山东省2017—2020年血流感染金黄色葡萄球菌耐药监测

目的 分析山东省50家医院儿童及成人血培养来源金黄色葡萄球菌耐药性,了解金黄色葡萄球菌血流感染的药敏特征,为临床经验用药提供参考。方法 依托于山东省儿童细菌＆真菌耐药监测研究协作网,对2017—2020年山东省50家医院由血培养分离的金黄色葡萄球菌分布和耐药性进行分析,同时对儿童组（<14岁）和成人组（≥14岁）金黄色葡萄球菌药敏特征进行比对分析。参考美国临床和实验室标准化协会（CLSI）2021年M100文件标准判断结果,采用Whonet 5.6和SPSS 22.0对数据进行分析。结果 共收集山东省50家医疗机构非重复血培养来源金黄色葡萄球菌 3 661株,其中2017年675株、2018年870株、2019年1 080株、2020年1 036株。血培养来源甲氧西林耐药金黄色葡萄球菌（MRSA）组与甲氧西林敏感金黄色葡萄球菌（MSSA）组多种抗菌药物耐药率差异有统计学意义（P<0.05）;成人组与儿童组比较多种抗菌药物耐药率差异有统计学意义（P<0.05）。MRSA总体检出率为27.5%,未发现对万古霉素、利奈唑胺、替加环素耐药的金黄色葡萄球菌菌株。结论 MRSA菌株检出率持续下降,2020年有所升高;成人组MRSA检出率低于儿童组MRSA检出率,提示我们应该重视儿童组细菌耐药监测,重视多重耐药菌管理,合理使用抗菌药物。

Surveillance on drug resistance of Staphylococcus aureus from bloodstream infection in Shandong, 2017-2020

Objective To analyze the drug resistance of Staphylococcus aureus in blood samples of children and adults from 50 hospitals in Shandong Province, and to understand the drug sensitivity characteristics of Staphylococcus aureus bloodstream infection (BSI), so as to provide reference for clinical experience. Methods The distribution and drug resistance of Staphylococcus aureus isolated from blood samples from 50 hospitals in Shandong province from 2017 to 2020 were analyzed based on the Cooperative Research Network of Pediatric Bacterial and Fungal Resistance Monitoring in Shandong Province. Meanwhile, the drug sensitivity characteristics of Staphylococcus aureus were divided into children group (<14 years old) and adult group (≥14 years old). The data were analyzed by Whonet 5.6 and SPSS 22.0 with reference to CLSI 2021 M100 document standard judgment results. Results A total of 3 661 Staphylococcus aureus strains were collected from 50 medical institutions in Shandong Province, including 675 in 2017, 870 in 2018, 1 080 in 2019, and 1 036 in 2020. The drug resistance rates of multiple antibiotics in blood culture methicillin-resistant Staphylococcus aureus (MRSA) group and methicillin-sensitive Staphylococcus aureus (MSSA) group were significantly different (P<0.05). There were significant differences in antibiotic resistance rates between adult group and children group (P<0.05). The overall detection rate of MRSA was 27.5%, and no staphylococcus aureus strains resistant to vancomycin, linezolid and tigecycline were found. Conclusion The detection rate of MRSA strains decreased continuously and increased by 2020. The detection rate of MRSA in adult group was lower than that in children group, suggesting that we should pay attention to the monitoring of bacterial resistance in children group, to the management of multiple resistant bacteria and rational use of antibacterial drugs.