2018至2022年中国西南地区重症监护病房细菌分布及耐药率变化分析
Analysis on Bacterial Distribution and Change of Drug Resistance Rate in ICUs Across Southwest China from 2018 to 2022.
作者信息
Chang Fan, Wang Xiao, Huang Xiangning, Liu Xin, Huang Lijun
机构信息
Department of Laboratory Medicine and Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, People's Republic of China.
West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China.
出版信息
Infect Drug Resist. 2023 Aug 29;16:5685-5696. doi: 10.2147/IDR.S421357. eCollection 2023.
PURPOSE
To analyze the distribution of bacteria and their drug resistance changes in Intensive Care Units (ICUs) across Southwest China from 2018 to 2022 and establish the antibiogram in this region to provide a basis for early empirical antimicrobial use.
METHODS
Non-repetitive pathogens isolated from 109 member units with qualified data were obtained from the Antimicrobial Resistance Surveillance System in Sichuan Province, southwest China. The results obtained were interpreted with reference to CLSI M100-31th, and analyzed with WHONET 5.6 software.
RESULTS
A total of 46,728 clinical isolates in ICUs were collected from 2018 to 2022, of which gram-negative organisms accounted for 76.1%, and gram-positive were 23.9%. The top 5 were , , aeruginosa and , respectively. From 2018 to 2022, the resistance rates of to imipenem and meropenem changed from 14.5% and 17.8% to 14.0% and 14.4%, showing a steady downward trend. was always highly sensitive to carbapenems, with a total resistance rate of 3.8%. Among non-fermented gram-negative bacteria, the resistance rates of to imipenem and meropenem decreased significantly, changed from 25.3% and 22.9% in 2018 to 20.0% and 15.1% in 2022. However, showed high resistance rates of 76.2% and 76.9% to imipenem and meropenem, respectively. MRSA and MRCNS accounted for 31.7% and 82.7%, respectively. No vancomycin and linezolid-resistant was isolated. maintained high activity to vancomycin, teicoplanin, and linezolid; no vancomycin or teicoplanin-resistant strains were detected.
CONCLUSION
From 2018 to 2022, the isolated bacteria in ICU were mainly gram-negative bacteria, and the growth of some multidrug-resistant bacteria was effectively controlled. All levels of medical institutions should continue to strengthen bacterial resistance surveillance, promote the establishment of antimicrobial stewardship program, and enhance restrictions on outpatient antimicrobial use.
目的
分析2018年至2022年中国西南地区重症监护病房（ICU）细菌分布及其耐药性变化，建立该地区的抗菌谱，为早期经验性抗菌药物使用提供依据。
方法
从中国西南地区四川省抗菌药物耐药性监测系统中获取109个数据合格的成员单位分离出的非重复病原体。所得结果参照CLSI M100-31th进行解释，并用WHONET 5.6软件进行分析。
结果
2018年至2022年共收集ICU临床分离株46728株，其中革兰阴性菌占76.1%，革兰阳性菌占23.9%。排名前5的分别是 、 、铜绿假单胞菌和 。2018年至2022年， 对亚胺培南和美罗培南的耐药率分别从14.5%和17.8%降至14.0%和14.4%，呈稳步下降趋势。 对碳青霉烯类始终高度敏感，总耐药率为3.8%。在非发酵革兰阴性菌中， 对亚胺培南和美罗培南的耐药率显著下降，从2018年的25.3%和22.9%降至2022年的20.0%和15.1%。然而， 对亚胺培南和美罗培南的耐药率分别高达76.2%和76.9%。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）分别占31.7%和82.7%。未分离出对万古霉素和利奈唑胺耐药的 。 对万古霉素、替考拉宁和利奈唑胺保持高活性；未检测到对万古霉素或替考拉宁耐药的 菌株。
结论
2018年至2022年，ICU分离的细菌以革兰阴性菌为主，部分多重耐药菌的生长得到有效控制。各级医疗机构应继续加强细菌耐药性监测，推动抗菌药物管理计划的建立，加强门诊抗菌药物使用限制。
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