Resistance reported from China antimicrobial surveillance network (CHINET) in 2018
Resistance reported from China antimicrobial surveillance network (CHINET) in 2018
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DOI：
10.1007/s10096-019-03673-1
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发表时间：
2019-12-01
影响因子：
4.5
通讯作者：
Yue, Chunlei
中科院分区：
文献类型：
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作者：
Hu, Fupin;Guo, Yan;Yue, Chunlei
本研究的目的是调查我国主要医院分离的细菌对抗菌药物的敏感性。共有44家教学医院参与。通过Kirby-Bauer自动化系统进行抗菌药物敏感性试验，并使用CLSI标准解释结果。2018年共分离出244,843株细菌，其中革兰阴性杆菌占71.8%，革兰阳性球菌占28.2%。下呼吸道、尿液、血液和脑脊液中的分离株分别占39.7%、18.8%、14.8%和1.3%。其中，5个主要物种最常分离（65.5%，63%，52.3%和30.3%）。MRSA对大多数抗菌药物的耐药率明显高于MSSA菌株，但尿标本中MRSA对复方新诺明的耐药率低于MSSA菌株。大肠埃希菌对碳青霉烯类抗生素仍高度敏感，耐药率低于5%。肺炎克雷伯菌对碳青霉烯类抗生素的耐药率从18.6%显著增加到64.1%，尤其是从脑脊液培养的肺炎克雷伯菌。血、尿、下呼吸道铜绿假单胞菌对碳青霉烯类抗生素的耐药率接近30%，而脑脊液中的耐药率约为60%。约80%的鲍曼不动杆菌对亚胺培南和美罗培南耐药。脑脊液中5种主要临床分离株对常用抗生素的耐药性（特别是耐碳青霉烯类肺炎克雷伯菌）目前呈上升趋势。重视医院感染的控制，加强抗菌药物的临床应用管理，是医院感染管理的重要内容。
The aim of this study is to investigate the antimicrobial susceptibility of strains isolated from the major hospitals in China. A total of 44 teaching hospitals were involved. Antimicrobial susceptibility testing was conducted by Kirby-Bauer automated systems, and results were interpreted using CLSI criteria. Totally 244,843 strains were isolated in 2018, of which gram-negative bacilli and gram-positive cocci were accounting for 71.8% and 28.2%, respectively. 39.7% of isolates were cultured from lower respiratory tract, 18.8% from urine, 14.8% from blood, 1.3% from cerebrospinal fluid, respectively. Of those, the five major species were most often isolated (65.5%, 63%, 52.3%, and 30.3%). The resistance rate of MRSA to most antimicrobial agents was significantly higher than that of MSSA strains, except for to trimethoprim-sulfamethoxazole in urine specimen. E.coli was still highly susceptible to carbapenem antibiotics, and the resistance rate was less than 5%. Carbapenem resistance among Klebsiella pneumoniae, especially cultured from cerebrospinal fluid, increased significance from 18.6 to 64.1%. The resistance rates of Pseudomonas aeruginosa to carbapenems were nearly 30% in the blood, in urine, and in the lower respiratory tract, but about 60% of that in cerebrospinal fluid. About 80% of Acinetobacter baumannii strains was resistant to imipenem and meropenem, respectively. Bacterial resistance of five major clinical isolates from cerebrospinal fluid to common antibiotics (in particular Carbapenem-resistant Klebsiella pneumoniae) currently shows an increasing trend. It is worth to emphasize the importance of serious control of hospital infection and better management of clinical use of antimicrobial agents.