2018—2020年多中心尿标本分离菌分布及耐药性分析  

Bacterial distribution and drug resistance of bacteria from urine specimens in a multicenter from 2018 to 2020

作　　者：赵梅[1] 杨丹 贾伟[1] 季萍[2] 蓝锴[3] 冀旭峰[4] 刘平娟 喻华[6] 谢小芳[7] 耿荣华[8] 单斌[9] 鲍春梅 刘家云 Zhao Mei;Yang Dan;Jia Wei;Ji Ping;Lan Kai;Ji Xu-feng;Liu Ping-Juan;Yu Hua;Xie Xiao-Fang;Geng Rong-Hua;Shan Bin;Bao Chun-Mei;Liu Jia-Yun(General Hospital of Ningxia Medical University,Yinchuan 750004;The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054;Guangdong Provincial TCM Hospital,Guangzhou 510120;The First Hospital of Jilin University,Changchun 130000;The first Affiliated Hospital Sun Yat-sen University,Guangzhou 510080;Sichuan Provincial People's Hospital,Chengdu 610072;The Second Affiliated Hospital of Soochow University,Suzhou 830054;General Aviation Hospital,Beijing 100012;The First Affiliated Hospital,Kunming Medical University,Kunming 650032;The Fifth Medical Center,PLA General Hospital,Beijing 100039;The First Affiliated Hospital of Air Force Military Medical University,Xi'an 710032)

机构地区：[1]宁夏医科大学总医院,银川750004 [2]新疆医科大学第一附属医院,乌鲁木齐830054 [3]广东省中医院,广州510120 [4]吉林大学第一医院,长春130000 [5]中山大学附属第一医院,广州510080 [6]四川省人民医院,成都610072 [7]苏州大学附属第二医院,苏州215004 [8]航空总医院,北京100012 [9]昆明医科大学第一附属医院,昆明650032 [10]解放军总医院第五医学中心,北京100039 [11]空军军医大学第一附属医院,西安710032

出　　处：《中国抗生素杂志》2021年第11期1008-1013,共6页Chinese Journal of Antibiotics

基　　金：宁夏自然科学基金项目(No.2020AAC03406)。

摘　　要：目的分析全国11家三级医院尿标本分离细菌的菌种分布及耐药性。方法应用WHONET 5.6软件对2018—2020年全国11家三级医院尿标本分离细菌药敏结果进行分析。结果男性患者尿标本分离细菌前5位的分别是大肠埃希菌(23.9%~27.4%)、屎肠球菌(12.5%~13.5%)、肺炎克雷伯菌(9.9%~11.5%)、粪肠球菌(8.5%~9.8%)、铜绿假单胞菌(5.2%~6.6%);女性患者尿标本分离细菌前5位的分别是大肠埃希菌(51.5%~52.8%)、屎肠球菌(9.8%~12.8%)、肺炎克雷伯菌(8.5%~9.2%)、粪肠球菌(5.3%~6.5%)、奇异变形杆菌(3.0%~3.6%)。屎肠球菌对左氧氟沙星、环丙沙星和氨苄西林耐药率均在90%以上,对万古霉素的耐药率为1.2%~1.6%。粪肠球菌对呋喃妥因和氨苄西林的耐药率分别为1.8%~2.4%和3.1%~4.2%,对万古霉素的耐药率从0增加至0.5%。大肠埃希菌ESBL检出率为46.7%~50.4%,对哌拉西林/他唑巴坦的耐药率为3%~3.2%,对碳青霉烯类的耐药率为0.7%~1.6%。肺炎克雷伯菌ESBL检出率为38.7%~50.5%,对碳青霉烯类耐药率从9.2%增加至15.2%。奇异变形杆菌对头孢曲松的耐药率为34%~42.9%,对哌拉西林/他唑巴坦的耐药率为0.2%~1.6%,对美罗培南的耐药率由0增加至0.9%。阴沟肠杆菌对头孢曲松的耐药率为38.9%~50.7%,对哌拉西林/他唑巴坦的耐药率为11.8%~21.2%,3年间对碳青霉烯类耐药率逐年上升,从5.4%上升至22%。铜绿假单胞菌对哌拉西林/他唑巴坦的耐药率为5.5%~14%,对碳青霉烯类耐药率为9%~20.5%。鲍曼不动杆菌对碳青霉烯类耐药率为35.5%~54%。结论尿标本分离细菌在不同性别构成上有所不同,尿路感染多重耐药菌逐年增加,尤其是碳青霉烯类耐药的革兰阴性菌。应加强医院感染防控和抗菌药物的科学化管理。Objective To investigate the change in distribution and antimicrobial resistance of bacteria isolated from urine specimens in 11 hospitals of China.Methods Data of bacteria isolated from urine specimens and antimicrobial susceptibility testing results reported by 11 hospitals of China from 2018 to 2020 were analyzed by WHONET 5.6 software.Results The top 5 bacteria isolated from urine specimens of male patients were Escherichia coli(23.9%~27.4%),Enterococcus faecium(12.5%~13.5%),Klebsiella pneumoniae(9.9%~11.5%),Enterococcus faecalis(8.5%~9.8%),Pseudomonas aeruginosa(5.2%~6.6%);The top 5 bacteria isolated from urine specimens of female patients were Escherichia coli(51.5%~52.8%),Enterococcus faecium(9.8%~12.8%),Klebsiella pneumoniae(8.5%~9.2%),Enterococcus faecalis(5.3%~6.5%),and Prpteus mirabilis(3.0%~3.6%).Resistance rates of Enterococcus faecium from urine specimens to levofloxacin,ciprofloxacin and ampicillin were all>90%,to vancomycin were 1.2%~1.6%;resistance rates of Enterococcus faecalis to nitrofurantoin and ampicillin were 1.8%~2.4%and 3.1%~4.2%respectively,and those to vancomycin increased from 0 to 0.5%.The detection rates of ESBL in Escherichia coli were 46.7%~50.4%.The resistance rates of Escherichia coli to piperacillin/tazobactam were 3%~3.2%,and to carbapenem were 0.7%~1.6%.The detection rates of ESBL in Klebsiella pneumoniae were 38.7%~50.5%.The resistance rates of Klebsiella pneumoniae to carbapenem increased from 9.2%to 15.2%.Resistance rates of Proteus mirabilis to ceftriaxone were 34%~42.9%,to piperacillin/tazobactam were 0.2%~1.6%,and those to carbapenem increased from 0 to 0.9%.Resistance rates of Enterobacter cloacae to ceftriaxone was 38.9%~50.7%,to piperacillin/tazobactam were 11.8%~21.2%,and those to carbapenem increased from 5.4%to 22%.Resistance rates of Pseudomonas aeruginosa to piperacillin/tazobactam were 5.5%~14%,and to carbapenem were 9%~20.5%.Resistance rates of Acinetobacter baumannii to carbapenem were 35.5%~54%.Conclusion Constituent of bacteria isolated from urine specimens

关 键 词：尿标本 抗菌药物 耐药性 

分 类 号：R978.1[医药卫生—药品]