四川省2019—2023年腹腔分离细菌的分布及耐药性分析  

Distribution and antimicrobial resistance analysis of bacteria isolated from the celiac cavity in Sichuan from 2019 to 2023

作　　者：杨传松[1] 黄湘宁 喻华 邓稀仁 YANG Chuansong;HUANG Xiangning;YU Hua;DENG Xiren(Jiangyou People's Hospital,Jiangyou,Sichuan 621700,China;Department of Laboratory Medicine,Sichuan Provincial People's Hospital,School of Medicine,University of Electronic Science and Technology of China,Chengdu,Sichuan 610072,China)

机构地区：[1]江油市人民医院,四川江油621700 [2]四川省医学科学院,四川省人民医院(电子科技大学附属医院),临床医学检验中心,四川成都610072

出　　处：《中国热带医学》2024年第12期1480-1487,共8页China Tropical Medicine

摘　　要：目的 了解四川省腹腔标本分离细菌分布及耐药情况,为选择临床抗菌药物提供参考。方法 按照四川省细菌耐药监测网技术方案,利用WHONET 5.6软件对2019—2023年四川省细菌耐药监测网成员单位上报的腹腔标本分离的细菌及药敏结果数据进行统计分析,同一患者相同细菌仅纳入第1株菌。结果 四川省2019—2023年腹腔标本共分离出22 204株非重复细菌,其中革兰阳性细菌6 023株(27.1%),革兰阴性细菌16 181株(72.9%)。居前10位依次为大肠埃希菌(45.8%,10 179/22 204)、肺炎克雷伯菌(8.1%,1 788/22 204)、屎肠球菌(6.1%,1 361/22 204)、铜绿假单胞菌(5.8%,1 289/22 204)、粪肠球菌(3.0%,676/22 204)、咽峡炎链球菌(3.0%,6 624/22 204)、金黄色葡萄球菌(2.2%,484/22 204)、表皮葡萄球菌(2.1%,473/22 204)、阴沟肠杆菌(2.0%,439/22 204)、星座链球菌(1.8%,399/22 204)。药敏结果显示,5年间大肠埃希菌对环丙沙星和左氧氟沙星的耐药率较为稳定(平均耐药率分别为42.5%和38.8%),其对三代头孢菌素的耐药率呈下降趋势,耐碳青霉烯大肠埃希菌为0.7%~0.8%。肺炎克雷伯菌对头孢曲松、头孢噻肟和头孢他啶的5年平均耐药率分别为24.2%、28.3%和17.8%,耐碳青霉烯肺炎克雷伯为8.2%~9.9%。铜绿假单胞菌对碳青霉烯类、喹诺酮类、头孢他啶、哌拉西林/他唑巴坦等抗菌药物的5年平均耐药率均未超过5.0%。屎肠球菌对环丙沙星、左氧氟沙星和氨苄西林的5年平均耐药率均在80.0%以上,而粪肠球菌对这3种抗菌药物的平均耐药率均低于24.0%。5年间,耐甲氧西林金黄色葡萄球菌的平均检出率为33.9%,耐万古霉素的屎肠球菌和耐万古霉素的粪肠球菌平均检出率分别为0.8%和0.1%。结论 四川省腹腔标本分离细菌中,阴性菌与阳性菌之比约为7∶3,以大肠埃希菌、肺炎克雷伯菌、屎肠球菌、铜绿假单胞菌和粪肠球菌为主。碳青霉烯类药物对肠杆菌目细菌和铜绿假单Objective To investigate the distribution and antimicrobial resistance of bacteria isolated from celiac specimens in Sichuan region,and to provide a reference for the selection of clinical antibiotics.Methods According to the technical protocol of the Sichuan Provincial Antimicrobial Resistance Technical Program,the data of bacteria isolated from celiac specimens and drug sensitivity results reported by members of Sichuan bacterial resistance monitoring network from 2019-2023 were statistically analyzed by WHONET 5.6 software,and only the first strain of the same bacteria from the same patient was included.Results A total of 22204 non-repetitive bacterial isolates were obtained from celiac specimens in Sichuan region from 2019 to 2023,including 6023 Gram-positive bacteria(27.1%)and 16181 Gram-negative bacteria(72.9%).The top 10 bacteria in celiac specimens were Escherichia coli 45.8%(10179/22204),Klebsiella pneumoniae 8.1%(1788/22204),Enterococcus faecium 6.1%(1361/22204),Pseudomonas aeruginosa 5.8%(1289/22204),Enterococcus faecalis 3.0%(676/22204),Streptococcus anginosus 2.8%(624/22204),Staphylococcus aureus 2.2%(484/22204),Staphylococcus epidermidis 2.1%(473/22204),Enterobacter cloacae 2.0%(439/22204),and Streptococcus constellatus 1.8%(399/22204).The results of in vitro antimicrobial susceptibility testing showed that from 2019 to 2023,the resistance rates of Escherichia coli(E.coli)to ciprofloxacin and levofloxacin remained stable(average resistance rates were 42.5%and 38.8%respectively),with a decreasing trend in the rate of their resistance to third-generation cephalosporins,and carbapenem-resistant Escherichia coli was 0.7%-0.8%.Klebsiella pneumoniae had five-year average resistance rates of 24.2%,28.3%,and 17.8%to ceftriaxone,cefotaxime,and ceftazidime,respectively,with 8.2%-9.9%carbapenem-resistant Klebsiella pneumoniae.The 5-year average resistance rate of Pseudomonas aeruginosa showed average resistance rates over five years not exceeding 5.0%to carbapenems,quinolones,ceftazidime,and piperacillin/tazob

关 键 词：腹腔感染 腹水 细菌分布 药物敏感性试验 耐药变迁/细菌耐药监测 

分 类 号：R446.5[医药卫生—诊断学]