全国细菌耐药监测网2021年肿瘤科患者分离细菌耐药监测报告

Antimicrobial resistance of bacteria isolated from patients in department of oncology: surveillance report from China Antimicrobial Resistance Surveillance System, 2021

摘要:

目的 了解肿瘤科患者感染常见病原菌的分布及耐药性, 为临床合理选择抗菌药物提供科学依据。 方法 选取2020年10月—2021年9月全国细菌耐药监测网的监测数据, 应用WHONET 5.6软件对纳入统计的102 570株细菌数据进行分析。 结果 肿瘤科患者主要标本来源为痰(38.3%)、尿(18.5%)和血(12.2%)。临床分离菌株中, 革兰阳性菌居前3位的分别是金黄色葡萄球菌(35.9%)、粪肠球菌(13.6%)和屎肠球菌(10.6%)。耐甲氧西林金黄色葡萄球菌(MRSA)检出率为25.0%。粪肠球菌和屎肠球菌对万古霉素耐药率分别为0.1%、0.8%。革兰阴性菌居前3位的分别是大肠埃希菌(30.6%)、肺炎克雷伯菌(21.7%)和铜绿假单胞菌(12.0%)。大肠埃希菌对头孢噻肟、头孢曲松耐药率超过50%, 对碳青霉烯类耐药率约为1%。肺炎克雷伯菌对碳青霉烯类耐药率约为3%。耐碳青霉烯类铜绿假单胞菌检出率约为6%。 结论 肿瘤患者临床分离细菌主要以革兰阴性菌为主, 但耐药率不高。临床应继续加强抗菌药物合理使用, 做好细菌耐药监测工作。

Abstract:

Objective To investigate the distribution and antimicrobial resistance of pathogenic bacteria isolated from infected patients in department of oncology, and provide scientific basis for rational selection of antimicrobial agents in clinical practice. Methods Antimicrobial resistance data of 102 570 bacterial strains from department of on- cology reported by China Antimicrobial Resistance Surveillance System (CARSS) from October 2020 to September 2021 were analyzed with WHONET 5.6. Results The main sources of specimens of patients from department of oncology were sputum (38.3%), urine (18.5%), and blood (12.2%). Among clinically isolated bacteria, the top 3 Gram-positive bacteria were Staphylococcus aureus (35.9%), Enterococcus faecalis (13.6%), and Enterococcus faecium (10.6%). Isolation rate of methicillin-resistant Staphylococcus aureus (MRSA) was 25.0%. Resistance rates of Enterococcus faecalis and Enterococcus faecium to vancomycin were 0.1% and 0.8%, respectively. The top 3 Gram-negative bacteria were Escherichia coli (30.6%), Klebsiella pneumoniae (21.7%), and Pseudomonas aeruginosa (12.0%). Resistance rate of Escherichia coli to third-generation cephalosporins cefotaxime and ceftria-xone exceeded 50%, resistance rate to carbapenems was about 1%. Resistance rate of Klebsiella pneumoniae to carba-penems was about 3%. The isolation rate of carbapenem-resistant Pseudomonas aeruginosa was about 6%. Conclusion Gram-negative bacteria are the major clinically isolated bacteria from tumor patients, resistance rate of which is not high. Rational use of antimicrobial agents should be strengthened in clinical practice, and monitoring on bacterial resistance should be conducted well.