2017-2021年新疆维吾尔自治区耐碳青霉烯类肠杆菌目细菌的分布特征及耐药性监测  

Distribution and antimicrobial resistance profiles of carbapenem-resistant Enterobacterales in Xinjiang Uygur Autonomous Region from 2017 to 2021

作　　者：姜艳[1] 陈娜 季萍[1] 李辉[1] JIANG Yan;CHEN Na;JI Ping;LI Hui(Center for Laboratory Medicine,the First Affiliated Hospital of Xinjiang Medical University,Wulumuqi 830000,China)

机构地区：[1]新疆医科大学第一附属医院医学检验中心,乌鲁木齐830000

出　　处：《中国感染与化疗杂志》2025年第2期174-180,共7页Chinese Journal of Infection and Chemotherapy

摘　　要：目的了解2017-2021年新疆维吾尔自治区(新疆地区)碳青霉烯类耐药肠杆菌目细菌(CRE)检出情况及耐药性变迁。方法按照全国细菌耐药监测网统一方案纳入并分析新疆地区2017-2021年参加细菌耐药监测网成员单位CRE相关数据,采用WHONET 5.6软件对数据进行统计分析。结果5年间新疆地区共检出CRE 5071株,历年检出率分别为2.8%、3.2%、2.9%、3.1%和3.2%,其中北疆检出率较高(3.3%),东疆最低(0),三级医院CRE的检出率高于二级医院。5071株CRE菌株中前三位的菌株是碳青霉烯类耐药的肺炎克雷伯菌、大肠埃希菌和阴沟肠杆菌;科室分布主要在重症监护病房(ICU)(34.6%)、呼吸重症监护病房(RICU)(8.1%)、神经外科(7.5%)和呼吸内科(5.2%),不同年龄、不同性别间菌种分布存在差异,临床常用抗菌药物对碳青霉烯类敏感肠杆菌目细菌的体外抗菌活性高于CRE,除庆大霉素、甲氧苄啶-磺胺甲噁唑外,分离自儿童的碳青霉烯类敏感和耐药的肠杆菌目细菌对临床常用抗菌药物的耐药率低于成人分离株。结论新疆地区CRE临床分离株耐药形势严峻,需继续加强细菌耐药监测,开展多学科联动以遏制其播散流行。Objective To investigate the changing prevalence and antimicrobial resistance profiles of carbapenem-resistant Enterobacterales(CRE)in Xinjiang Uygur Autonomous Region from 2017 to 2021.Methods Relevant CRE data in hospitals across Xinjiang from 2017 to 2021 were summarized according to the unified protocol of the National Antimicrobial Resistance Surveillance Network.The data were statistically analyzed by WHONET 5.6 software.Results A total of 5071 CRE strains were identified from 165786 strains of Enterobacterales in Xinjiang in the five-year period.The prevalence of CRE was 2.8%in 2017,3.2%in 2018,2.9%in 2019,3.1%in 2020,and 3.2%in 2021.The highest prevalence(3.3%)was in northern Xinjiang and the lowest prevalence(0)was in eastern Xinjiang.The prevalence of CRE in tertiary hospitals was higher than that in secondary hospitals.The top three species among the 5071 CRE strains were carbapenem-resistant Klebsiella pneumoniae,carbapenem-resistant Escherichia coli,and carbapenem-resistant Enterobacter cloacae.The CRE strains were mainly isolated from the patients in ICU(34.6%),respiratory ICU(8.1%),neurosurgery(7.5%),and respiratory medicine(5.2%).The distribution of CRE species varied with patient age and gender.The carbapenem-susceptible Enterobacterales and CRE strains isolated from children were less resistant to the commonly used antibiotics in clinical practice than the corresponding strains isolated from adult patients.Conclusions The prevalent CRE strains from patients in Xinjiang are still serious.It is necessary to strengthen the surveillance of bacterial resistance and carry out multidisciplinary linkage to curb the spread and outbreak of CRE.

关 键 词：细菌耐药监测 耐碳青霉烯类肠杆菌目细菌 耐碳青霉烯类肺炎克雷伯菌 耐碳青霉烯类大肠埃希菌 耐碳青霉烯类阴沟肠杆菌 

分 类 号：R378[医药卫生—病原生物学]