摘要
目的 了解2015年1月1日—2021年12月31 日 CHINET耐药监测网变形杆菌属、摩根菌属和普罗威登菌属细菌分布及耐药性变化.方法 按CHINET统一方案进行药物敏感性试验.按CLSIM100 31st 2021年版折点标准判断结果.结果 7年间共监测收集到肠杆菌目摩根菌科细菌32 433株,其中变形杆菌属24 160株,摩根菌属6 704株,普罗威登菌属1 569株,细菌数量呈增长趋势.标本分布前三位依次为尿液、下呼吸道和伤口分泌物.三种菌属细菌对阿米卡星、美罗培南、头孢西丁、头孢吡肟、头孢哌酮-舒巴坦和哌拉西林-他唑巴坦的耐药率均较低,其中变形杆菌属和摩根菌属对受测试抗菌药物的耐药率大多＜10％,普罗威登菌属的耐药率大多＜20％.变形杆菌属、摩根菌属和普罗威登菌属中的碳青霉烯类耐药菌株检出率分别为1.4％、1.9％和15.6％.结论 变形杆菌属、摩根菌属和普罗威登菌属临床分离菌株近年有明显增加趋势;这些菌株中碳青霉烯类耐药菌株的检出亦有明显增多.应加强关注,重视细菌耐药监测,合理用药,防止耐药细菌的发生和耐药率上升.
Abstract
Objective To understand the changing distribution and antimicrobial resistance profiles of Proteus,Morganella and Providencia in hospitals across China from January 1,2015 to December 31,2021 in the CHINET Antimicrobial Resistance Surveillance Program.Methods Antimicrobial susceptibility testing was carried out following the unified CHINET protocol.The results were interpreted in accordance with the breakpoints in the 2021 Clinical & Laboratory Standards Institute(CLSI)M100(31 st Edition).Results A total of 32 433 Enterobacterales strains were isolated during the 7-year period,including 24 160 strains of Proteus,6 704 strains of Morganella,and 1 569 strains of Providencia.The overall number of these Enterobacterales isolates increased significantly over the 7-year period.The top 3 specimen source of these strains were urine,lower respiratory tract specimens,and wound secretions.Proteus,Morganella,and Providencia isolates showed lower resistance rates to amikacin,meropenem,cefoxitin,cefepime,cefoperazone-sulbactam,and piperacillin-tazobactam.For most of the antibiotics tested,less than 10％of the Proteus and Morganella strains were resistant,while less than 20％of the Providencia strains were resistant.The prevalence of carbapenem-resistant Enterobacterales(CRE)was 1.4％in Proteus isolates,1.9％in Morganella isolates,and 15.6％in Providencia isolates.Conclusions The overall number of clinical isolates of Proteus,Morganella and Providencia increased significantly in the 7-year period from 2015 to 2021.The prevalence of CRE strains also increased.More attention should be paid to antimicrobial resistance surveillance and rational antibiotic use so as to prevent the emergence and increase of antimicrobial resistance.
基金项目
CHINET中国细菌耐药监测网基金(2020QD049)
万方数据