Department of Laboratory Medicine, 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 100730, China;Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing 100730, China.
Department of Laboratory Medicine, 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 100730, China;Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing 100730, China;Graduate School, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Biomed Environ Sci. 2023 Aug 20;36(8):732-742. doi: 10.3967/bes2023.072.
To investigate the distribution and antimicrobial susceptibility of causative microorganisms recovered from patients with intra-abdominal infections (IAIs).
A total of 2,926 bacterial and fungal strains were identified in samples collected from 1,679 patients with IAIs at the Peking Union Medical College Hospital between 2011 and 2021. Pathogenic bacteria and fungi were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antimicrobial susceptibility testing (AST) was performed using the VITEK 2 compact system and the Kirby-Bauer method. AST results were interpreted based on the M100-Ed31 clinical breakpoints of the Clinical and Laboratory Standards Institute.
Of the 2,926 strains identified, 49.2%, 40.8%, and 9.5% were gram-negative bacteria, gram-positive bacteria, and fungi, respectively. was the most prevalent pathogen in intensive care unit (ICU) and non-ICU patients; however, a significant decrease was observed in the isolation of between 2011 and 2021. Specifically, significant decreases were observed between 2011 and 2021 in the levels of extended-spectrum β-lactamase (ESBL)-producing (from 76.9% to 14.3%) and (from 45.8% to 4.8%). Polymicrobial infections, particularly those involving co-infection with gram-positive and gram-negative bacteria, were commonly observed in IAI patients. Moreover, was more commonly isolated from hospital-associated IAI samples, while had a higher ratio in community-associated IAIs. Additionally, AST results revealed that most antimicrobial agents performed better in non-ESBL-producers than in ESBL-producers, while the overall resistance rates (56.9%-76.8%) of were higher against all antimicrobial agents than those of other common gram-negative bacteria. Indeed, , , , and were consistently found to be susceptible to vancomycin, teicoplanin, and linezolid. Similarly, exhibited high susceptibility to all the tested antifungal drugs.
The distribution and antimicrobial susceptibility of the causative microorganisms from patients with IAIs were altered between 2011 and 2021. This finding is valuable for the implementation of evidence-based antimicrobial therapy and provides guidance for the control of hospital infections.
研究从 2011 年至 2021 年在我院收治的 1679 例腹腔感染（IAI）患者的标本中分离的病原菌的分布及药敏情况。
采用基质辅助激光解吸电离飞行时间质谱仪（MALDI-TOF MS）对我院 2011 年至 2021 年收治的 1679 例 IAI 患者的标本中分离的 2926 株病原菌进行鉴定，采用 VITEK 2 compact 系统和纸片扩散法进行药敏试验，按照美国临床和实验室标准化协会（CLSI）的 M100-Ed31 临床折点进行判读。
在 2926 株分离菌中，革兰阴性菌、革兰阳性菌和真菌分别占 49.2%、40.8%和 9.5%。肠杆菌科细菌是 ICU 和非 ICU 患者中最常见的病原体，但 2011 年至 2021 年间 分离率显著下降。具体来说，2011 年至 2021 年间，产超广谱β-内酰胺酶（ESBL）的肠杆菌科细菌（从 76.9%降至 14.3%）和肺炎克雷伯菌（从 45.8%降至 4.8%）的检出率显著下降。IAI 患者常发生混合感染，尤其是革兰阳性菌和革兰阴性菌混合感染。此外，医院获得性 IAI 样本中更常分离出 ，而社区获得性 IAI 中 检出率更高。药敏结果显示，非产 ESBL 者对抗菌药物的敏感性普遍优于产 ESBL 者，且所有常见革兰阴性菌对 的总体耐药率（56.9%-76.8%）均高于其他常见革兰阴性菌。实际上，所有抗菌药物对 、替考拉宁和利奈唑胺均保持敏感， 对所有测试的抗真菌药物也表现出高度敏感性。
2011 年至 2021 年间，IAI 患者病原菌的分布及药敏情况发生了变化。该研究结果有助于实施基于循证的抗菌治疗，并为医院感染的防控提供指导。
