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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年胆汁分离细菌耐药性监测报告

湖南省细菌耐药监测网2012-2021年胆汁分离细菌耐药性监测报告OA北大核心CSTPCD

Antimicrobial resistance of bacteria isolated from bile:surveillance report from Hunan Province Antimicrobial Resistance Surveillance System,2012-2021

中文摘要英文摘要

目的 分析湖南省细菌耐药监测网胆汁分离病原菌的分布、耐药情况及变迁.方法 收集2012-2021年湖南省细菌耐药监测网胆汁分离的病原菌数据,应用WHONET 5.6软件分析其构成及抗菌药物的敏感试验结果,使用趋势卡方检验分析抗菌药物的耐药率变迁.结果 胆汁分离的病原菌以革兰阴性菌为主,占70.84%;革兰阴性菌居前3位的分别是大肠埃希菌(30.14%)、肺炎克雷伯菌(12.15%)、铜绿假单胞菌(5.18%),革兰阳性菌居前2位的分别是屎肠球菌(10.34%)、粪肠球菌(9.52%).肺炎克雷伯菌、大肠埃希菌对亚胺培南的耐药率以2012-2013年最高,分别是15.7%、14.9%,呈逐年下降趋势(P<0.05);对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦的耐药率<24%,呈逐年上升趋势(P<0.05);对阿米卡星的敏感率>94%;对左氧氟沙星、环丙沙星的敏感率为15.5%~65.2%.铜绿假单胞菌对亚胺培南的最高耐药率(32.0%)高于美罗培南(22.9%),对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦的耐药率<19%.鲍曼不动杆菌对亚胺培南、美罗培南的最高耐药率分别为59.4%、62.6%,对头孢哌酮/舒巴坦的耐药率<48%,且耐药率呈上升趋势(P<0.05);对环丙沙星的最高耐药率(60.8%)高于左氧氟沙星(48.7%),对替加环素的耐药率<8%.屎肠球菌对青霉素、氨苄西林的耐药率均高于粪肠球菌,且耐药率呈上升趋势(P<0.05),屎肠球菌对万古霉素的耐药率高于粪肠球菌,屎肠球菌对万古霉素、利奈唑胺耐药率分别为0.5%~4.5%、0.5%~3.4%,粪肠球菌对万古霉素、利奈唑胺耐药率分别为0.2%~1.7%、0.5%~3.5%,均呈下降趋势(均P<0.05).结论 胆汁分离的病原菌主要与肠道菌群有关.粪肠球菌和屎肠球菌对万古霉素、利奈唑胺的耐药率及肠杆菌目细菌对碳青霉烯类抗生素的耐药率均呈下降趋势.

Objective To analyze the distribution and changing trend of antimicrobial resistance of bacteria isolated from bile from Hunan Province Antimicrobial Resistance Surveillance System.Methods Data of pathogens isolated from bile from Hunan Province Antimicrobial Resistance Surveillance System from 2012 to 2021 were collected.The constituent of bacteria and antimicrobial susceptibility testing results were analyzed by WHONET 5.6 software.Changes in antimicrobial resistance was analyze by trend chi-square test.Results The major pathogenic bacteria isolated from bile were Gram-negative bacteria,accounting for 70.84%.The top three isolated Gram-negative pathogens were Escherichia coli(30.14%),Klebsiella pneumoniae(12.15%),and Pseudomonas aeruginosa(5.18%),and the top two Gram-positive bacteria were Enterococcus faecium(10.34%)and Enterococcus faecalis(9.52%).The resistance rates of Klebsiella pneumoniae and Escherichia coli to imipenem were highest in 2012-2013,being 15.7%and 14.9%,respectively,presenting an downward trend(P<0.05);resistance rates to piperacillin/tazobactam and cefoperazone/sulbactam were<24%,presenting an upward trend year by year(P<0.05);the sus-ceptibility rate to amikacin was>94%,to levofloxacin and ciprofloxacin was 15.5%-65.2%.The highest resis-tance rate of Pseudomonas aeruginosa to imipenem(32.0%)was higher than that of meropenem(22.9%),resis-tance rates to piperacillin/tazobactam and cefoperazone/sulbactam were<19%.The highest resistance rates of Acinetobacter baumannii to imipenem and meropenem were 59.4%and 62.6%,respectively,resistance rate to cefo-perazone/sulbactam was<48%,presenting an upward trend(P<0.05);the highest resistance rate to ciprofloxa-cin(60.8%)was higher than levofloxacin(48.7%);resistance rate to tigecycline was<8%.The resistance rates of Enterococcus faecium to penicillin and ampicillin were both higher than those of Enterococcus faecalis,presenting an upward trend(P<0.05).Resistance rate of Enterococcus faecium to vancomycin was lower than that of Entero-coccus faecalis.The resistance rates of Enterococcus faecium to vancomycin and linezolid were 0.5%-4.5%and 0.5%-3.4%,respectively;resistance rates of Enterococcus faecalis to vancomycin and linezolid were 0.2%-1.7%and 0.5%-3.5%,respectively(both P<0.05),all presenting a downward trend(all P<0.05).Conclusion Pathogenic bacteria isolated from bile are mainly related to the intestinal flora.The resistance rates of Enterococcus faecalis and Enterococcus faecium to vancomycin and linezolid as well as resistance rate of Enterobacterales to car-bapenem antibiotics all present a downward trend.

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

浏阳市中医医院检验科,湖南浏阳 410300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中南大学湘雅医院检验科,湖南长沙 410008湘潭市中心医院检验科,湖南湘潭 411100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郴州市第一人民医院检验医学中心,湖南郴州 423000

预防医学

胆汁胆道感染病原菌耐药性湖南省细菌耐药监测网

bilebiliary tract infectionpathogenantimicrobial resistanceHunan Province Antimicrobial Re-sistance Surveillance System

《中国感染控制杂志》 2024 (008)

963-974 / 12

10.12138/j.issn.1671-9638.20245426

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