2021年全国细菌耐药监测网重症监护病房临床分离细菌耐药监测报告

Antimicrobial resistance surveillance reports from intensive care units from China Antimicrobial Resistance Surveillance System in 2021

    摘要
  • 摘要: 目的 监测2021年全国各重症监护室(ICU)、急症监护室(EICU)、呼吸监护室(RICU)及心脏监护室(CCU)患者临床分离菌株分布及耐药情况。方法 按照全国细菌耐药监测网(CARSS)方案(2020版),应用WHONET 5.6软件对2020年10月-2021年9月CARSS成员单位上报的ICU、EICU、RICU及CCU患者临床分离细菌及药敏结果数据进行分析。结果 2021年ICU、EICU、RICU及CCU患者分离的总菌株数为449 279、33 909、18 518、10 241株,其中耐甲氧西林金黄色葡萄球菌(MRSA)的检出率为36.2%、34.1%、46.7%和35.5%,未发现对万古霉素、替考拉宁及利奈唑胺耐药的菌株。除利奈唑胺外,粪肠球菌对多数测试抗菌药物的耐药率均低于屎肠球菌,其中万古霉素耐药粪肠球菌(VREFA)为0.5%、0.2%、0、0;万古霉素耐药屎肠球菌(VREFM)为1.5%、1.2%、1.1%、1.4%。铜绿假单胞菌、鲍氏不动杆菌对碳青霉烯类抗菌药物耐药率分别为28.7%、26.9%、36.0%和17.7%;78.2%、78.3%、86.1%和56.2%。大肠埃希菌对碳青霉烯类抗菌药物耐药率为3.5%、3.5%、4.2%和1.5%;肺炎克雷伯菌对碳青霉烯类抗菌药物耐药率为20.6%、20.2%、40.1%和9.9%。结论 ICU患者中MRSA、碳青霉烯类耐药鲍氏不动杆菌(CRAB)、碳青霉烯类耐药铜绿假单胞菌(CRPA)、碳青霉烯类耐药大肠埃希菌、碳青霉烯类耐药肺炎克雷伯菌(CRKP)等表型的发生率明显更高,其中RICU耐药率高于其他三个监护室。

     

    Abstract: OBJECTIVE To understand the distribution and drug resistance of clinical isolates from intensive care unit (ICU), emergency intensive care unit (EICU), respiratory intenvise care unit (RICU) and cardiac care unit (CCU) of China in 2021. METHODS Accordiong to the programs of China Antimicrobial Resistance Surveillance System (CARSS) (2020 edition),the data of clinical isolates and results of drug susceptibility testing that were reported from CARSS members were analyzed by WHONET 5.6 software from Oct 2020 to Sep 2021. RESULTS In 2021, the total number of cliical isolates was 449 279 from ICU patients, 33 909 from EICU patients, 18 518 from RICU patients, 10 241 from CCU patients. The isolation rates of methicillin-resistant Staphylococcus aureus (MRSA) were 36.2%, 34.1%, 46.7% and 35.5%,respectively. No strains that were resistant to vancomycin, teicoplanin or linezolid. The drug resistance rates of Enterococcus faecalis to all the tested antibiotics were higher than those of Enterococcus faecium except for linezolid; the drug resistance rates of E.faecalis to vancomycin were 0.5%, 0.2%, 0 and 0, respectively; the drug resistance rates of E.faecium strains to vancomycin were 1.5%, 1.2%, 1.1% and 1.4%, respectively. The drug resistance rates of Pseudomonas aeruginosa strains to carbapenems were 28.7%, 26.9%, 36.0% and 17.7%, respectively; the drug resistance rates of Acinetobacter baumannii strains to carbapenems were 78.2%, 78.3%, 86.1% and 56.2%, respectively; the drug resistance rates of the Escherichia coli strains to carbapenems were 3.5%, 3.5%,4.2% and 1.5%, respectively; the drug resistance rates of Staphylococcus aureus strains to carbapenems were 20.6%, 20.2%, 40.1% and 9.9%, respectively. CONCLUSION The incidence rates of the phenotypes such as MRSA, carbapenem-resistant A.baumannii (CRAB), carbapenem-resistant P.aeruginosa (CRPA), carbapenem-resistant E.coli and carbapenem-resistant K.pneumoniae (CRKP) are remarkably higher among the ICU patients, and the drug resistance rates are higher in RICU than in other three care units.

     

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