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中国1439株耐碳青霉烯类菌株的临床分布特征:耐药性、地理分布、抗生素MIC50/90

Clinical Distribution Characteristics of 1439 Carbapenem-Resistant Strains in China: Drug Resistance, Geographical Distribution, Antibiotic MIC50/90.

作者信息

Zhang Wei, Li Zhirong, Wang Na, Yang Zhicong, Li Jia, Li Caiqing, Han Xuying, Liu Jinlu, Li Liping, Wang Shuwang, Zhan Minghua

机构信息

Microbiology Department, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei Province, People's Republic of China.

Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China.

出版信息

Infect Drug Resist. 2021 Nov 12;14:4717-4725. doi: 10.2147/IDR.S334283. eCollection 2021.

Abstract

PURPOSE

To explore the clinical distribution characteristics and antimicrobial susceptibilities of carbapenem-resistant () in Hebei Province, China, from 2017 to 2019, and provide data on the treatment of this bacterial infection and the prevention of its spread.

MATERIALS AND METHODS

A total of 1439 strains were collected from 2017 to 2019 in Hebei Province, China. Drug sensitivity tests were performed using the minimum inhibitory concentration (MIC) method, and the data were analyzed statistically using WHONET5.6 software.

RESULTS

A total of 54,377 strains of were isolated in Hebei Province from 2017 to 2019, of which 1439 strains were (2.65%). The highest proportion (33.78%) of strains was isolated from urine, and the detection rate showed a slow downward trend over the past 3 years. was mainly detected in densely populated and economically developed areas. Of all the patients, 54.2% were from the medical ward; the ratio of male to female patients with infections was 1.35:1; elderly patients and adults accounted for 59.6% and 30.8%, respectively, whereas minors and newborns accounted for 4.9% and 4.7%, respectively. For , the drug resistance rates to β-lactams were all higher than 80% and there was an annual increasing trend, while the drug resistance rates to quinolones remained nearly unchanged. The rate of resistance to aminoglycosides was relatively low, especially to amikacin (approximately 22%). The MIC50 of other antibacterial drugs, except amikacin, was equal to or higher than the break point of drug resistance.

CONCLUSION

From 2017 to 2019, the isolation rate of in Hebei Province, China, remained stable; however, the drug resistance rate showed an upward trend, primarily in cases of urinary tract infections in older men; the resistance rate to amikacin was the lowest.

摘要

目的

探讨2017年至2019年中国河北省耐碳青霉烯类肠杆菌科细菌(CRE)的临床分布特征及抗菌药物敏感性,为该细菌感染的治疗及传播预防提供数据。

材料与方法

2017年至2019年在中国河北省共收集1439株CRE菌株。采用最低抑菌浓度(MIC)法进行药敏试验,并用WHONET5.6软件对数据进行统计学分析。

结果

2017年至2019年河北省共分离出54377株肠杆菌科细菌,其中1439株为CRE(2.65%)。菌株分离比例最高的是尿液(33.78%),过去3年检测率呈缓慢下降趋势。CRE主要在人口密集和经济发达地区检出。所有患者中,54.2%来自内科病房;CRE感染患者中男女比例为1.35:1;老年患者和成人分别占59.6%和30.8%,而未成年人和新生儿分别占4.9%和4.7%。对于CRE,对β-内酰胺类药物的耐药率均高于80%且呈逐年上升趋势,而对喹诺酮类药物的耐药率基本保持不变。对氨基糖苷类药物的耐药率相对较低,尤其是对阿米卡星(约22%)。除阿米卡星外,其他抗菌药物的MIC50等于或高于耐药折点。

结论

2017年至2019年,中国河北省CRE的分离率保持稳定;然而,耐药率呈上升趋势,主要见于老年男性的尿路感染病例;对阿米卡星的耐药率最低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f70f/8594617/85fe19c5043d/IDR-14-4717-g0001.jpg

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