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湖南省细菌耐药监测网2012—2021年鲍曼不动杆菌耐药性监测报告

Antimicrobial resistance of Acinetobacter baumannii: surveillance report from Hunan Provincial Antimicrobial Resistance System, 2012-2021

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【作者】 刘思娣陈丽华付陈超李晨李艳明刘君宁兴旺石国民邬靖敏杨怀德袁红霞郑铭黄勋任南吴安华

【Author】 LIU Si-di;CHEN Li-hua;FU Chen-chao;LI Chen;LI Yan-ming;LIU Jun;NING Xing-wang;SHI Guo-min;WU Jing-min;YANG Huai-de;YUAN Hong-xia;ZHENG Ming;HUANG Xun;REN Nan;WU An-hua;Center for Healthcare-associated Infection Control, Xiangya Hospital, Central South University;Department of Laboratory Medicine, The Third Xiangya Hospital of Central South University;Hunan Provincial Antimicrobial Resistance Surveillance System Office;Department of Laboratory Medicine, Liu-yang Traditional Chinese Medicine Hospital;Department of Laboratory Medicine, Xiangya Hospital, Central South University;Department of Laboratory Medicine, Xiangtan Central Hospital;Medical Laboratory and Pathology Center, The First Hospital of Hunan University of Chinese Medicine;Department of Laboratory Medicine, Changsha Central Hospital;Department of Laboratory Medicine, The First Hospital of Changsha;Department of Laboratory Medicine, Zhangjiajie People’s Hospital;Center of Laboratory Medicine, The First People’s Hospital of Chenzhou;Hunan Provincial Healthcare-associated Infection Management Quality Control Center;National Clinical Research Center for Geriatric Disorders[Xiangya Hospital];

【通讯作者】 吴安华;

【机构】 中南大学湘雅医院医院感染控制中心中南大学湘雅三医院检验科湖南省细菌耐药监测网办公室浏阳市中医医院检验科中南大学湘雅医院检验科湘潭市中心医院检验科湖南中医药大学第一附属医院医学检验与病理中心长沙市中心医院检验科长沙市第一医院检验科张家界市人民医院检验科郴州市第一人民医院检验医学中心湖南省医院感染管理质量控制中心国家老年疾病临床医学研究中心(湘雅医院)

【摘要】 目的 了解湖南省临床分离鲍曼不动杆菌的流行病学情况。方法 按照全国细菌耐药监测网技术方案要求开展细菌耐药监测工作,参考美国临床实验室标准化协会标准,对2012—2021年湖南省多中心上报至湖南省细菌耐药监测网的不动杆菌属的临床资料进行总结与分析。结果 10年间共检出不动杆菌属169 438株,其中以鲍曼不动杆菌检出最多(82.74%)。耐碳青霉烯类鲍曼不动杆菌(CRAB)和碳青霉烯类敏感鲍曼不动杆菌(CSAB)分别检出70 923株(53.63%)和58 149株(43.97%)。CRAB与CSAB均在>70岁年龄段中检出最多,分别为34.44%、32.02%;CRAB与CSAB在ICU中检出的占比分别为34.80%、11.31%。CRAB与CSAB主要分离自痰/支气管肺泡灌洗液,其次为脓/分泌物、尿、血。10年间CRAB对常用抗菌药物的耐药率变化不大。CRAB对头孢他啶和头孢吡肟的耐药率均>84%;对氨苄西林/舒巴坦、哌拉西林/他唑巴坦的耐药率均>82%;对氨基糖苷类、喹诺酮类药物耐药率均>59%;对米诺环素、多黏菌素B的耐药率分别为15.9%~25.0%、1.3%~6.9%。CSAB对常用抗菌药物均较敏感。结论 CRAB分离率较高,对常用抗菌药物的耐药性无明显变化。

【Abstract】 Objective To understand the epidemiology of clinically isolated Acinetobacter baumannii(A. bauma-nnii) in Hunan Province. Methods Bacterial antimicrobial resistance surveillance was carried out according to the requirements of the technical program of National Antimicrobial Resistance Surveillance System. Clinical data of Acinetobacter spp. reported to Hunan Provincial Antimicrobial Resistance Surveillance System by multiple centers in Hunan Province from 2012 to 2021 were summarized and analyzed with reference to the standards of the American Clinical and Laboratory Standards Institute. Results A total of 169 438 strains of Acinetobacter spp. were detected during the 10-year period, with the detection rate of A. baumannii being the highest(82.74%). 70 923 strains(53.63%) of carbapenem-resistant A. baumannii(CRAB) and 58 149 strains(43.97%) of carbapenem-sensitive A. baumannii(CSAB) were detected respectively. Both CRAB and CSAB were detected most frequently in the age group >70 years, which were 34.44% and 32.02%, respectively. The percentage of CRAB and CSAB detected in the intensive care unit were 34.80% and 11.31%, respectively. CRAB and CSAB were mainly isolated from sputum/bronchoalveolar lavage fluid, followed by pus/secretion, urine, and blood. The resistance rates of CRAB to commonly used antimicrobial agents didn’t change much during the 10-year period. Resistance rates of CRAB to ceftazidime and cefepime were both >84%, to ampicillin/sulbactam and piperacillin/tazobactam were both >82%, to aminoglycosides and quinolones were both >59%, to minocycline and polymyxin B were 15.9%-25.0% and 1.3%-6.9%, respectively. CSAB were sensitive to commonly used antimicrobial agents. Conclusion The isolation rate of CRAB is high and there is no significant change in resistance to commonly used antimicrobial agents.

【基金】 国家重点研发计划项目(2022YFC2009801,2022YFC2009805);湖南省自然科学基金项目(NO01JJY2119);“感·动中国”医疗机构感染预防与控制科研项目(GY2023013-A)
  • 【文献出处】 中国感染控制杂志 ,Chinese Journal of Infection Control , 编辑部邮箱 ,2023年12期
  • 【分类号】R446.5
  • 【下载频次】119
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