中国儿童细菌耐药监测组2021年儿童细菌耐药监测  

Antimicrobial resistance profile of clinical strains isolated from children in China:A report from the ISPED program in 2021

作　　者：付盼 王传清 俞蕙[2] 吴霞[2] 许红梅[3] 景春梅[4] 邓继岿[5] 王红梅[5] 华春珍[6] 陈英虎[6] 陈学军[7] 张婷[8] 张泓[9] 陈益平[10] 杨锦红[11] 林爱伟 王世富 曹清 王星 邓慧玲[16] 曹三成[17] 郝建华 高巍 黄园园[20] 项红霞[21] 卓志强[22] 黄美恋 FU Pan;WANG Chuanqing;YU Hui;WU Xia;XU Hongmei;JING Chunmei;DENG Jikui;WANG Hongmei;HUA Chunzhen;CHEN Yinghu;CHEN Xuejun;ZHANG Ting;ZHANG Hong;CHEN Yiping;YANG Jinhong;LIN Aiwei;WANG Shifu;CAO Qing;WANG Xing;DENG Huiling;CAO Sancheng;HAO Jianhua;GAO Wei;HUANG Yuanyuan;XIANG Hongxia;ZHUO Zhiqiang;HUANG Meilian(Clinical Microbiology Department,Children's Hospital of Fudan University,Shanghai 201102,China;Infectious Disease Department,Children's Hospital of Fudan University,Shanghai 201102,China;Infectious Disease Department,Children's Hospital of Chonqing Medical University,Chongqing 400014,China;Department of Medical Laboratory,Children's Hospital of Chonqing Medical University,Chongqing 400014,China;Infectious Disease Departmen,Shenzhen Children's Hospital,Shenzhen 518026,China;Infectious Disease Department,The Children's Hospital Zhejiang University School of Medicine,Hangzhou 310005,China;Department of Medical Laboratory,The Children's Hospital Zhejiang University School of Medicine,Hangzhou 310005,China;Digestive and Infectious Disease Department,Children's Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200040,China;Department of Medical Laboratory,Children's Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200040,China;Infectious Disease Department,Yuying Children's Hospital of Wenzhou Medical University,Wenzhou 325027,China;Department of Medical Laboratory,Yuying Children's Hospital of Wenzhou Medical University,Wenzhou 325027,China;Infectious Disease Department,Qilu Children's Hospital of Shandong University,Jinan 250100,China;Department of Medical Laboratory,Qilu Children's Hospital of Shandong University,Jinan 250100,China;Infectious Disease Department,Shanghai Children's Medical Center,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China;Department of Medical Laboratory,Shanghai Children's Medical Center,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China;Infectious Disease Department,Xi'an Children's Hospi

机构地区：[1]复旦大学附属儿科医院细菌室,上海201102 [2]复旦大学附属儿科医院感染科,上海201102 [3]重庆医科大学附属儿童医院感染科,重庆400014 [4]重庆医科大学附属儿童医院检验科,重庆400014 [5]广东省深圳市儿童医院检验科,深圳518026 [6]浙江大学医学院附属儿童医院感染科,杭州310005 [7]浙江大学医学院附属儿童医院检验科,杭州310005 [8]上海交通大学医学院附属儿童医院消化感染科,上海200040 [9]上海交通大学医学院附属儿童医院检验科,上海200040 [10]温州医科大学附属育英儿童医院感染科,温州325027 [11]温州医科大学附属育英儿童医院检验科,温州325027 [12]山东大学齐鲁儿童医院感染科,济南250100 [13]山东大学齐鲁儿童医院检验科,济南250100 [14]上海交通大学医学院附属上海儿童医学中心感染科,上海200127 [15]上海交通大学医学院附属上海儿童医学中心检验科,上海200127 [16]陕西省西安市儿童医院感染科,西安710043 [17]陕西省西安市儿童医院检验科,西安710043 [18]河南省开封市儿童医院感染科,开封475099 [19]河南省开封市儿童医院检验科,开封475099 [20]吉林大学白求恩第一医院儿科,长春130021 [21]江苏省无锡市儿童医院感染科,无锡214023 [22]复旦大学附属儿科医院厦门分院感染科,厦门361006 [23]复旦大学附属儿科医院厦门分院检验科,厦门361006

