2019-2020年山东省医院感染监测网细菌监测报告

Bacteria surveillance report of 2019 and 2020 based on Shandong Province nosocomial infection surveillance network

目的 了解2019年和2020年山东省各级医院临床标本中常见病原菌分布及耐药性。方法 通过山东省医院感染监测网(SDNICC)平台直接提取2019和2020年医院感染病原菌信息,利用WHONET 5.6软件进行数据分析。结果 截止2020年末,SDNICC数据直报单位已覆盖山东省16地市。革兰阳性菌中,占前5位的分别为金黄色葡萄球菌、表皮葡萄球菌、屎肠球菌、肺炎链球菌和粪肠球菌;革兰阴性杆菌中,占前5位分别为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍氏不动杆菌和阴沟肠杆菌。其中,金黄色葡萄球菌对青霉素、红霉素和克林霉具有较高的耐药率;鲍氏不动杆菌和铜绿假单胞菌对头孢唑林、头孢替坦的耐药率均在90%以上。2019和2020年耐甲氧西林金黄色葡萄球菌(MRSA)的检出率分别为31.28%、32.59%;耐万古霉素肠球菌(VRE)的检出率分别为1.16%、0.90%;耐碳青霉烯类的大肠埃希菌、阴沟肠杆菌和肺炎克雷伯菌(CRE)检出率分别为2.28%、2.40%;6.94%、6.60%;6.84%、7.92%;耐碳青霉烯类的铜绿假单胞菌(CRPA)检出率分别为25.88%、23.63%;耐碳青霉烯类的鲍氏不动杆菌(CRAB)检出率分别为60.88%、55.76%。结论 基于区域医疗中心建立的SDNICC监测网能够准确提取山东省各级医院病原菌信息,其中MRSA和CRE中前两种菌的检出率略有升高,VRE、CRPA和CRAB的检出率略有降低,应进一步加强对碳青霉烯类等抗菌药物的管理。

OBJECTIVE To investigate the distribution and drug resistance of common pathogens isolated from clinical specimens in hospitals of Shandong Province in 2019 and 2020. METHODS The information of pathogens causing nosocomial infection in 2019 and 2020 was directly extracted from Shandong Nosocomial Infection Control Center(SDNICC), and the data were analyzed with the use of WHONET 5.6 software. RESULTS By the end of 2020, SDNICC direct reporting units have covered 16 cities of Shandong Province. Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecium, Streptococcus pneumoniae and Enterococcus faecalis ranked the top 5 species of gram-positive bacteria. Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii and Enterobacter cloacae ranked the top 5 species of gram-negative bacilli. S.aureus strains were highly resistant to penicillin, erythromycin and clindamycin. The drug resistance rates of A.baumannii and P.aeruginosa strains to cefazolin and cefotetan were more than 90%. The isolation rate of methicillin-resistant S.aureus(MRSA) was 31.28% in 2019, 32.59% in 2020;the isolation rate of vancomycin-resistant Enterococcus(VRE) was 1.16% in 2019, 0.90% in 2020;the isolation rates of carbapenem-resistant E.coli, E.cloacae and K.pneumoniae were 2.28%, 2.40%, 6.94%, 6.60%, 6.84% and 7.92%, respectively;the isolation rates of carbapenem-resistant P.aeruginosa(CRPA) were 25.88% and 23.63%, respectively;the isolation rates of carbapenem-resistant A.baumannii were 60.88% and 55.76%, respectively. CONCLUSION The data of pathogens can be accurately extracted through SDNICC surveillance network established based on regional medical center, the isolation rates of MRSA and CRE are slightly increased, and the isolation rates of VRE, CRPA and CRAB are slightly decreased. It is necessary to strengthen the management of antibiotics such as carbapenems.