喹诺酮类药物对2018—2020年多中心临床分离菌的耐药性分析  

Analysis of quinolone resistance in multicenter clinical isolates from 2018 to 2020

作　　者：周珊 刘家云 曲芬 喻华[3] 李刚[4] 蓝锴[5] 王晓明[6] 季萍[7] 刘平娟 伍众文[8] 谢小芳[9] 贾伟[4] 单斌[10] 耿荣华[2] 鲍春梅 Zhou Shan;Liu Jia-yun;Qu Fen;Yu Hua;Li Gang;Lan Kai;Wang Xiao-ming;Ji Ping;Liu Ping-juan;Wu Zhong-wen;Xie Xiao-fang;Jia Wei;Shan Bin;Geng Rong-hua;Bao Chun-mei(Xijing Hospital,the First Affiliated Hospital of Air Force Military Medical University,Xi'an 710032;General Aviation Hospital,Beijing 100012;Sichuan Provincial People's Hospital,Chengdu 610072;General Hospital,Ningxia Medical University,Yinchuan 750004;Chinese Medicine Hospital,Guangdong Provincial,Guangzhou 510120;The First Hospital,Jilin University,Changchun 180431;The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054;The First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510080;The Second Affiliated Hospital,Soochow University,Suzhou 215004;The First Affiliated Hospital,Kunming Medical University,Kunming 650032;The Fifth Medical Center of PLA General Hospital,Beijing 100039)

机构地区：[1]空军军医大学第一附属医院,西京医院,西安710032 [2]航空总医院,北京100012 [3]四川省人民医院,成都610072 [4]宁夏医科大学总医院,银川750004 [5]广东省中医院,广州510120 [6]吉林大学第一医院,长春180431 [7]新疆医科大学第一附属医院,乌鲁木齐830054 [8]中山大学附属第一医院,广州510080 [9]苏州大学附属第二医院,苏州215004 [10]昆明医科大学第一附属医院,昆明650032 [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1050-1053,共4页Chinese Journal of Antibiotics

摘　　要：目的分析2018—2020年多中心临床分离主要病原菌对诺酮类药物的耐药性。方法对国内主要地区11所三级医院临床分离菌株,按2020年CLSI文件统一进行抗菌药物敏感性试验并判断结果。结果近3年多中心耐药监测共收集临床分离菌215299株,分离前10位病原菌分别为大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、鲍曼不动杆菌、铜绿假单胞菌、屎肠球菌、粪肠球菌、表皮葡萄球菌、嗜麦芽窄食单胞菌和阴沟肠杆菌。大肠埃希菌对环丙沙星和左氧氟沙星的耐药率分别为65.3%和56.9%;其它肠杆菌目细菌对喹诺酮类药物的耐药率均在50%以下;肠道感染沙门菌属对环丙沙星和左氧氟沙星的耐药率分别为20.2%和12.6%;志贺菌属对环丙沙星和左氧氟沙星的耐药率41.2%和33.3%。鲍曼不动杆菌对环丙沙星和左氧氟沙星的耐药率为79.9%和59.7%。葡萄球菌属中凝固酶阴性葡萄球菌对喹诺酮类药物耐药率均较高,屎肠球菌耐药率明显高于粪肠球菌。肺炎链球菌对莫西沙星和左氧氟沙星的耐药率分别为1.6%和3.3%。未检出对莫西沙星、左氧氟沙星耐药的流感嗜血杆菌。结论喹诺酮类药物对大多数病原菌具有较好抗菌活性,但大肠埃希菌及肠道感染沙门菌敏感性较低,应加强医院感染防控措施和抗菌药物临床应用管理措施。Objective Analysis of the resistance of major pathogens isolated from multi-center clinical trials to quinolones.Methods A total of 11 hospitals were involved in this program.Antimicrobial susceptibility tests and result evaluation were carried out according to the CLSI document.Results The total of 215,299 strains were collected for multi-center monitoring in the past three years.The top ten pathogenic bacteria isolated were Escherichia coli,Klebsiella pneumoniae,Staphylococcus aureus,Acinetobacter baumannii,Pseudomonas aeruginosa,Enterococcus faecium,Enterococcus faecalis,Staphylococcus epidermidis,Stenotrophomonas maltophilia,and Enterobacter cloacae.The resistance rate of E.coli to ciprofloxacin was 65.3%,and that to levofloxacin was 56.9%.The other Enterobacteriaceae to quinolones were below 50%.The resistance rates of Salmonella to ciprofloxacin and levofloxacin in intestinal infections were respectively 20.2%and 12.6%,and the those of Shigella were respectively 41.2%and 33.3%.The resistance rates of Acinetobacter baumannii to ciprofloxacin and levofloxacin were 79.9%and 59.7%,respectively.Coagulase-negative staphylococci were all have high resistance rates to quinolones.The resistance rates of Enterococcus faecium was significantly higher than that of Enterococcus faecalis.The resistance rates of Streptococcus pneumoniae to moxifloxacin and levofloxacin were 1.6%and 3.3%,respectively.Haemophilus influenzae resistant to moxifloxacin and levofloxacin was not detected.Conclusion Quinolones have good antibacterial activity against most pathogens,but it is less sensitive to E.coli and Salmonella intestinal infection.We should strengthen the prevention and control measures of nosocomial infections and the management measures of the clinical application of antimicrobials.

关 键 词：细菌耐药监测 药物敏感性试验 喹诺酮 耐药 病原菌 

分 类 号：R978.1[医药卫生—药品]