出　　处：《中国循证儿科杂志》2022年第5期355-362,共8页Chinese Journal of Evidence Based Pediatrics

基　　金：复旦大学附属儿科医院重点发展项目,感染传染与免疫临床中心的子项目:EK2022ZX05。

摘　　要：背景中国儿童细菌耐药监测组(ISPED)每年对成员单位的耐药监测数据进行汇总和分析,以监测中国儿童感染性病原学变迁和耐药情况。目的对我国儿童细菌感染和耐药现状进行监测汇总,以期指导儿童抗生素合理应用。设计横断面调查。方法菌株资料来源于2021年1月1日至12月31日国内13所三级甲等儿童教学医院,细菌抗菌药物敏感性试验采用自动化仪器法及KB纸片法,肺炎链球菌青霉素药物敏感性试验采用E-test法,结果判断采用美国临床实验室标准化委员会2021年标准。各成员单位统一细菌培养、鉴定方法、抗菌药物敏感试验条件和方法,每年以统一格式上报分离到的有效菌株和细菌耐药资料,进行数据汇总和统计分析。主要结局指标儿科菌群分布特征及主要病原菌耐药性变化。结果2021年ISPED单位共分离到63508株临床有效菌株,革兰阳性菌和革兰阴性菌的比例分别为39.9%和60.1%。前10位分离株分别是:大肠埃希菌12.7%、肺炎链球菌12.3%、金黄色葡萄球菌11.6%、流感嗜血杆菌11.4%、卡他莫拉菌6.5%、肺炎克雷伯菌5.2%、铜绿假单胞菌4.0%、表皮葡萄球菌3.7%、鲍曼不动杆菌2.4%和化脓性链球菌2.1%。不同年龄组的主要分离菌分布不同,其中金黄色葡萄球菌在新生儿中分离率最高(18.7%),肺炎链球菌是>28 d至5岁儿童主要分离菌(13.6%~20.8%),大肠埃希菌是>5岁儿童最主要分离菌(22.4%)。青霉素不敏感的肺炎链球菌为9.6%。多重耐药菌(MDROs)对临床多种抗生素呈现高水平耐药,碳青霉烯类耐药的肠杆菌目细菌、肺炎克雷伯菌、铜绿假单胞菌(CR-PA)和鲍曼不动杆菌(CR-AB)检出率分别为4.6%、14.8%、6.7%和30.7%,CR-PA在新生儿组检出率较高,CR-AB在非新生儿组检出率较高,CR-PA和CR-AB对多种抗生素耐药率在非新生儿组中均明显高于新生儿组。甲氧西林耐药金黄色葡萄球菌检出率为33.2%。结论2021年MDROs�Background Chinese Infectious Disease Surveillance of Pediatrics(ISPED)was established in 2015.The data of antibiotics resistance were collected from each hospital and summarized every year to monitor the infectious etiology changes and bacterial drug resistance among Chinese children.Objective This study is aimed to investigate the bacterial infectious and antimicrobial resistance profiles of pathogens in Chinese children and guide the reasonable use of antibiotics.Design A cross-sectional survey.Methods Clinical isolates were collected from 13 tertiary children hospitals in China from January 1st to December 31st in 2021.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Penicillin susceptibility of streptococcus pneumonia was detected by E-test.All of the antimicrobial susceptibility testing results were interpreted according to the criteria of Clinical and Laboratory Standards Institute(CLSI)2021.All members used the standard methods to perform bacterial culture,identification and antimicrobial susceptibility test and reported the isolated effective strains and bacterial resistance data in a structured format every year for data summary and statistical analysis.Main outcome measures Detect the distribution of bacteria strains in children and the changes of bacteria drug resistance.Results A total of 63508 isolates were collected,of which 39.9%was gram-positive organisms and 60.1%was gram-negative organisms.Top ten pathogens were as follows,Escherichia coli(12.7%),Streptococcus pneumonia(12.3%),Straphylococcus aureus(11.6%),Haemophilus influenza(11.4%),Moraxella catarrhalis(6.5%),Klebsiella pneunoniae(5.2%),Pseudomonas aeruginosa(4.0%),Staphylococcus epidermidis(3.7%),Acinetobacter baumannii(2.4%)and Streptococcus pyogenes(2.1%).The distribution of the primary pathogenic bacteria in different age groups was different.Among them,Saureus had the highest isolation rate in neonates(18.7%),and S.pneumoniae was the main pathogenic bacter

关 键 词：细菌 耐药 儿童 中国儿童细菌耐药监测组 2021 

分 类 号：R446.5[医药卫生—诊断学]