湖南省细菌耐药监测网2012—2021年埃希菌属细菌耐药性监测报告

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

摘要:

目的 了解2012—2021年湖南省细菌耐药监测网成员单位临床分离埃希菌属细菌的耐药情况。方法 按照全国细菌耐药监测网技术方案,应用WHONET 5.6软件对所有湖南省细菌耐药监测网成员单位上报的埃希菌属细菌及其药敏结果数据进行分析。结果 2012—2021年共收集临床分离的埃希菌属细菌476 351株,其中大肠埃希菌475 520株,占99.8%;92.6%来自住院患者;分离自尿标本的菌株占39.3%。10年间,埃希菌属细菌占总检出病原菌的比例比较稳定,基本在20%~23%,其中2012年最低,为18.7%,2015年最高,达22.9%。10年间,埃希菌属细菌对氨苄西林的耐药率>80%,对头孢曲松的耐药率>47%,对头孢噻肟的耐药率>45%,对氨苄西林/舒巴坦的耐药率>39%;对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、呋喃妥因的耐药率均<8%;对替加环素、阿米卡星、亚胺培南、美罗培南(除2012年外)的耐药率均<5%;埃希菌属细菌对22种临床常用抗菌药物的耐药率有所波动,但总体呈逐年下降趋势。重症监护病房(ICU)患者、非ICU患者、门诊患者和急诊患者分离埃希菌属细菌对22种临床常用抗菌药物的耐药率,不同科室之间比较,差异均有统计学意义(均P<0.05)。ICU与非ICU住院患者分离埃希菌属细菌耐药率相比,除替加环素外,对其余21种抗菌药物的耐药率差异均具有统计学意义(均P<0.05)。患者分离埃希菌属细菌对临床常用抗菌药物的耐药率,不同年龄组之间比较,差异均有统计学意义(均P<0.05)。结论 不同年份、不同科室、不同标本、不同年龄患者分离的埃希菌属细菌对常用抗菌药物的耐药性有着不同的特点,应继续加强细菌耐药监测工作,以指导抗菌药物的合理选用。

Abstract:

Objective To understand the antimicrobial resistance of Escherichia spp. from member units of Hunan Province Antimicrobial Resistance Surveillance System from 2012 to 2021. Methods According to the technical scheme of China Antimicrobial Resistance Surveillance System (CARSS), data about Escherichia spp. and the antimicrobial susceptibility testing results reported from member units of Hunan Province Antimicrobial Resistance Surveillance System were analyzed by WHONET 5.6 software. Results From 2012 to 2021, a total of 476 351 clinically isolated Escherichia spp. were collected, 475 520 of which were Escherichia coli, accounting for 99.8%; 92.6% were isolated from inpatients; 39.3% were isolated from urine specimens. Over the past 10 years, the proportion of Escherichia spp. in total detected pathogens remained relatively stable, ranging 20%-23%, the lowest rate was 18.7% in 2012, and the highest rate was 22.9% in 2015. In the past 10 years, the resistance rates of Escherichia spp. to ampicillin, ceftriaxone, cefotaxime and ampicillin/sulbactam were >80%, >47%, >45%, and >39%, respectively; resistance rates to piperacillin/tazobactam, cefoperazone/sulbactam, and nitrofurantoin were all <8%, to tigecycline, amikacin, imipenem, and meropenem (except in 2012) were all <5%. Resistance of Escherichia spp. to 22 commonly clinically used antimicrobial agents fluctuated, but overall trend decreased year by year. The resistance rates of Escherichia spp. from patients in the intensive care unit (ICU), non-ICU patients, outpatients, and emergency patients to 22 clinically commonly used antimicrobial agents were compared among different departments, and the differences were statistically significant (all P<0.05). The resistance rates of Escherichia spp. isolated from ICU and non-ICU patients were compared, and except for tigecycline, the resistance rates to the other 21 antimicrobial agents were statistically different (all P<0.05). The resistance rates of Escherichia spp. isolated from patients to commonly clinically used antimicrobial agents were statistically different among patients of different age groups (all P<0.05). Conclusion Escherichia spp. isolated from patients in different years, departments, specimens, and ages have different resistance to commonly used antimicrobial agents. It is necessary to continue to strengthen the surveillance on bacterial resistance, so as to guide the rational choice of antimicrobial agents.