摘要
目的 了解 2015-2021 年CHINET中国细菌耐药监测网成员单位临床分离枸橼酸杆菌属的分布特点及其耐药性变迁情况.方法 按照 CHINET 统一技术方案,采用纸片扩散法或自动化仪器法进行药敏试验,按 CLSI 2021 年版标准判读药敏结果,采用 WHONET 5.6 软件进行数据分析.结果 2015-2021年共分离出枸橼酸杆菌属细菌12 855株,其中弗劳地枸橼酸杆菌 7 925 株,占 61.65%,克氏枸橼酸杆菌 2 589 株,占 20.14%.7 年间枸橼酸杆菌属细菌在全部细菌和肠杆菌目细菌中的检出占比呈上升趋势,2015 年分别占 0.76%和 1.76%,2021 年分别占 0.94%和 2.09%.科室来源主要为外科病房(32.33%±5.42%),其次为内科病房(26.92%±3.70%).标本来源主要分离自尿液(34.15%±1.01%)及呼吸道(22.23%±2.09%).2015-2021 年枸橼酸杆菌属对氨苄西林耐药率有所升高,对其他抗菌药物耐药率均呈下降趋势;对亚胺培南和美罗培南耐药率分别从 9.5%和 8.3%下降到 5.5%和 5.8%,对环丙沙星、替加环素以及多黏菌素耐药率波动幅度较小;在所有枸橼酸杆菌属细菌中,弗劳地枸橼酸杆菌对各类抗菌药物耐药率最高.结论 枸橼酸杆菌对多数临床常用抗菌药物耐药率呈下降趋势,应继续加强抗菌药物合理应用管理及细菌耐药监测,以遏制细菌耐药率回升.
Abstract
Objective To investigate the distribution and changing pattern of antibiotic resistance in Citrobacter strains isolated from the hospitals participating in CHINET Antimicrobial Resistance Surveillance Program during the period from 2015 through 2021.Methods Antimicrobial susceptibility testing was carried out according to a unified protocol of CHINET program using Kirby-Bauer method or automated systems.Results were interpreted according to the Clinical&Laboratory Standards Institute(CLSI)breakpoints in 2021.The data were analyzed with WHONET 5.6 software.Results A total of 12 855 strains of Citrobacter spp were isolated from 2015 to 2021,including 7 925 strains of Citrobacter freundii(61.65%)and 2 589 strains of Citrobacter koseri(20.14%).The proportion of Citrobacter in all clinical isolates and in Enterobacterales increased from 0.76%and 1.76%in 2015 to 0.94%and 2.09%in 2021,respectively.The Citrobacter strains were mainly isolated from surgical wards(32.33%±5.42%)and internal medicine wards(26.92%±3.70%)and predominantly isolated from urine(34.15%±1.01%)and sputum(22.23%±2.09%)samples.During the period from 2015 to 2021,Citrobacter isolates showed decreasing resistance rates to all the antimicrobial agents tested except ampicillin,the resistance rate to which increased.The prevalence of imipenem-resistant and meropenem-resistant Citrobacter strains decreased from 9.5%and 8.3%in 2015 to 5.5%and 5.8%in 2021.No significant change was observed for the resistance rates to ciprofloxacin,tigecycline and polymyxin.Citrobacter freundii isolates demonstrated the highest resistance rate to the antimicrobial agents tested compared to other Citrobacter species.Conclusions Citrobacter spp isolates showed decreasing resistance rates to most of the commonly used antibiotics from 2015 to 2021.It is necessary to strengthen ongoing stewardship and rational use of antimicrobial agents and bacterial resistance surveillance to prevent the rise of antimicrobial resistance.
基金项目
CHINET中国细菌耐药监测网基金(2020QD049)
甘肃省卫生健康行业科研项目(GSWSKY2021-019)
NETL
NSTL
万方数据