摘要
目的 了解2016—2022年首都医科大学附属北京儿童医院临床分离细菌的分布及耐药性。方法 对2016年1月1日—2022年12月31日住院患儿所有标本初次分离菌株采用纸片扩散法或自动化仪器法进行抗菌药物敏感性试验。应用WHONET 5.6和CLSI M100 2022年版本折点标准对药敏结果进行分析。结果 共分离菌株24 904株,革兰阳性菌和革兰阴性菌分别为49.4%和50.6%。革兰阳性菌前三位为金黄色葡萄球菌(15.6%)、凝固酶阴性葡萄球菌(14.0%)和肺炎链球菌(8.9%),革兰阴性菌分离前三位为克雷伯菌属(8.6%)、铜绿假单胞菌(8.6%)和流感嗜血杆菌(8.1%)。甲氧西林耐药金黄色葡萄球菌(MRSA)和甲氧西林耐药凝固酶阴性葡萄球菌(MRCNS)平均检出率为30.9%和82.7%。发现32株脑脊液分离的肺炎链球菌中有24株(75.0%)细菌对青霉素耐药。2 195株非脑脊液分离肺炎链球菌对青霉素的耐药率为2.6%。发现5株屎肠球菌和10株粪肠球菌对利奈唑胺耐药,2株屎肠球菌对万古霉素耐药。大肠埃希菌产超广谱β内酰胺酶(ESBL)的检出率为69.0%,碳青霉烯类耐药株检出率为9.7%。肺炎克雷伯菌ESBL的检出率为73.7%,碳青霉烯类耐药菌株的检出率为37.2%。碳青霉烯类耐药铜绿假单胞菌和鲍曼不动杆菌的检出率分别为21.9%、59.3%。流感嗜血杆菌β内酰胺酶检出率为68.3%。结论 儿童群体中多重耐药的形势严峻,应加强细菌耐药监测。根据药敏试验结果,合理使用抗菌药物,控制细菌耐药率的上升和耐药菌株的播散。
Objective To investigate the distribution and antibiotic resistance profiles of clinical isolates in Beijing Children's Hospital,Capital Medical University from 2016 to 2022.Methods All the strains isolated from inpatients in Beijing Children's Hospital during the period from 2016 to 2022 were analyzed.Antimicrobial susceptibility test was conducted by Kirby-Bauer method or automated system.Results were interpreted according to the breakpoints recommended in the CLSI M1002022 edition.Results A total of 24904 isolates were analyzed,including Gram-positive bacteria(49.4%)and Gram-negative bacteria(50.6%).The top three Gram-positive bacteria were Staphylococcus aureus(15.6%),coagulase-negative Staphylococcus(14.0%),and Streptococcus pneumoniae(8.9%).The top three Gram-negative bacteria were Klebsiella spp.(8.6%),Pseudomonas aeruginosa(8.6%),and Haemophilus infuenzae(8.1%).The prevalence of methicillin-resistant strains was 30.9%in S.aureus(MRSA)and 82.7%in coagulase-negative Staphylococcus(MRCNS).The prevalence of PRSP was 75.0%(24/32)in meningitis isolates and 2.6%(57/2195)in non-meningitis isolates.Five strains of E.faecium and 10 strains of E.faecalis were found resistant to linezolid.Two strains of E.faecium were resistant to vancomycin.The prevalence of extended-spectrum beta-lactamases(ESBLs)and carbapenem-resistant strains(CREco)in E.coli isolates was 69.0%and 9.7%,respectively.The prevalence of ESBLs and carbapenem-resistant strains(CRKpn)in K.pneumoniae isolates was 73.7%,and 37.2%,respectively.The prevalence of carbapenem-resistant strains was 21.9%in P.aeruginosa isolates and 59.3%in A.baumannii isolates.β-lactamase was detected in 68.3%of the H.infuenzae isolates.Conclusions Antimicrobial resistance is still serious in children.It is necessary to strength the surveillance of bacterial resistance and use antibiotics rationally in order to curb the spread of drug-resistant strains.
作者
吕志勇
董方
孟庆盈
甄景慧
周为
刘锡青
安璟云
LU Zhiyong;DONG Fang;MENG Qingying;ZHEN Jinghui;ZHOU Wei;LIU Xiqing;AN Jingyun(Department of Laboratory Medicine,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing100045,China)
出处
《中国感染与化疗杂志》
北大核心
2025年第1期59-69,共11页
Chinese Journal of Infection and Chemotherapy
基金
北京市自然科学基金-海淀原始创新联合基金项目(L202004)。
关键词
儿童
细菌
抗菌药物
细菌耐药监测
children
bacteria
antimicrobial agent
bacterial resistance surveillance
