xi'an 710032;The First Affiliated Hospital,Kunming Medical University,Kunming 650032;The First Hospital of Jilin University,Changchun 130061;General Aviation Hospital,Beijing 100012;The Second Affiliated Hospital of Soochow University,Suzhou 215004;The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054;The Fifth Medical Center of PLA General Hospital,Beijing 100039)

机构地区：[1]中山大学附属第一医院,广州510080 [2]四川省人民医院,成都610072 [3]广东省中医院,广州510120 [4]宁夏医科大学总医院,银川750004 [5]空军军医大学第一附属医院,西安710032 [6]昆明医科大学第一附属医院,昆明650032 [7]吉林大学第一医院,长春130061 [8]航空总医院,北京100012 [9]苏州大学附属第二医院,苏州215004 [10]新疆医科大学第一附属医院,乌鲁木齐830054 [11]解放军总医院第五医学中心,北京100039

出　　处：《中国抗生素杂志》2021年第11期1002-1007,共6页Chinese Journal of Antibiotics

摘　　要：目的了解全国11家三级医院腹腔标本分离细菌的分布和对主要抗菌药物的敏感性变化,为临床治疗提供参考依据。方法用WHONET5.6软件分析来自全国11家三级医院2018—2020年腹腔标本分离的菌株资料。结果3年内从腹腔标本中共分离细菌18602株,革兰阴性杆菌占57.6%,居前五的细菌分别是大肠埃希菌(23.4%)、屎肠球菌(11.9%)、肺炎克雷伯菌(11.9%)、粪肠球菌(6.0%)、铜绿假单胞菌(4.5%)。药敏结果显示,肠杆菌目细菌对阿米卡星和碳青霉烯类抗生素敏感性较好,肺炎克雷伯菌和阴沟肠杆菌对碳青霉烯类抗生素的耐药率逐年上升,2020年对厄他培南的耐药率分别达到15.6%和11.1%,大肠埃希菌对左氧氟沙星和环丙沙星耐药率的耐药率较高(58.0%~69.7%)。非发酵菌中,铜绿假单胞菌和嗜麦芽窄食单胞菌对常用抗生素均保持较好的敏感性,鲍曼不动杆菌对大部分抗生素都高度耐药(超过60%)。未发现万古霉素耐药的葡萄球菌,屎肠球菌和粪肠球菌对万古霉素耐药率分别为0.6%~1.6%和0~0.9%。结论全国11家三级医院腹腔标本分离细菌以肠源性病原菌为主,最常见的是大肠埃希菌、屎肠球菌、肺炎克雷伯菌和粪肠球菌;常见病原菌对多种抗菌药物耐药,临床经验性使用抗菌药物前应参考耐药监测结果。Objective This paper investigated the distribution of bacteria isolated from abdominal cavity and the changes of sensitivity to main antibiotics among 11 hospitals in China,which can provide references for clinical treatment.Methods Data of strains isolated from abdominal cavity samples among 11 teaching hospitals in China from 2018 to 2020 were analyzed by Whonet5.6 software.Results A total of 18602 strains of bacteria were isolated from abdominal cavity samples in three years,of which Gram-negative bacilli covered 57.6%.Respectively,the top five bacteria were Escherichia coli(23.4%),Enterococcus faecium(11.9%),Klebsiella pneumoniae(11.9%),Enterococcus faecalis(6.0%),and Pseudomonas aeruginosa(4.5%).The drug sensitivity results showed that Enterobacteria bacteria were more sensitive to amikacin and carbapenem antibiotics.The resistance rates of Klebsiella pneumoniae and Enterobacter cloacae to carbapenem antibiotics increased year by year.While the resistance rates of Escherichia coli to ertapenem in 2020 were 15.6%and 11.1%respectively.The resistance rate of Escherichia coli to levofloxacin and ciprofloxacin was high(58.0%~69.7%).Among the non-fermentative bacteria,Pseudomonas aeruginosa and Stenotrophomonas maltophilia maintained good sensitivity to commonly used antibiotics,and Acinetobacter baumannii were highly resistant to most antibiotics(more than 60%).No staphylococci resistant to vancomycin were detected.The resistance rate of Enterococcus faecium and Enterococcus faecalis to vancomycin were 0.6%~1.6%and 0~0.9%.Conclusion Intestinal pathogenic bacteria were mainly isolated from abdominal specimens from 11 third-class hospitals in China.The most common bacteria were Escherichia coli,Enterococcus faecium,Klebsiella pneumoniae and Enterococcus faecalis.The common pathogenic bacteria were resistant to various antimicrobials.Before clinical empirical use of antibiotics,the monitoring results of drug resistance should be referred to.

关 键 词：腹腔标本 细菌 耐药性 

分 类 号：R978.1[医药卫生—药品]