2021年度全国细菌耐药监测网神经外科细菌耐药监测报告

Antimicrobial resistance surveillance reports from patients of neurosurgery departments from China Antimicrobial Resistance Surveillance System in 2021

目的了解2021年度全国神经外科细菌的分离及耐药性现状.方法应用WHONET 5.6软件对2020年10月-2021年9月全国细菌耐药监测网1371所医院神经外科分离的细菌进行分析,分析内容包括各菌株的标本分布、菌种分布及对常用抗菌药物的敏感率和耐药率.结果2020年10月-2021年9月全国细菌耐药监测网1371所医院神经外科共分离细菌180909株,其中痰为主要标本来源,痰分离的菌株占所有菌株的72.04%;革兰阴性菌占78.97%,革兰阳性菌占21.03%.分离前五的细菌分别为:肺炎克雷伯菌39812株,占22.01%,其次为鲍氏不动杆菌,24177株,占13.36%,铜绿假单胞菌22591株,占12.49%,大肠埃希菌17293株,占9.56%,金黄色葡萄球菌16158株,占8.93%.神经外科耐甲氧西林金黄色葡萄球菌(MRSA)的分离率为36.7%,屎肠球菌和粪肠球菌对万古霉素、替考拉宁和利奈唑胺的耐药率分别为1.7%和0.2%、2.1%和0.7%、0.4%和2.5%;大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌和鲍氏不动杆菌对亚胺培南和美罗培南的的耐药率分别为2.9%和3.0%、16.6%和17.2%、24.4%和20.7%、65.8和67.2%,均高于2020年所有科室来源菌株.结论应加强神经外科抗菌药物的监管,提高医院感染防控能力.

OBJECTIVE To understand the current status of distribution and drug resistance of pathogens isolated from the patients of neurosurgery department in 2021.METHODS The pathogens that were isolated from the neurosurgery department patients of 1371 hospitals of China Antimicrobial Resistance Surveillance System(CARSS)from Oct 2020 to Sep 2021 were analyzed by using WHONET 5.6 software.The distribution of specimens,distribution of species,drug susceptibility rates and drug resistance rates to the commonly used antibiotics were observed.RESULTS Totally 180909 strains of pathogens were isolated from the neurosurgery department patients of 1371 hospitals of CARSS,sputum was the major specimen source,and 72.04%of the strains were isolated from sputum specimens;gram-negative bacteria accounted for 78.97%,and gram-positive bacteria accounted for 21.03%.Klebsiella pneumoniae(39812 strains,22.01%),Acinetobacter baumanni(24177 strains,13.36%),Pseudomonas aeruginosa(22591 strains,12.49%),Escherichia coli(17293 strains,9.56%)and Staphylococcus aureus(16158 strains,8.93%)ranked the top 5 species of pathogens.The isolation rate of methicllin-resistant Staphylococcus aureus(MRSA)was 36.7%among the neurosurgery department patients.The drug resistance rates of the Enterococcus faecium strains to vancomycin,teicoplanin and linezolid were 1.7%,2.1%and 0.4%,respectively;the drug resistance rates of Enterococcus faecalis strains to vancomycin,teicoplanin and linezolid were 0.2%,0.7%and 2.5%,respectively.The drug resistance rates of E.coli,K.pneumoniae,P.aeruginosa and A.baumanni strains to imipenem were 2.9%,16.6%,24.4%and 65.8%,respectively;the drug resistance rates of the above species to meropenem were 3.0%,17.2%,20.7%and 67.2%,respectively;the drug resistance rates of the pathogens were higher than those of the pathogens isolated from all the departments in 2020.CONCLUSION It is necessary to strengthen the supervision of antibiotics for the neurosurgery department patients and improve the capability of prevention and control of nosocomial infection.