全国细菌耐药监测网2014-2019年临床伤口及脓液标本细菌耐药监测报告

目的 分析全国细菌耐药监测网成员单位患者伤口、脓液标本来源细菌分布及对临床常用抗菌药物的敏感性和耐药性.方法 对全国细菌耐药监测网成员单位2014-2019年伤口及脓液标本来源细菌的药敏数据进行分析,药敏试验结果依据美国临床实验室标准化协会(CLSI)标准判读,应用WHONET 5.6软件进行药敏结果分析.结果 201...

Antimicrobial resistance of bacteria from wound and pus specimens:surveillance report from China Antimicrobial Resistance Surveillance System in 2014-2019

Objective To analyze the distribution as well as antimicrobial susceptibility and resistance of bacteria isolated from wound and pus specimens from member hospitals of China Antimicrobial Resistance Surveillance System(CARSS). Methods Antimicrobial susceptibility testing data of bacteria from wound and pus specimens from member hospitals of CARSS in 2014-2019 were analyzed, antimicrobial susceptibility testing results were interpreted according to Clinical and Laboratory Standards Institute (CLSI) and analyzed by WHONET 5.6 software. Results A total of 1 182 888 bacterial strains from wound and pus were isolated in 2014-2019, the top 5 bacteria were Escherichia coli (27.8%), Staphylococcus aureus (21.0%), Klebsiella pneumoniae (9.0%), Pseudomonas aeruginosa (6.7%), and Staphylococcus epidermidis (3.8%). In 2014-2019, isolate rates of methicillin-resistant Staphylococcus aureus (MRSA) were 30.8%, 30.0%, 29.9%, 29.4%, 27.4% and 26.9% respectively, isolate rates of methicillin-resistant coagulase negative Staphylococcus (MRCNS) were 75.2%, 76.1%, 73.0%, 72.1%, 71.3% and 71.0% respectively, linezolid- and vancomycin-resistant Staphylococcus were not found. Resistance rates of Enterococcus faecium to common antimicrobial agents were significantly higher than those of Enterococcus faecalis, resistance rates of Enterococcus faecalis and Enterococcus faecium to vancomycin were 0.2%-0.7% and 0.7%-2.0% respectively, to linezolid were 1.4%-2.3% and 0.4%-1.5% respectively, and to teicoplanin were 0.3%-0.7% and 0.9%-1.9% respectively. Resistance rate of Streptococcus pneumoniae to penicillin decreased from 8.1% in 2015 to 1.4% in 2019, vancomycin- and linezolid-resistant Streptococcus pneumoniae was not found. Resistance rates of Escherichia coli to cefotaxime and ceftriaxone were both above 50% in 2014-2016, slightly lower than 50% in 2017-2019, resistance rate to quinolones was>38%, to trimethoprim-sulfamethoxazole was above 58%, and susceptibility rates to imipenem and meropenem were the highest, both were higher than 98%, followed by cefoperazone/sulbactam (>83%). Resistance rates of Klebsiella pneumoniae to ceftriaxone, cefotaxime, quinolones, and trimethoprim-sulfamethoxazole were all lower than those of Escherichia coli, but resistance rate to carbapenems was higher than that of Escherichia coli, resistance rate to cefoperazone/sulbactam was <10%. Resistance rates of Pseudomonas aeruginosa to cefoperazone/sulbactam, ceftazidime, cefepime, imipenem, meropenem, and ciprofloxacin were all <15%, to amikacin were all <10%, the overall resistance rate of Acinetobacter baumannii was higher than that of Pseudomonas aeruginosa, resistance rates to cefepime, imipenem, meropenem and ciprofloxacin were all >47%, while resistance rates to minocycline was <25%. Conclusion Pathogens isolated from wound and pus are mainly Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae and Pseudomonas aeruginosa, antimicrobial resistance rate of bacteria is high, change of antimicrobial resistance of bacteria from wound and pus should be surveilled regularly to provide basis for rational use of antimicrobial agents and clinical treatment experience.