2021年全国细菌耐药监测网感染性疾病科细菌耐药监测报告

Antimicrobial resistance surveillance reports from infectious diseases departments from China Antimicrobial Resistance Surveillance System in 2021 China

目的监测2021年全国感染性疾病科分离细菌的耐药情况,为临床合理应用抗菌药物提供依据.方法全部监测数据来源于全国细菌耐药监测网(CARSS)成员单位2020年10月-2021年9月感染性疾病科分离获得的菌株,依据保留同一患者相同细菌第一株的原则剔除重复菌株后,应用WHONET 5.6软件对数据进行分析.结果2020年10月-2021年9月共收集全国感染性疾病科患者分离菌61491株,其中革兰阳性菌占28.8%,革兰阴性菌占71.2%.耐甲氧西林葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率分别为28.3%和64.5%,MRSA和MRCNS对绝大多数抗菌药物的耐药率均高于甲氧西林敏感株,MRSA中有12.8%菌株对磺胺甲噁唑/甲氧苄啶耐药,未发现万古霉素耐药株.非脑膜炎肺炎链球菌中青霉素敏感和耐药株检出率分别为94.5%和1.1%.大肠埃希菌对头孢噻肟和亚胺培南的耐药率分别为50.5%和1.4%;肺炎克雷伯菌对头孢噻肟和亚胺培南的耐药率分别为26%和6.1%.铜绿假单胞菌和鲍氏不动杆菌对亚胺培南耐药率分别为11.8%和37.2%.流感嗜血杆菌对氨苄西林的耐药率为67.9%.结论2021年全国感染性疾病科患者分离菌对常见抗菌药物的耐药性形势仍较严峻,尤其是MRSA和耐碳青霉烯类革兰阴性杆菌,应坚持加强感染性疾病科抗菌药物的监管.

OBJECTIVE To understand the drug resistance rates of pathogens isolated from patients of infectious diseases department so as to provide guidance for reasonable clinical use of antibiotics.METHODS All of the surveillance data were extracted from the pathogens isolated from the infectious diseases departments of the members of China Antimicrobial Resistance Survellance System(CARSS)from Oct 2020 to Sep 2021.The'repetitive strains were eliminated based on the principle that the first strain of the same species from the same patient was eliminated,and the data were analyzed by using WHONET 5.6 software.RESULTS A total of 61491 strains of pathogens were isolated from the infectious diseases department patients from Oct 2020 to Sep 2021,28.8%of which were gram-positive bacteria,and 71.2%were gram-negative bacteria.The isolation rates of methicllin-resistant Staphylococcus aureus(MRSA)and methicillin-resistant coagulase-negative Staphylococcus(MRCNS)were 28.3%and 64.5%,respectively.The drug resistance rates of MRSA and MRCNS were higher than those of the methicllin-sensitive strains to most of the antibiotics.12.8%of the MRSA strains were resistant to sulfamethoxazole-trimethoprim,and no vancomycin-resistant strains were found.Among the non-meningitis Streptococcus pneumoniae strains,the isolation rates of penillin-sensitive and penillin-resistant strains were 94.5%and 1.1%,respectively.The drug resistance rates of Escherichia coli strains to cefotaxime and imipenem were 50.5%and 1.4%,respectively;the drug resistance rates of the Klebsiella pneumoniae strains to cefotaxime and imipenem were 26%and 6.1%,respectively.The drug resistance rates of the Pseudomonas aeruginosa and Acinetobacter baumanni strains to imipenem were 11.8%and 37.2%,respectively.The drug resistance rate of the Haemophilus influenzae strains to ampicillin was 67.9%.CONCLUSION The pathogens that are isolated from the patients of infectious diseases department are highly resistant to the commonly used antibiotics,especially the MRSA and carbapenem-resistant gram-negative bacilli.It is necessary to strengthen the supervision of antibiotics for the patients of infectious diseases department.