【摘要】 目的 了解国内主要地区临床分离沙雷菌属细菌对常用抗菌药物的耐药率及变迁。方法 由CHINET中国细菌耐药性监测网参与成员单位将临床分离菌采用纸片扩散法或自动化商业药敏测试系统按CHINET统一技术方案进行仪器法药物敏感性试验。结果 2015年1月—2021年12月从我国不同地区53所医院临床分离到的沙雷菌属17 226株。分离的菌株数从2015年959株上升到2021年3 588株，自门急诊患者中分离到的沙雷菌占7.3%(1 265/17 226)，住院患者菌株占92.7%(15 961/17 226)。17 226株沙雷菌属细菌中呼吸道标本占比最高(57.5%±2.5%)，其次为血液标本(11.5%±1.5%)。7年连续监测发现除氨苄西林、头孢唑林及呋喃妥因外其他抗菌药物细菌耐药率均有所下降，亚胺培南和美罗培南虽然耐药率数值有所反复，但仍从8.1%和8.3%降到5.3%和5.2%。成年患者来源的菌株对头孢哌酮-舒巴坦、头孢他啶-阿维巴坦、头孢噻肟、亚胺培南、呋喃妥因和替加环素耐药率三级医院高于二级医院，其他抗菌药物耐药率均低于二级医院。分离自儿童患者的沙雷菌对头孢哌酮-舒巴坦、哌拉西林-他唑巴坦、阿米卡星、甲氧苄啶-磺胺甲唑和替加环素的耐药率低于5%。分离自ICU的菌株对抗菌药物的耐药率普遍高于其他监测科室。7年监测碳青霉烯类耐药肠杆菌目菌株检出率为8.2%。结论 7年中沙雷菌属细菌耐药率呈缓慢下降趋势，继续加强标本及时送检及合理使用抗菌药物对细菌耐药率下降起着尤为重要的作用，落实医院感染控制可有效降低耐药细菌的发生。更多还原

【Abstract】 Objective To understand the changing resistance rate of Serratia isolates collected across China to commonly used antibiotics. Methods The participating member hospitals of China Antimicrobial Surveillance Network(CHINET) used disk diffusion method or automated susceptibility testing system to conduct antimicrobial susceptibility testing of Serratia isolates according to the unified technical protocol. Results A total of 17 226 strains of Serratia were collected from 53 hospitals across China from January 2015 to December 2021. The number of Serratia isolates increased from 959 in 2015 to 3 588 in 2021. Overall,about 7.3%(1 265/17 226) of the strains were isolated from outpatients and emergency patients and 92.7%(15 961/17 226) of the strains were isolated from inpatients. About half of the strains(57.5% ± 2.5%) were isolated from respiratory samples, followed by blood samples(11.5% ± 1.5%). Over the 7-year period, the resistance rates of Serratia isolates to the antimicrobial agents tested decreased to some extent except ampicillin, cefazolin and nitrofurantoin. The resistance rates to imipenem and meropenem decreased from 8.1% and 8.3% to 5.3% and 5.2%, respectively. The strains isolated from adults in tertiary hospitals showed higher resistance rates to cefoperazone-sulbactam, ceftazidime-avibactam, cefotaxime, imipenem, nitrofurantoin and tigecycline compared to the strains isolated from secondary hospitals. The strains isolated from tertiary hospitals showed lower resistance rates to other antibacterial agents than the strains isolated from secondary hospitals. The Serratia isolates from children showed resistance rates lower than 5% to cefoperazone-sulbactam, piperacillin-tazobactam, amikacin, trimethoprim-sulfamethoxazole and tigecycline. The Serratia isolates from ICUs generally had higher resistance rates than the isolates from other clinical settings. The overall prevalence of carbapenem-resistant Enterobacterales(CRE) was 8.2% in the 7-year period. Conclusions The Serratia isolates showed slightly decreasing resistance rates to most of the antimicrobial agents tested over the 7-year period from 2015 to 2021. It is particularly important to strengthen antimicrobial resistance surveillance and rational use of antibiotics in order to reduce the resistance rates.Proper implementation of hospital infection control measures can effectively reduce the emergence of drug-resistant bacteria.更多还原