摘要
目的了解2022—2024年中国中医医院来源细菌的分布和耐药情况,为临床抗菌药物合理使用提供参考。方法监测数据来源于2022—2024年全国细菌耐药监测网(CARSS)成员单位上报的中医医院细菌及抗菌药物敏感性测试结果。同一患者相同细菌仅纳入首株。应用WHONET 5.6软件进行统计分析。结果2022—2024年共纳入1491099株细菌。大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌和金黄色葡萄球菌为前4位分离菌。分析显示,肺炎克雷伯菌和金黄色葡萄球菌检出率呈上升趋势,大肠埃希菌和铜绿假单胞菌等呈下降趋势。标本类型前4位的分别为痰、尿、脓液、血。药敏统计结果显示,革兰阴性菌对哌拉西林/他唑巴坦的耐药率普遍上升,其中铜绿假单胞菌从12.0%升至16.5%。主要病原菌对多数第三代头孢菌素的耐药率呈下降趋势,肺炎克雷伯菌对头孢噻肟的耐药率从30.3%降至27.0%。万古霉素耐药屎肠球菌(VREM)检出率从2.8%升至4.3%,耐碳青霉烯类大肠埃希菌(CRECO)从1.9%升至2.1%。与全国总体数据(以2023年为例)相比,中医医院标本中CRECO(2.1%VS 1.7%)和耐碳青霉烯类铜绿假单胞菌(CRPAE,19.5%VS 16.3%)检出率更高,而耐碳青霉烯类鲍曼不动杆菌(CRABA,49.4%VS 55.5%)和头孢噻肟或头孢曲松耐药大肠埃希菌(CTX/CRO-R ECO)(46.4%VS 48.9%)检出率更低。结论中国中医医院分离细菌构成相对稳定,需重视VREM和CRECO等检出率增加的问题,应进一步加强抗菌药物管理。
Objective To understand the distribution and antimicrobial resistance of bacteria from traditional Chinese medicine hospitals in China from 2022 to 2024,and provide reference for the rational use of antimicrobial agents in clinical practice.Methods Surveillance data of bacteria and antimicrobial susceptibility testing results were collected from traditional Chinese medicine hospitals as member units of China Antimicrobial Resistance Surveillance System(CARSS)from 2022 to 2024.Only the first strain of the same bacteria from the same patient was included in the analysis.Statistical analysis was conducted using WHONET 5,6 software.Results From 2022 to 2024,a total of 1491099 bacterial strains were included in the analysis.The top 4 isolated bacteria were Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa,and Staphylococcus aureus.Analysis showed that the detection rates of Klebsiella pneumoniae and Staphylococcus aureus were on the rise,while those of Escherichia coli and Pseudomonas aeruginosa were on the decline.The top 4 types of specimens were sputum,urine,pus+and blood.Antimicrobial susceptibility testing results showed that the resistance rate of Gram-negative bacteria to piperacillin/tazobactam has generally increased,with Pseudomonas aeruginosa increasing from 12.0%to 16.5%.The resistance rates of the main pathogenic bacteria to most third-generation cephalosporins presented decreased trends.The resistance rate of Klebsiella pneumoniae to cefotaxime has decreased from 30.3%to 27.0%.The detection rate of vancomycin-resistant Enterococcus faecium(VREM)increased from 2.8%to 4.3%,and the detection rate of carbapenem-resistant Escherichia coli(CRECO)increased from 1.9%to 2.1%.Compared with the overall data nationwide(taking 2023 as an example),the detection rates of CRECO(2.1%vs 1.7%)and carbapenem-resistant Pseudomonas aeruginosa(CRPAE,19.5%vs 16.3%)from specimens from traditional Chinese medicine hospitals were higher,while the detection rates of carbapenem-resistant Acinetobacter baumannii(CRABA,49.4%vs 55.5%)and cefotaxime-or ceftriaxone-resistant Escherichia coli(CTX/CRO-R ECO)(46.4%vs 48.9%)were lower.Conclusion The constituent of bacteria isolated from traditional Chinese medicine hospitals in China is relatively stable.Attentions should be paid to the increased detection rates of VREMand CRECO,and the management of antimicrobial agents should be streng thened further.
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1794-1802,共9页
Chinese Journal of Infection Control
关键词
多重耐药菌
细菌耐药监测
抗菌药物
细菌
药物敏感性试验
中医医院
全国细菌耐药监测网
multidrug-resistant organism
antimicrobial resistance surveillance of bacteria
antimicrobial agent
bacteria
antimicrobial susceptibility testing
traditional Chinese medicine hospital
China Antimicrobial Resistance Surveillance System
