【摘要】 目的 了解中国儿童患者葡萄球菌属、肠球菌属细菌的临床分离情况和耐药性变迁。方法 回顾性分析2015—2021年全国52所CHINET 细菌耐药监测网中年龄<18岁以下儿童群体中葡萄球菌属及肠球菌属细菌的分离情况及耐药监测结果，抗菌药物敏感性试验判断参考美国临床和实验室标准化协会(CLSI) 2021 年标准。结果 7年间共监测到葡萄球菌属细菌46 334株，其中金黄色葡萄球菌32 537株，凝固酶阴性葡萄球菌13 797株；肠球菌属细菌16 287株，其中屎肠球菌8 434株，粪肠球菌6 525株。金黄色葡萄球菌主要分离于下呼吸道(43.4±6.7)%、伤口分泌物(27.8±4.3)%及血液(6.2±1.2)%。(58.6±5.1)%的粪肠球菌和(62.9±2.0)%屎肠球菌分离于尿液。此外，普通内科病房是所有葡萄球菌属和肠球菌属最主要分离病房。甲氧西林耐药的金黄色葡萄球菌(MRSA)和凝固酶阴性葡萄球菌(MRCNS)的检出率为29.5%和79.8%。其中新生儿(0～28天)和婴儿组(>28天～1岁)MRSA的检出率最高，分别为31.7%和30.9%。MRSA分离株对庆大霉素、利福平、左氧氟沙星、甲氧苄啶-磺胺甲噁唑仍保持低耐药率；未监测到对万古霉素和利奈唑胺耐药葡萄球菌。屎肠球菌及粪肠球菌对万古霉素和利奈唑胺有1%左右的耐药率；近2年粪肠球菌对利奈唑胺耐药率>1.0%。结论 2015—2021年间，金黄色葡萄球菌、屎肠球菌、粪肠球菌仍是儿童患者临床分离菌株中最常见的革兰阳性菌。MRSA检出率未见升高态势，其对抗菌药物的耐药率呈现下降。屎肠球菌、粪肠球菌对抗菌药物的耐药率变化不明显。持续开展细菌耐药性监测对于儿童感染性疾病的防控及临床治疗具有重要指导意义。更多还原

【Abstract】 Objective To investigate the changing distribution and antibiotic resistance (AMR) profiles of Staphylococcus spp.and Enterococcus spp.isolated from children in China.Methods A retrospective analysis was conducted on the Staphylococcus spp.and Enterococcus spp.isolated from children under 18 years in 52 hospitals participating in the CHINET program from January 2015 to December 2021.The results of antimicrobial susceptibility test (AST) were interpreted according to the Clinical and Laboratory Standards Institute (CLSI) breakpoints (2021 edition).Results In the 7-year period,46 334 strains of Staphylococcus were isolated from children,including 32 537 strains of S.aureus and 13 797 strains of coagulase-negative Staphylococcus.Meanwhile,16 287 strains of Enterococcus were isolated,including E.faecium (8 434 strains) and E. faecalis (6 525 strains).S.aureus strains were mainly isolated from lower respiratory tract specimens (43.4%±6.7%),wound secretions (27.8%±4.3%) and blood (6.2%±1.2%).Most of the E. faecalis strains (58.6%±5.1%) and E.faecium strains (62.9%±2.0%) were isolated from urine.Both Staphylococcus and Enterococcus strains were most frequently isolated from internal medicine wards.The prevalence of methicillin-resistant S.aureus (MRSA) and coagulase-negative Staphylococcus (MRCNS) was 29.5% and 79.8%,respectively.The prevalence of MRSA was relatively high in neonates (0-28 days) and infants (>28 days to 1 year old),31.7% and 30.9%,respectively.MRSA strains showed low and decreasing resistance rate to gentamicin,rifampicin,levofloxacin,and trimethoprim-sulfamethoxazole from 2015 to 2021.None of vancomycin-resistant or linezolid-resistant Staphylococcus was detected.Vancomycin-resistant or linezolid-resistant Enterococcus strains were rarely detected (0 to 1.0%).Moreover,more than 1.0% of the E. faecalis isolates were resistant to linezolid in recent two years.Conclusions From 2015 to 2021,S.aureus,E. faecalis,and E. faecalis were still the most common gram-positive bacteria isolated from children.The prevalence of MRSA did not change significantly from 2015 to 2022.MRSA strains showed a trend of decreasing antimicrobial resistance.The antimicrobial resistance rates of E. faecalis and E. faecalis did not change significantly during the 7-year period.Ongoing AMR surveillance in the Staphylococcus and Enterococcus isolates from children is important for prevention,control,and treatment of the infections caused by Staphylococcus and Enterococcus in pediatric patients.更多还原