2005—2017年中国CHINET常见革兰阴性菌对碳青霉烯类抗生素耐药的监测结果

CHINET surveillance of carbapenem-resistant gram-negative bacteria in China from 2005 to 2017

目的:从中国CHINET多年监测结果分析常见革兰阴性菌对碳青霉烯类抗生素耐药情况,为临床使用碳青霉烯类药物提供流行病学依据。方法:登陆http://www.chinets.com,收集2005—2017年中国CHINET细菌耐药性监测数据结果,对常见细菌数量进行构成比的趋势分析。结果:临床标本分离菌中革兰阴性菌(65.7%～72.6%)已经明显超过革兰阳性菌(27.0%～34.3%),其中革兰阴性菌主要为肠杆菌科细菌和不发酵糖细菌,革兰阳性菌主要为葡萄球菌属细菌和肠球菌属细菌。除铜绿假单胞菌外,革兰阴性菌对美罗培南和亚胺培南耐药率呈逐年增加。肠杆菌属细菌与不发酵糖细菌对碳青霉烯类药物耐药率比较,后者明显高于前者,其中鲍曼不动杆菌耐药率及增长率均居于首位,铜绿假单胞菌耐药率次之。结论:中国常见革兰阴性菌对碳青霉烯类抗生素耐药已经明显突出,尤其是鲍曼不动杆菌全国耐药率已经呈现爆发流行。

Objective:To analyze the surveillance of carbapenem-resistant gram-negative bacteria from the data of China CHINET and provide an epidemiological basis for clinical use of carbapenems.Method:We visited the website of http://www.chinets.com and collected the monitoring data of China CHINET from 2005 to 2017.We analyzed the proportions of common bacteria.Result:Gram-negative bacteria(65.7%-72.6%,mainly including Enterobacteriaceae and Non-fermentative bacteria)significantly exceeded gram-positive bacteria(27.0%-34.3%,mainly including Staphylococcus and Enterococcus)in the isolated bacteria of clinical specimens.Except Pseudomonas aeruginosa,the resistance rate to meropenem and imipenem have increased year by year in gram-negative bacteria.Compared with Non-fermentable bacteria,Enterobacteriaceae have higher carbapenem-resistant rate,and the resistant and growth rate of Acinetobacter baumannii taken the first place,which was followed by Pseudomonas aeruginosa.Conclusion:The carbapenem-resistant gram-negative bacteria has been obviously prominent in China,especially Acinetobacter baumannii has been in a nationwide outbreak.