全国细菌耐药监测网2021年风湿免疫科患者分离细菌耐药监测报告

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

摘要:

目的 了解2021年全国风湿免疫科患者临床分离菌株分布及对抗菌药物敏感情况。 方法 按照全国细菌耐药监测网(CARSS)方案, 将2021年所有CARSS成员单位上报的风湿免疫科患者临床分离细菌的数据纳入统计分析, 药敏试验结果依据2022年美国临床实验室标准化协会(CLSI)标准判读。 结果 2021年风湿免疫科患者分离非重复细菌28 863株, 其中革兰阴性菌占72.0%(20 784株), 革兰阳性菌占28.0%(8 079株)。居前5位的菌种分别为大肠埃希菌(9 825株, 34.0%)、肺炎克雷伯菌(3 222株, 11.2%)、金黄色葡萄球菌(3 002株, 10.4%)、铜绿假单胞菌(1 793株, 6.2%)、粪肠球菌(866株, 3.0%)。标本来源主要为尿(13 496株, 46.8%)、痰(7 597株, 26.3%)、血(2 402株, 8.3%)、脓液(1 243株, 4.3%)。耐甲氧西林金黄色葡萄球菌(MRSA)与耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率分别为22.8%、67.2%, MRCNS对利奈唑胺耐药率为0.1%, 未发现对万古霉素及替考拉宁耐药的葡萄球菌。粪肠球菌和屎肠球菌对万古霉素及利奈唑胺的耐药率为0.2%~4.0%。非脑脊液标本分离的肺炎链球菌对青霉素的耐药率为2.8%。铜绿假单胞菌和鲍曼不动杆菌对亚胺培南的耐药率分别为9.6%、20.2%。大肠埃希菌对头孢噻肟的耐药率为41.0%, 对亚胺培南的耐药率为0.9%;肺炎克雷伯菌对头孢噻肟的耐药率为18.2%, 对亚胺培南的耐药率为4.5%。流感嗜血杆菌对氨苄西林的耐药率为69.4%。 结论 风湿免疫科患者临床分离菌主要来自尿标本, 分离的细菌对常见抗菌药物的耐药率仍处于较高水平。

Abstract:

Objective To understand the distribution and antimicrobial susceptibility of clinically isolated bacteria from department of rheumatology and immunology in China in 2021. Methods According to China Antimicrobial Resistance Surveillance System (CARSS) program, information of clinically isolated bacteria from department of rheumatology and immunology reported by all CARSS member hospitals in 2021 were statistically analyzed. Antimicrobial susceptibility testing results were interpreted according to the standards from Clinical and Laboratory Stan-dards Institute (CLSI). Results In 2021, 28 863 strains of non-repetitive bacteria were isolated from patients in the department rheumatology and immunology, with Gram-negative bacteria and Gram-positive bacteria accounting for 72.0% (n=20 784) and 28.0% (n=8 079), respectively. The top five detected bacterial strains were Escherichia coli (n=9 825, 34.0%), Klebsiella pneumoniae (n=3 222, 11.2%), Staphylococcus aureus (n=3 002, 10.4%), Pseudomonas aeruginosa (n=1 793, 6.2%) and Enterococcus faecalis (n=866, 3.0%). The specimens were mainly from urine (n=13 496, 46.8%), sputum (n=7 597, 26.3%), blood (n=2 402, 8.3%) and pus (n=1 243, 4.3%). Isolation rates of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coa-ulase negative Staphylococcus (MRCNS) were 22.8% and 67.2%, respectively. The resistance rate of MRCNS to linezolid was 0.1%, and no strains were found to be resistant to vancomycin and teicoplanin. Resistance rates of Enterococcus faecalis and Enterococcus faecium to vancomycin and linezolid were 0.2%-4.0%. Resistance rate of Streptococcus pneumoniae isolated from non-cerebrospinal fluid specimens to penicillin was 2.8%. Resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii to impenem were 9.6% and 20.2%, respectively. Resis-tance rates of Escherichia coli to cefotaxime and imipenem were 41.0% and 0.9%, respectively. Resistance rates of Klebsiella pneumoniae to cefotaxime and imipenem were 18.2% and 4.5%, respectively. Resistance rate of Haemophilus influenzae to ampicillin was 69.4%. Conclusion Clinically isolated bacteria from patients in department of rheumatology and immunology mainly come from urine specimens, and antimicrobial resistance of bacteria still remains at a high level.