全国细菌耐药监测网2021年神经内科患者分离细菌耐药监测报告

Antimicrobial resistance of bacteria isolated from patients in department of neurology: surveillance report from China Antimicrobial Resistance Surveillance System, 2021

目的 了解全国神经内科患者分离病原菌的种属分布及耐药特点,为医院感染的防控和临床抗菌药物的合理应用提供依据。方法 选取全国细菌耐药监测网成员单位神经内科患者2021年细菌耐药监测数据,采用WHONET 5.6软件进行分析总结。结果 2021年神经内科患者共检出127 506株菌,其中革兰阳性菌占21.6%(27 526株),革兰阴性菌占78.4%(99 980株);主要标本来源为痰(67 782株,53.2%)、尿(37 789株,29.6%)和血(10 599株,8.3%)。耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)分离率分别为31.9%、66.4%,未发现对万古霉素或替考拉宁耐药的葡萄球菌。粪肠球菌和屎肠球菌对万古霉素的耐药率分别为0.4%、1.7%。肠杆菌目细菌中,肺炎克雷伯菌对亚胺培南和美罗培南的耐药率分别为9.8%、11.4%,高于大肠埃希菌(分别为1.2%、1.3%)。鲍曼不动杆菌对碳青霉烯类药物耐药率较高,对亚胺培南和美罗培南的耐药率分别为52.0%、54.4%。结论 神经内科患者分离的细菌以革兰阴性杆菌为主,主要来自下呼吸道标本。临床常见细菌耐药较为严重,应持续进行细菌耐药监测,促进抗菌药物的合理使用。

Objective To understand the species distribution and antimicrobial resistance characteristics of pathogenic bacteria isolated from patients in department of neurology in China,and provide a basis for the prevention and control of healthcare-associated infection as well as the rational use of antimicrobial agents in clinical.Methods Bacterial resistance monitoring data of patients in department of neurology in member units of China Antimicrobial Resistance Surveillance System in 2021 were selected,and analyzed with WHONET 5.6 software.Results In 2021,a total of 127506 strains of bacteria were isolated from patients in department of neurology.Gram-positive bacteria and Gram-negative bacteria accounted for 21.6%(n=27526)and 78.4%(n=99980),respectively.The major specimens were sputum(n=67782,53.2%),urine(n=37789,29.6%)and blood(n=10599,8.3%).Isolation rates of methicillin-resistant Staphylococcus aureus(MRSA)and methicillin-resistant coagulase negative Staphylococcus(MRCNS)were 31.9%and 66.4%,respectively.No Staphylococcus strains were found to be resistant to vancomycin and teicoplanin.Resistance rates of Enterococcus faecalis and Enterococcus faecium to vancomycin were 0.4%and 1.7%,respectively.Among Enterobacterales,resistance rates of Klebsiella pneumoniae to imipenem and meropenem were 9.8%and 11.4%,which were higher than those of Escherichia coli(1.2%and 1.3%,respectively).Acinetobacter baumannii had a high resistance rate to carbapenems,with resistance rates to imipenem and meropenem being 52.0%and 54.4%,respectively.Conclusion Bacteria isolated from patients in department of neurology are mainly Gram-negative bacteria,mostly from lower respiratory tract specimens.Antimicrobial resistance of the frequently clinically isolated bacteria is severe.Cntinuous monitoring on bacterial resistance should be carried out to promote the rational use of antimicrobial agents.