2021年南昌大学第一附属医院细菌耐药性监测  

Surveillance of antimicrobial resistance among bacterial strains isolated from the First Affiliated Hospital of Nanchang University in 2021

作　　者：刘衍伶 曾令兵[1] 胡妮娅[1] 胡雪飞[1] 魏丹丹[1] 李俊明[1] LIU Yanling;ZENG Lingbing;HU Niya;HU Xuefei;WEI Dandan;LI Junming(Department of Laboratory Medicine,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院检验科,江西南昌330006

出　　处：《中国感染与化疗杂志》2023年第3期364-370,共7页Chinese Journal of Infection and Chemotherapy

基　　金：江西省科技厅青年基金项目(20202BABL216084)。

摘　　要：目的了解2021年南昌大学第一附属医院临床分离菌的分布及对常用抗菌药物的敏感性。方法收集该院2021年1月1日—12月31日非重复临床分离株,采用自动化仪器或纸片扩散法按照CHINET统一监测方案进行抗菌药物敏感性试验。按2021年CLSI文件标准判断结果,WHONET 5.6软件进行耐药性分析。结果共收集非重复临床分离菌9024株,其中革兰阳性菌2149株,占23.8%,革兰阴性菌6875株,占76.2%。甲氧西林耐药金黄色葡萄球菌(MRSA)和甲氧西林耐药凝固酶阴性葡萄球菌(MRCNS)检出率分别为30.8%和68.2%,未发现万古霉素和替加环素耐药株。92.3%MRSA对甲氧苄啶-磺胺甲唑敏感,89.4%MRCNS对利福平敏感。肠球菌属中粪肠球菌对多数抗菌药物的耐药率显著低于屎肠球菌,但对利奈唑胺的耐药率(2.4%)高于屎肠球菌(0.3%),两者中均有少量万古霉素耐药株。肺炎链球菌青霉素耐药株检出率为14.3%。肠杆菌目细菌中,除克雷伯菌属对碳青霉烯类抗生素耐药率高于40%外,其余菌属对碳青霉烯类药物仍较敏感。碳青霉烯类耐药肠杆菌目细菌(CRE)的检出率为28.3%,其中肺炎克雷伯菌在CRE菌株中占76.4%。不动杆菌属对亚胺培南和美罗培南的耐药率分别为75.5%和81.1%,铜绿假单胞菌对两药的耐药率分别为33.6%和30.5%。结论临床分离株对常用抗菌药物耐药率呈增长趋势,尤其是碳青霉烯类耐药革兰阴性杆菌,对临床抗感染治疗带来巨大挑战,医院各相关部门应加强协作以遏制耐药细菌的传播。Objective To investigate the antimicrobial resistance of clinical isolates in the First Affiliated Hospital of Nanchang University in 2021.Methods Nonduplicate clinical isolates were collected from January 1 to December 31,2021.Antimicrobial susceptibility was carried out according to a unified protocol of China Antimicrobial Resistance Surveillance Network using automated systems or Kirby-Bauer method.The data were analyzed using WHONET 5.6 software and interpreted according to the Clinical and Laboratory Standards Institute 2021 breakpoints.Results Of the 9024 nonduplicate clinical isolates,grampositive and gram-negative bacteria accounted for 23.8%(2149/9024)and 76.2%(6875/9024),respectively.Methicillinresistant strains in S.aureus(MRSA)and coagulase-negative Staphylococcus(MRCNS)accounted for 30.8%and 68.2%,respectively.No Staphylococcus strains were found resistant to vancomycin or tigecycline.Overall,92.3%of MRSA strains were susceptible to trimethoprim-sulfamethoxazole,while 89.4%of MRCNS strains were susceptible to rifampin.The resistance rates of E.faecalis strains to most tested antimicrobial agents were much lower than those of E.faecium,but higher to linezolid(2.4%versus 0.3%).A few strains of both species were resistant to vancomycin.The prevalence of penicillin-resistant S.pneumoniae strains were 14.3%.Most Enterobacterales species except Klebsiella spp(carbapenem-resistant strains>40%)showed high susceptibility to carbapenems.The prevalence of carbapenemresistant Enterobacterales(CRE)and carbapenem-resistant K.pneumoniae was 28.3%and 76.4%,respectively.About 75.5%and 81.8%of Acinetobacter spp.strains were resistant to imipenem and meropenem,respectively.The resistance rates of Pseudomonas aeruginosa to imipenem and meropenem were 33.6%and 30.5%,respectively.Conclusions The antimicrobial resistance of clinical bacterial isolates is still increasing,especially for carbapenems-resistant gram-negative bacilli.It poses a serious threat and implies the importance of strengthening the collaboration among

关 键 词：耐药性监测 药敏试验 碳青霉烯类耐药肠杆菌目细菌 甲氧西林耐药金黄色葡萄球菌 多重耐药菌 

分 类 号：R378[医药卫生—病原生物学]