摘要
目的了解2015—2021年CHINET耐药监测网52所医院的克雷伯菌属细菌分布及对各类抗菌药物的耐药性变迁。方法按照CHINET技术方案对菌株进行抗菌药物敏感性试验,参照2021年CLSI M100折点标准。结果2015—2021年共分离到非重复克雷伯菌属细菌241549株,其中肺炎克雷伯菌88.0%、产气克雷伯菌5.8%、产酸克雷伯菌5.7%、其他克雷伯菌属0.6%。克雷伯菌属细菌主要分离自呼吸道标本(48.49±5.32)%;分离率前三的科室分别是内科(22.79±3.28)%、外科(17.98±3.10)%和ICU(14.03±1.39)%。肺炎克雷伯菌对大部分抗菌药物耐药率高于同属其他菌种,但替加环素及多黏菌素B仍在克雷伯菌属中显示较低的耐药性。肺炎克雷伯菌和产酸克雷伯菌的超广谱β内酰胺酶阳性菌株对抗菌药物的耐药率均高于其阴性菌株。ICU患者分离的肺炎克雷伯菌和碳青霉烯类耐药肺炎克雷伯菌(CRKP)对绝大部分抗菌药物耐药率高于非ICU患者,成年患者的CRKP对大部分抗菌药物耐药率高于儿童患者。结论2015—2021年临床分离克雷伯菌属细菌对碳青霉烯类抗生素的耐药率呈较大幅度增长,对替加环素、多黏菌素B仍保持较高的敏感率,仍需加强克雷伯菌属细菌耐药性监测。
Objective To understand the changing distribution and antimicrobial resistance profiles of Klebsiella strains in 52 hospitals across China in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Methods Antimicrobial susceptibility testing was carried out according to the unified CHINET protocol.The susceptibility results were interpreted according to the breakpoints in the Clinical&Laboratory Standards Institute(CLSI)M100 document.Results A total of 241,549 nonduplicate Klebsiella strains were isolated from 2015 to 2021,including Klebsiella pneumoniae(88.0%),Klebsiella aerogenes(5.8%),Klebsiella oxytoca(5.7%),and other Klebsiella species(0.6%).Klebsiella strains were mainly isolated from respiratory tract(48.49±5.32)%.Internal medicine(22.79±3.28)%,surgery(17.98±3.10)%,and ICU(14.03±1.39)%were the top 3 departments where Klebsiella strains were most frequently isolated.K.pneumoniae isolates showed higher resistance rate to most antimicrobial agents compared to other Klebsiella species.Klebsiella isolates maintained low resistance rates to tigecycline and polymyxin B.ESBLsproducing K.pneumoniae and K.oxytoca strains showed higher resistance rates to all the antimicrobial agents tested compared to the corresponding ESBLs-nonproducing strains.The K.pneumoniae and carbapenem-resistant K.pneumoniae(CRKP)strains isolated from ICU patients demonstrated higher resistance rates to majority of the antimicrobial agents tested than the strains isolated from non-ICU patients.The CRKP strains isolated from adult patients had higher resistance rates to most of the antimicrobial agents tested than the corresponding CRKP strains isolated from paediatric patients.Conclusions The prevalence of carbapenem-resistant strains in Klebsiella isolates increased greatly from 2015 to 2021.However,the Klebsiella isolates remained highly susceptible to tigecycline and polymyxin B.Antimicrobial resistance surveillance should still be strengthened for Klebsiella strains.
作者
卓楚越
郭颖异
卓超
杨洋
胡付品
朱德妹
徐英春
张小江
张峰波
季萍
谢轶
康梅
王传清
付盼
徐元宏
黄颖
孙自镛
陈中举
倪语星
孙景勇
褚云卓
田素飞
胡志东
李金
俞云松
林洁
单斌
杜艳
郭素芳
魏莲花
邹凤梅
张泓
王春
胡云建
艾效曼
郭大文
赵金英
喻华
黄湘宁
刘文恩
李艳明
金炎
邵春红
徐雪松
鄢超
王山梅
楚亚菲
张利侠
马娟
周树平
周艳
朱镭
孟晋华
董方
吕志勇
胡芳芳
沈瀚
周万青
贾伟
李刚
吴劲松
卢月梅
李继红
段金菊
康建邦
马晓波
郑燕萍
郭如意
朱焱
陈运生
孟青
王世富
胡雪飞
沈继录
黄文辉
汪瑞忠
房华
俞碧霞
赵勇
龚萍
温开镇
张贻荣
刘江山
廖龙凤
顾洪芹
姜琳
贺雯
薛顺虹
冯佼
岳春雷
ZHUO Chuyue;GUO Yingyi;ZHUO Chao;YANG Yang;HU Fupin;ZHU Demei;XU Yingchun;ZHANG Xiaojiang;ZHANG Fengbo;JI Ping;XIE Yi;KANG Mei;WANG Chuanqing;FU Pan;XU Yuanhong;HUANG Ying;SUN Ziyong;CHEN Zhongju;NI Yuxing;SUN Jingyong;CHU Yunzhuo;TIAN Sufei;HU Zhidong;LI Jin;YU Yunsong;LIN Jie;SHAN Bin;DU Yan;GUO Sufang;WEI Lianhua;ZOU Fengmei;ZHANG Hong;WANG Chun;HU Yunjian;AI Xiaoman;GUO Dawen;ZHAO Jinying;YU Hua;HUANG Xiangning;LIU Wen’en;LIYanming;JIN Yan;SHAO Chunhong;XU Xuesong;YAN Chao;WANG Shanmei;CHU Yafei;ZHANG Lixia;MA Juan;ZHOU Shuping;ZHOU Yan;ZHU Lei;MENG Jinhua;DONG Fang;LÜZhiyong;HU Fangfang;SHEN Han;ZHOU Wanqing;JIA Wei;LI Gang;WU Jinsong;LU Yuemei;LI Jihong;DUAN Jinju;KANG Jianbang;MA Xiaobo;ZHENG Yanping;GUO Ruyi;ZHU Yan;CHEN Yunsheng;MENG Qing;WANG Shifu;HU Xuefei;SHEN Jilu;HUANG Wenhui;WANG Ruizhong;FANG Hua;YU Bixia;ZHAO Yong;GONG Ping;WEN Kaizhen;ZHANG Yirong;LIU Jiangshan;LIAO Longfeng;GU Hongqin;JIANG Lin;HE Wen;XUE Shunhong;FENG Jiao;YUE Chunlei(Department of Infectious Diseases,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510030,China)
出处
《中国感染与化疗杂志》
CAS
CSCD
北大核心
2024年第4期418-426,共9页
Chinese Journal of Infection and Chemotherapy
基金
CHINET中国细菌耐药监测网基金(2020QD049)。
关键词
克雷伯菌属
细菌耐药监测
耐药性变迁
Klebsiella
bacterial resistance surveillance
antimicrobial resistance