中国儿童细菌耐药监测组2017年儿童细菌感染及耐药监测

Antimicrobial resistance profile of clinical isolates in pediatric hospitals in China: report from the ISPED Surveillance Program,2017

目的了解目前中国大陆儿童细菌感染和耐药现状。方法菌株资料来源2017年1至12月国内10所三级甲等儿童教学医院,抗生素敏感性试验采用自动化仪器法及KB纸片法,结果判断采用美国临床实验室标准化委员会(CLSI)2017年标准。结果共监测到67 774临床分离株,其中革兰阳性菌占42.1%,革兰阴性菌占57.9%,前5位分离株分别为:大肠埃希菌8 904株,肺炎链球菌8 354株,金黄色葡萄球菌6 976株,流感嗜血杆菌6 515株,凝固酶阴性葡萄球菌5 618株。碳青霉烯类耐药的肠杆菌、鲍曼不动杆菌和铜绿假单孢菌在新生儿组及非新生儿组分别占17.9%和9.5%、42.9%和55.4%、39.5%和24.3%,耐甲氧西林金黄色葡萄球菌在两组检出率为35.8%和39.5%。非脑膜炎来源肺炎链球菌分离株中,青霉素不敏感株在新生儿组和非新生儿组分别为23.2%和21.7%,流感嗜血杆菌β-内酰胺酶阳性检出率在两组分别为54.8%和59.9%。结论我国儿童碳青霉烯类耐药菌检出比例逐年升高,新生儿碳青霉烯类耐药肠杆菌科细菌比例较高。

Objective To investigate the antimicrobial resistance profiles of pathogens in Chinese children.Methods Clinical isolates were collected from 10 tertiary children hospitals in China,2017.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems interpreted according to the criteria of Clinical and Laboratory Standards Institute (CLSI) 2017 breakpoints.Results A total of 67 774 isolates were collected,of which 42.1% was gram-positive organisms and 57.9% was gram-negative organisms.The number of five primary pathogens were as follows,Escherichia coli (8 904 isolates),Streptococcus pneumonia (8 354 isolates),Straphylococcus aureus (6 976 isolates),Haemophilus influenza (6 515 isolates),Coagulase negative staphylococci (5 618 isolates).In neonatal group and non-neonatal group,carbapenem resistance Enterobacteriaceae,Acinetobacter baumannii and Pseudomonas aeruginosa accounted for 17.9% and 9.5%,42.9% and 55.4%,39.5% and 24.3%,respectively.The methicillin-resistant Staphylococcus aureus (MRSA) was detected from neonatal group (35.8%) and non-neonatal group (39.5%).The penicillin non-susceptible rates of Streptococcus pneumonia in the two groups were 23.2% and 21.7%.The β-lactamase positive rates of Haemophilus pneumonia isolated from the neonatal group and non-neonatal groups were up to 54.8% and 59.9%.Conclusion This investigation highlights the worrisome trend of antimicrobial resistance in children.Carbapenem-resistant bacteria have increased gradually,which makes a big challenge of clinical effective therapy for pediatric infections.