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首页|期刊导航|中国感染控制杂志|湖南省细菌耐药监测网2012-2021年脑脊液标本分离细菌耐药性监测报告

湖南省细菌耐药监测网2012-2021年脑脊液标本分离细菌耐药性监测报告OA北大核心CSTPCD

Antimicrobial resistance of bacteria from cerebrospinal fluid specimens:surveillance report from Hunan Province Antimicrobial Resistance Survei-llance System,2012-2021

中文摘要英文摘要

目的 了解湖南省脑脊液标本分离细菌的分布及耐药性变迁,为临床正确诊断及合理用药提供参考.方法 收集湖南省细菌耐药监测网2012-2021年各成员单位上报数据,参照全国细菌耐药监测网(CARSS)技术方案执行,应用WHONET 5.6和SPSS 20.0软件对脑脊液标本分离细菌及其药敏结果数据进行分析.结果 2012-2021年湖南省细菌耐药监测网成员单位脑脊液标本共分离细菌11 837株,前5位依次为凝固酶阴性葡萄球菌(6 397株,54.0%)、鲍曼不动杆菌(764株,6.5%)、金黄色葡萄球菌(606株,5.1%)、屎肠球菌(465株,3.9%)、大肠埃希菌(447株,3.8%);耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率为58.9%~66.3%,耐甲氧西林金黄色葡萄球菌(MRSA)的检出率为34.4%~62.1%,未发现对万古霉素、利奈唑胺和替考拉宁耐药的葡萄球菌属细菌;屎肠球菌检出率高于粪肠球菌,屎肠球菌对青霉素、氨苄西林、高浓度链霉素、左氧氟沙星的耐药率高于粪肠球菌(均P=0.001);肺炎链球菌对青霉素的耐药率为85.0%,处于较高水平;大肠埃希菌对头孢曲松的耐药率>60%,对含酶抑制剂和碳青霉烯类抗生素的耐药率较低;肺炎克雷伯菌对头孢曲松的耐药率>60%,对含酶抑制剂哌拉西林/他唑巴坦、头孢哌酮/舒巴坦的耐药率>30%,对碳青霉烯类药物(亚胺培南、美罗培南)耐药率在30%左右;鲍曼不动杆菌对大部分测试药物的耐药率>60%,对亚胺培南和美罗培南的耐药率为59.0%~79.4%,对多黏菌素B保持较低水平耐药.结论 脑脊液标本分离细菌中,凝固酶阴性葡萄球菌占比最高,病原菌整体耐药情况较为严重,细菌耐药监测对中枢神经系统感染的有效治疗非常重要.

Objective To investigate changes in the distribution and antimicrobial resistance of bacteria isolated from cerebrospinal fluid(CSF)specimens in Hunan Province,and provide reference for correct clinical diagnosis and rational antimicrobial use.Methods Data reported by member units of Hunan Province Antimicrobial Resistance Surveillance System from 2012 to 2021 were collected according to China Antimicrobial Resistance Surveillance Sys-tem(CARSS)technical scheme.Data of bacteria isolated from CSF specimens and antimicrobial susceptibility tes-ting results were analyzed with WHONET 5.6 and SPSS 20.0 software.Results A total of 11 837 bacterial strains were isolated from CSF specimens from member units of Hunan Province Antimicrobial Resistance Surveillance Sys-tem from 2012 to 2021.The top 5 strains were coagulase-negative Staphylococcus(n=6 397,54.0%),Acineto-bacter baumannii(n=764,6.5%),Staphylococcus aureus(n=606,5.1%),Enterococcus faecium(n=465,3.9%),and Escherichia coli(n=447,3.8%).The detection rates of methicillin-resistant coagulase-negative Staphyloco-ccus(MRCNS)and methicillin-resistant Staphylococcus aureus(MRSA)were 58.9%-66.3%and 34.4%-62.1%,respectively.No Staphylococcus spp.were found to be resistant to vancomycin,linezolid,and teicoplanin.The de-tection rate of Enterococcus faecium was higher than that of Enterococcus faecalis,and the resistance rates of En-terococcus f aecium to penicillin,ampicillin,high concentration streptomycin and levofloxacin were all higher than those of Enterococcus faecalis(all P=0.001).Resistance rate of Streptococcus pneumoniae to penicillin was 85.0%,at a high level.Resistance rate of Escherichia coli to ceftriaxone was>60%,while resistance rates to enzyme inhibitors and carbapenem antibiotics were low.Resistance rate of Klebsiella pneumoniae to ceftriaxone was>60%,to en-zyme inhibitors piperacillin/tazobactam and cefoperazone/sulbactam was>30%,to carbapenem imipenem and me-ropenem was about 30%.Resistance rates of Acinetobacter baumannii to most tested antimicrobial agents were>60%,to imipenem and meropenem were 59.0%-79.4%,to polymyxin B was low.Conclusion Among the bac-teria isolated from CSF specimens,coagulase-negative Staphylococcus accounts for the largest proportion,and the overall resistance of pathogenic bacteria is relatively serious.Bacterial antimicrobial resistance surveillance is very important for the effective treatment of central nerve system infection.

刘君;袁红霞;郑铭;任南;吴安华;黄勋;唐曼娟;陈丽华;付陈超;李晨;李艳明;宁兴旺;石国民;邬靖敏;杨怀德

湘潭市中心医院检验科,湖南 湘潭 411100郴州市第一人民医院检验医学中心,湖南 郴州 423000中南大学湘雅医院医院感染控制中心,湖南 长沙 410008||湖南省细菌耐药监测网办公室,湖南 长沙 410008中南大学湘雅医院医院感染控制中心,湖南 长沙 410008||湖南省细菌耐药监测网办公室,湖南 长沙 410008||湖南省医院感染管理质量控制中心,湖南长沙 410008||国家老年疾病临床医学研究中心(湘雅医院),湖南长沙 410008中南大学湘雅三医院检验科,湖南 长沙 410013浏阳市中医医院检验科,湖南浏阳 410300中南大学湘雅医院检验科,湖南 长沙 410008湖南中医药大学第一附属医院医学检验与病理中心,湖南长沙 410011长沙市中心医院检验科,湖南 长沙 410004长沙市第一医院检验科,湖南 长沙 410005张家界市人民医院检验科,湖南 张家界 427000

预防医学

脑脊液病原菌耐药性凝固酶阴性葡萄球菌鲍曼不动杆菌湖南省细菌耐药监测网

cerebrospinal fluidpathogenantimicrobial resistancecoagulase-negative StaphylococcusAcineto-bacter baumanniiHunan Province Antimicrobial Resistance Surveillance system

《中国感染控制杂志》 2024 (008)

932-941 / 10

10.12138/j.issn.1671-9638.20245427

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