湖南省细菌耐药监测网2012-2021年肠球菌属细菌耐药性监测报告  

Antimicrobial resistance of Enterococcus spp.:surveillance report from Hunan Province Antimicrobial Resistance Surveillance System,2012-2021

作　　者：付陈超[1,2] 陈丽华 李晨[4] 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[1,2] 吴安华 黄勋[1,2,12,13] 任南 FU Chen-chao;CHEN Li-hua;LI Chen;LI Yan-ming;LIU Jun;NING Xing-wang;SHI Guo-min;WU Jing-min;YANG Huai-de;YUAN Hong-xia;ZHENG Ming;WU An-hua;HUANG Xun;REN Nan(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,The Third Xiangya Hospital of Central South University,Changsha 410013,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,Xiangtan 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]中南大学湘雅医院医院感染控制中心,湖南长沙410008 [2]湖南省细菌耐药监测网办公室,湖南长沙410008 [3]中南大学湘雅三医院检验科,湖南长沙410013 [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954-962,共9页Chinese Journal of Infection Control

基　　金：湖南省自然科学基金项目(2021JJ40980);“感·动中国”医疗机构感染预防与控制科研项目(GY2023013-A)。

摘　　要：目的了解湖南省临床分离肠球菌属细菌对各类抗菌药物的耐药情况及变迁。方法收集湖南省细菌耐药监测网成员单位2012—2021年临床分离的肠球菌属细菌耐药性监测数据,按照统一方法进行数据清洗后应用WHONET 5.6软件进行统计分析。结果2012—2021年共纳入110652株非重复肠球菌属细菌,主要为粪肠球菌、屎肠球菌,分别占46.9%(37774株)、45.9%(36968株),其次为鸟肠球菌(2.5%,1982株)、鹑鸡肠球菌(1.8%,1428株)、铅黄肠球菌(1.5%,1185株)。肠球菌属细菌主要标本来源为尿(51.8%,57350株),其次是分泌物(9.6%,10660株)、胆汁(8.5%,9377株)。2012—2021年粪肠球菌对氨苄西林、替考拉宁和万古霉素的耐药率分别为5.5%~12.0%、1.3%~2.0%、0.6%~1.4%,屎肠球菌对氨苄西林、替考拉宁和万古霉素的耐药率分别为69.2%~85.0%、1.5%~2.8%、0.7%~2.5%。除利奈唑胺和米诺环素,屎肠球菌对检测抗菌药物的耐药率均高于粪肠球菌。粪肠球菌、屎肠球菌对万古霉素的耐药率分别从2012年的1.4%、2.1%下降至2021年的0.6%、0.7%,呈下降趋势。结论肠球菌属临床分离菌对万古霉素和替考拉宁保持较好的敏感性,粪肠球菌、屎肠球菌对万古霉素的耐药率呈下降趋势。Objective To understand the antimicrobial resistance of clinically isolated Enterococcus spp.in Hunan Province.Methods Surveillance data of Enterococcus spp.resistance from member units of Hunan Provincial Antimicrobial Resistance Surveillance System from 2012 to 2021 were collected.Data were cleaned according to a unified method,and WHONET 5.6 software was adopted for statistical analysis.Results From 2012 to 2021,a total of 110652 non-repetitive Enterococcus spp.strains were included in the analysis,mainly Enterococcus faecalis and Enterococcus faecium,accounting for 46.9%(n=37774)and 45.9%(n=36968),respectively,followed by Enterococcus avium(2.5%,n=1982),Enterococcus gallinarum(1.8%,n=1428),and Enterococcus casseliflavus(1.5%,n=1185).The main specimen sources of Enterococcus spp.was urine(51.8%,n=57350),followed by secretions(9.6%,n=10660)and bile(8.5%,n=9377).From 2012 to 2021,the resistance rates of Enteroco-ccus faecalis to ampicillin,teicoplanin,and vancomycin were 5.5%-12.0%,1.3%-2.0%,and 0.6%-1.4%,respectively.The resistance rates of Enterococcus faecium to ampicillin,teicoplanin,and vancomycin were 69.2%-85.0%,1.5%-2.8%,and 0.7%-2.5%,respectively.Except for linezolid and minocycline,the resistance rates of Enterococcus faecium to tested antimicrobial agents were all higher than those of Enterococcus faecalis.The resistance rates of Enterococcus faecalis and Enterococcus faecium to vancomycin decreased from 1.4%and 2.1%in 2012 to 0.6%and 0.7%in 2021,respectively,presenting a decreased trend.Conclusion Clinically isolated Enterococcus spp.maintain high antimicrobial susceptibility to vancomycin and teicoplanin.Resistance rates of Enterococcus faecalis and Enterococcus faecium to vancomycin present decreased trends.

关 键 词：肠球菌属 细菌耐药性监测 耐药性变迁 抗菌药物 湖南省细菌耐药监测网 

分 类 号：R181.32[医药卫生—流行病学] R378[医药卫生—公共卫生与预防医学]