摘要
目的 了解全国2020—2024年胆汁标本来源细菌的分布和耐药性情况,为临床抗菌药物合理使用提供参考。方法 全部监测数据来自2020—2024年全国细菌耐药监测网(CARSS)成员单位上报的胆汁来源细菌及抗菌药物敏感性测试结果。同一患者仅纳入第一株菌。采用Mantel-Haenszel χ^(2)检验分析菌株构成比及耐药率的变化趋势。结果 2020—2024年共纳入407 605株细菌。大肠埃希菌、肺炎克雷伯菌、屎肠球菌和粪肠球菌是前4位分离菌。趋势分析显示,肺炎克雷伯菌检出率呈上升趋势(P<0.01),屎肠球菌、粪肠球菌等呈下降趋势(均P<0.05)。药敏统计结果显示,主要革兰阴性菌对哌拉西林/他唑巴坦的耐药率普遍呈上升趋势,其中大肠埃希菌从8.7%升至14.3%。耐万古霉素屎肠球菌(VREM)检出率从0.4%升至1.7%,耐碳青霉烯类大肠埃希菌(CRECO)从2.3%升至2.6%。主要病原菌对多数第三代头孢菌素的耐药率呈下降趋势,大肠埃希菌对头孢他啶的耐药率从34.2%降至29.8%。与全国总体数据相比(以2023年为例),胆汁标本中CRECO(2.4%VS 1.7%)和耐碳青霉烯类铜绿假单胞菌(CRPAE)(25.6%VS 16.3%)检出率更高,而耐碳青霉烯类鲍曼不动杆菌(CRABA)(40.4%VS 55.5%)和肺炎克雷伯菌(CRKPN)(7.0%VS 10.8%)检出率更低。结论 2020—2024年全国胆汁标本分离细菌构成相对稳定,VREM和CRECO检出率增加是目前主要问题。应关注胆汁标本分离铜绿假单胞菌对碳青霉烯类药物的耐药情况。
Objective To understand the distribution and antimicrobial resistance of bacteria isolated from bile specimens in China in 2020-2024,and provide reference for clinical anti-infection treatment and rational antimicrobial use.MethodsAll data were collected from bacteria isolated from bile and antimicrobialsusceptibility testing results reported by member units of China Antimicrobial Resistance Surveillance System(CARSS)in 2020-2024.Only the first strain of each patient was included.Constituent ratios and changing trends of antimicrobial resistance rates of bacterial strains were analyzed by Mantel-Haenszel χ^(2) test.Results From 2020 to 2024,a total of 407605 bacterial strains were included in the analysis.The top 4 isolated bacteria were Escherichia coli,Klebsiella pneumoniae,Enterococcus faecium,and Enterococcus faecalis.Trend analysis showed that the detection rate of Klebsiella pneumoniae was on the rise(P<0.01),while those of Enterococcus faecium and Enterococcus faecalis were on the decline(both P<0.05).Antimicrobial susceptibility testing results showed that the resistance rates of major Gram-negative bacteria to piperacillin/tazobactam were generally on the rise,with that of Escherichia coli increasing from 8.7%to 14.3%.Detection rate of vancomycin-resistant Enterococcus faecium(VREM)increased from 0.4%to 1.7%,and that of carbapenem-resistant Escherichia coli(CRECO)increased from 2.3%to 2.6%.The resistance rates of major pathogenic bacteria to most third-generation cephalosporins presented decreasing trends,and the resistance rate of Escherichia coli to ceftazidime decreased from 34.2%to 29.8%.Compared with the overall data nationwide(taking 2023 as an example),the detection rates of CRECO and carbapenem-resistant Pseudomonas aeruginosa(CRPAE)from bile specimens were higher(2.4%vs 1.7%,25.6%vs 16.3%,respectively),while the detection rates of carbapenem-resistant Acinetobacter baumannii(CRABA)and Klebsiella pneumoniae(CRKPN)were lower(40.4%vs 55.5%,7.0%vs 10.8%,respectively).ConclusionThe constituent of bacteria isolated from bile specimens in China from 2020 to 2024 is relatively stable,and the increase in VREM and CRECO detection rates is currently the main problem.Attention should be paid to the resis-tance of Pseudomonas aeruginosa isolated from bile specimens to carbapenems.
作者
全国细菌耐药监测网
China Antimicrobial Resistance Surveillance System
出处
《中国感染控制杂志》
北大核心
2025年第12期1761-1771,共11页
Chinese Journal of Infection Control
关键词
胆汁
细菌
抗菌药物
耐药性
监测
全国细菌耐药监测网
bile
bacteria
antimicrobial agent
antimicrobial resistance
surveillance
China Antimicrobial Resistance Surveillance System
