2021年全国细菌耐药监测网骨科细菌耐药监测报告

Antimicrobial resistrance surveillance reports from patients of orthopedics departments from China Antimicrobial Resistance Surveillance System in 2021

    摘要
  • 摘要: 目的 研究2021年全国细菌耐药监测网(CARSS)医院骨科感染细菌分布及耐药情况。方法 从2021年全国细菌耐药监测报告中提取骨科相关数据,采用WHONET 5.6软件分析主要病原菌分布及其耐药性。结果 对全部骨科患者临床资料进行分析,共检出非重复菌株130 928株,主要包括脓液(25.7%)、尿液(14.2%)、痰液(7.1%)、血液(4.1%)和腹水(0.3%)等。不同于其他科室患者标本构成,脓液标本构成比较高。菌种分布包括,金黄色葡萄球菌(21.4%),其次是大肠埃希菌(15.0%)、肺炎克雷伯菌(7.3%)、铜绿假单胞菌(7.2%)、表皮葡萄球菌(6.1%)、阴沟肠杆菌(5.9%)、鲍氏不动杆菌(3.8%)、粪肠球菌(3.6%)、奇异变形杆菌(2.5%)、溶血葡萄球菌(2.5%)、屎肠球菌(1.8%)。重要耐药菌如碳青霉烯耐药的肺炎克雷伯菌发生率为6.7%,碳青霉烯耐药的铜绿假单胞发生率为8.2%,甲氧西林耐药的金黄色葡萄球菌发生率为28.1%,碳青霉烯耐药的鲍氏不动杆菌发生率为36.8%,均低于全国患者数据。结论 骨科患者具有特殊的病原菌分布特征,金黄色葡萄球菌分离率高,且耐药性较其他科室患者相对较低。但仍需继续加强抗菌药物合理应用的管理及医院感染防控,警惕特殊耐药菌的潜在传播风险,做好耐药监测工作。

     

    Abstract: OBJECTIVE To observe the distribution and drug resistance of pathogens isolated from orthopedics department patients of China Antimicrobial Resistance Surveillance System (CARSS) in 2021. METHODS The orthopedics department-related data were extracted from the reports of CARSS. The distribution and drug resistance of the major species of pathogens were analyzed by WHONET 5.6 software. RESULTS The clinical data of all the orthopedics department patients were analyzed. Totally 130 928 strains of non-repetitive pathogens were isolated, 25.7% of which were isolated from pus specimens, 14.2% from urine specimens, 7.1% from sputum specimens, 4.1% from blood specimens, 0.3% from ascites specimens. The constituent ratio of pus specimens was higher than that of specimens of patients in other departments. Among the species of pathogens, Staphylococcus aureus accounted for 21.4%, Escherichia coli 15.0%, Klebsiella pneumoniae 7.3%, Pseudomonas aeruginosa 7.2%, Staphylococus epidermidis 6.1%, Enterobacter cloacae 5.9%, Acinetobacter baumannii 3.8%, Enterococcus faecalis 3.6%, Proteus mirabilis (2.5%), Staphylococcus haemolyticus (2.5%), Enterococcus faecium 1.8%. In terms of the major species of drug-resistant pathogens, the isolation rate of carbapenem-resistant Klebsiella pneumoniae was 6.7%, the isolation rate of carbapenem-resistant Pseudomonas aeruginosa was 8.2%, the isolation rate of methicillin-resistant Staphylococcus aureus was 28.1%, and the isolation rate of carbapenem-resistant A.baumannii was 36.8%, lower than the data of the patients of the whole country. CONCLUSION The orthopedics department patients show remarkable characteristics of distribution of pathogens, the isolation rate of S.aureus strains is high, and the drug resistance rate is lower in the orthopedics department than in other departments. It is necessary to continuously strengthen the reasonable use of antibiotics and prevention and control of nosocomial infection, maintain vigilant for the risk of potential transmission of drug-resistant strains and carry out the antimicrobial surveillance.

     

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