中国临床药理学杂志2025，Vol.41Issue(18)：2567-2587,21.DOI:10.13699/j.cnki.1001-6821.2025.18.002
中国细菌耐药监测研究(CARST)2023-2024年革兰氏阴性菌监测报告
Antimicrobial susceptibility of gram-negative organisms:Results from China antimicrobial resistance surveillance trial(CARST)program,2023-2024
李耘 1俞云松 2蔡璇 3刘文恩 4刘德华 5费樱 6刘家云 7裴凤艳 8孟灵 9季萍 10汤进 11郑波 1朱镭 12潘开素 13徐和平 14张健东 15薛峰 1王珊 1刘姚姚 1钟巍 1崔兰卿 1张秀珍 16胡云建 16金玉芬 17潘世扬 18郭玮 19赵锋20
作者信息
- 1. 北京大学第一医院临床药理研究所,北京 100034
- 2. 浙江大学医学院附属邵逸夫医院感染科,浙江 杭州 310003
- 3. 武汉大学人民医院检验科,湖北武汉 430060
- 4. 中南大学湘雅医院检验科,湖南长沙 410008
- 5. 昆明市第一人民医院检验科,云南 昆明 650011
- 6. 贵州医科大学附属医院检验科,贵州贵阳 550001
- 7. 空军军医大学西京医院检验科,陕西西安 710032
- 8. 济南市中心医院检验科,山东济南 250013
- 9. 兰州大学第二医院检验科,甘肃兰州 730030
- 10. 新疆医科大学第一医院检验科,新疆维吾尔自治区乌鲁木齐 830054
- 11. 汉中市中心医院检验科,陕西汉中 723000
- 12. 山西省儿童医院检验科,山西太原 300012
- 13. 广西医科大学第一附属医院皮肤科,广西壮族自治区南宁 530021
- 14. 厦门大学附属第一医院检验科,福建厦门 361003
- 15. 天津市第三中心医院检验科,天津 300170
- 16. 北京医院检验科,北京 100730
- 17. 吉林大学第二医院检验科,吉林长春 130041
- 18. 南京医科大学第一附属医院检验科,江苏南京 210029
- 19. 复旦大学中山医院检验科,上海 200023
- 20. 浙江大学医学院附属邵逸夫医院检验科,浙江 杭州 310003
- 折叠
摘要
Abstract
Objective To investigate the gram-negative bacteria resistance in nationwide tietiary hospitals,understand the trend of antimicrobial resistance and provide scientific data for the rational use of antibiotis.Method All the clinical isolates were collected from 18 hospitals and the minimal inhibitory concentrations(MICs)were tested using agar/broth dilution method recommended by Clinical and Laboratory Standards Institute(CLSI)in central laboratory.Results A total of 4 681 pathogenic isolates from 18 tertiary hospitals in 18 cities nationwide over the period from July 2023 to June 2024 were studied.Based on the MIC results,Escherichia coli and Klebsiella pneumoniae showed extended spectrum β-lactamase(ESBLs)phenotype rates of 50.7％and 20.7％,respectively,ESBLs phenotype rate keeps going down.The ratio of carbapenems resistance Klebsiella pneumoniae(CRKP)was 35.4％,increased by 10 percentage points compared with the previous monitoring.Carbapenems,β-lactam combination agents and amikacin displayed desirable antibacterial activity against Enterobacterales,susceptibal rates were above 78％.In addition,tigacycline,eravacycline,colistin maintained good antibacterial activity against their respective effective bacteria/species,and the bacterial sensitivity rates by more than 90％.Resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannnii to imipennnem were 32.7％and 70.7％and multidrug-resistant(MDR)detection rates were 43.3％and 78.3％,Extensively drug-resistant(MDR)were 17.0％and 71.0％,respectively.Comparison of drug resistance rates from different wards,ages and specimen sources indicated that the proportion of resistance in Klebsiella pneumoniae,Pseudomonas aeruginosa and Acinetobacter baumannii isolated from intensive care unit(ICU)were significantly higher than non-ICU.Resistance rates of Pseudomonas aeruginosa isolated from children were significantly lower than that in adults and the elderly.However,the detection rate of ESBLs phenotypes in Klebsiella pneumoniae in children was 57.1％,significantly higher than that in adults(16.3％)and the elderly(19.8％).In addition,the strains of Haemophilus influenzae from children had a higher resistance rates to cephalosporins,macrolides,and clindamycin than those in adults and the elderly.Comparisons of different specimen sources showed that the resistance rates of Acinetobacter baumannii isolated from urine specimens were significantly lower than that from other sources.No statistical differences were observed among other major bacterial species in different specimens,while the resistance rates of Pseudomonas aeruginosa in sputum specimens and Escherichia coli in source drainage fluids were slightly higher than those from other sources.Conclusion The detection rates of ESBLs phenotypes in Escherichia coli and Klebsiella pneumoniae have continued to decline,while the detection rates of CRKP and ampicillin-resistant Haemophilus influenzae have shown an upward trend,which requires continuous attention.关键词
细菌耐药监测/革兰氏阴性菌/最低抑菌浓度/敏感率/耐药率/最低抑菌浓度分布Key words
antimicrobial resistance surveillance/gram-negative bacteria/minimum inhibitory concentration/susceptibility/resistance/minimal inhibitory concentration distribution分类
医药卫生引用本文复制引用
李耘,俞云松,蔡璇,刘文恩,刘德华,费樱,刘家云,裴凤艳,孟灵,季萍,汤进,郑波,朱镭,潘开素,徐和平,张健东,薛峰,王珊,刘姚姚,钟巍,崔兰卿,张秀珍,胡云建,金玉芬,潘世扬,郭玮,赵锋..中国细菌耐药监测研究(CARST)2023-2024年革兰氏阴性菌监测报告[J].中国临床药理学杂志,2025,41(18):2567-2587,21.
