湖南省细菌耐药监测网2012-2021年ICU分离细菌耐药性监测报告  

Antimicrobial resistance of bacteria from intensive care units:surveillance report from Hunan Province Antimicrobial Resistance Surveillance System,2012-2021

作　　者：陈丽华[1] 付陈超[2,3] 李晨 李艳明 刘君[6] 宁兴旺 石国民[8] 邬靖敏[9] 杨怀德 袁红霞 郑铭[2,3] 任南 黄勋[2,3,12,13] 吴安华 周建党[1] CHEN Li-hua;FU Chen-chao;LI Chen;LI Yan-ming;LIU Jun;NING Xing-wang;SHI Guo-min;WU Jing-min;YANG Huai-de;YUAN Hong-xia;ZHENG Ming;REN Nan;HUANG Xun;WU An-hua;ZHOU Jian-dang(Department of Laboratory Medicine,The Third Xiangya Hospital of Central South University,Changsha 410013,China;Center for Healthcare-associated Infection Control,Xiangya Hospital,Central South University,Changsha 410008,China;Hunan Provincial Bacterial Antimicrobial Resistance Surveillance System Office,Changsha 410008,China;Department of Laboratory Medicine,Liuyang Traditional Chinese Medicine Hospital,Liuyang 410300,China;Department of Laboratory Medicine,Xiangya Hospital,Central South University,Changsha 410008,China;Department of Laboratory Medicine,Xiangtan Central Hospital,Xiang-tan 411100,China;Medical Laboratory and Pathology Center,The First Hospital of Hunan University of Chinese Medicine,Changsha 410011,China;Department of Laboratory Medicine,Changsha Central Hospital,Changsha 410004,China;Department of Laboratory Medicine,The First Hospital of Changsha,Changsha 410005,China;Department of Laboratory Medicine,Zhangjiajie People’s Hospital,Zhangjiajie 427000,China;Center for Laboratory Medicine,The First People’s Hospital of Chenzhou,Chenzhou 423000,China;Hunan Provincial Healthcare-associated Infection Management Quality Control Center,Changsha 410008,China;National Clinical Research Center for Geriatric Disorders,Changsha 410008,China)

机构地区：[1]中南大学湘雅三医院检验科,湖南长沙410013 [2]中南大学湘雅医院医院感染控制中心,湖南长沙410008 [3]湖南省细菌耐药监测网办公室,湖南长沙410008 [4]浏阳市中医医院检验科,湖南浏阳410300 [5]中南大学湘雅医院检验科,湖南长沙410008 [6]湘潭市中心医院检验科,湖南湘潭411100 [7]湖南中医药大学第一附属医院医学检验与病理中心,湖南长沙410011 [8]长沙市中心医院检验科,湖南长沙410004 [9]长沙市第一医院检验科,湖南长沙410005 [10]张家界市人民医院检验科,湖南张家界427000 [11]郴州市第一人民医院检验医学中心,湖南郴州423000 [12]湖南省医院感染管理质量控制中心,湖南长沙410008 [13]国家老年疾病临床医学研究中心(湘雅医院),湖南长沙410008

出　　处：《中国感染控制杂志》2024年第8期942-953,共12页Chinese Journal of Infection Control

基　　金：湖南省自然科学基金项目(2021JJ30996)。

摘　　要：目的了解2012—2021年湖南省细菌耐药监测网网点医院重症监护病房(ICU)患者临床分离菌株分布情况及对抗菌药物的敏感性。方法按照全国细菌耐药监测网方案,应用WHONET 2022软件对所有湖南省耐药监测网成员单位上报的ICU临床分离细菌及药敏结果数据进行分析。结果2012—2021年各年份湖南省细菌耐药监测网成员单位ICU分离细菌总数为5777~22369株,其中革兰阴性菌每年占比为76.1%~78.0%。金黄色葡萄球菌一直稳居每年分离的革兰阳性菌之首。革兰阴性菌中,居前5位的细菌分别为鲍曼不动杆菌、肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌和嗜麦芽窄食单胞菌。耐甲氧西林金黄色葡萄球菌检出率呈逐年下降趋势,未发现对万古霉素、替考拉宁及利奈唑胺耐药的葡萄球菌属细菌。耐万古霉素粪肠球菌检出率为0.6~1.1%,耐万古霉素屎肠球菌检出率为0.6%~2.2%。大肠埃希菌、肺炎克雷伯菌对亚胺培南的耐药率分别为3.1%~5.7%、7.7%~20.9%。铜绿假单胞菌、鲍曼不动杆菌对亚胺培南耐药率分别为24.6%~40.1%、76.1%~80.9%,耐碳青霉烯类铜绿假单胞菌检出率呈逐年下降趋势,鲍曼不动杆菌对多黏菌素B保持了较高的敏感性,耐药率<10%。结论ICU临床分离菌对常见抗菌药物的耐药形势较严峻,尤其是耐碳青霉烯类肠杆菌目细菌在2019年后有升高趋势,需要加强细菌耐药监测,开展多学科联动。Objective To investigate the distribution and antimicrobial susceptibility of clinically isolated bacteria from intensive care units(ICUs)in hospitals of Hunan Province Antimicrobial Resistance Surveillance System from 2012 to 2021.Methods According to China Antimicrobial Resistance Surveillance System,data of clinically isolated bacterial strains and antimicrobial susceptibility testing results of bacteria from ICUs reported by all member units of Hunan Province Antimicrobial Resistance Surveillance System were analyzed with WHONET 2022 software.Results From 2012 to 2021,the total number of bacteria isolated from ICUs of member units of the Hunan Province Antimicrobial Resistance Surveillance System was 5777-22369,with Gram-negative bacteria accounting for 76.1%-78.0%annually.Staphylococcus aureus ranked first among isolated Gram-positive bacteria each year.The top 5 bacteria among Gram-negative bacteria were Acinetobacter baumannii,Klebsiella pneumoniae,Escherichia coli,Pseudomonas aeruginosa,and Stenotrophomonas maltophilia.Detection rate of methicillin-resistant Staphylococcus aureus showed a downward trend year by year.No Staphylococcus spp.were found to be resistant to vancomycin,teicoplanin and linezolid.Detection rates of vancomycin-resistant Enterococcus faecalis and vancomycin-resistant Enterococcus faecium were 0.6-1.1%and 0.6%-2.2%,respectively.Resistance rates of Escherichia coli and Klebsiella pneumoniae to imipenem were 3.1%-5.7%and 7.7%-20.9%,respectively.Resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii to imipenem were 24.6%-40.1%and 76.1%-80.9%,respectively.Detection rates of carbapenem-resistant Pseudomonas aeruginosa declined year by year.Acinetobacter baumannii maintained high susceptibility to polymyxin B,with resistance rate<10%.Conclusion Antimicrobial resistance of bacteria from ICUs is serious.Carbapenem-resistant Enterobacteriales has an upward trend after 2019.It is nece-ssary to strengthen the surveillance of bacterial resistance and carry out multidisciplinary c

关 键 词：病原菌 耐药性 重症监护病房 耐碳青霉烯类革兰阴性菌 湖南省细菌耐药监测网 

分 类 号：R181.32[医药卫生—流行病学]