2023 年第 8 期 第 18 卷

2014—2021年海南省临床分离细菌的分布及其耐药性分析

Distribution and drug resistance of clinically isolated bacteria in Hainan province from 2014 to 2021

作者：程世超1陈林2陈少文2周晓君1李天娇1林翀2吴华1黄涛1

英文作者：Cheng Shichao1 Chen Lin2 Chen Shaowen2 Zhou Xiaojun1 Li Tianjiao1 Lin Chong2 Wu Hua1 Huang Tao1

单位：1海南省人民医院海南医学院附属海南医院检验科，海口570311；2海南医学院第二附属医院检验科，海口570216

英文单位：1Department of Laboratory Medicine Hainan General Hospital Hainan Affiliated Hospital of Hainan Medical University Haikou 570311 China; 2Department of Laboratory Medicine the Second Affiliated Hospital of Hainan Medical University Haikou 570216 China

关键词：细菌分布；耐药菌；耐药监测；多重耐药菌

英文关键词：Distributionofpathogenicbacteria;Drug-resistantbacteria;Drugresistancemonitoring;Multidrug-resistantbacteria

• 摘要：

• 目的 了解2014—2021年海南省临床标本中常见分离细菌的分布及耐药情况变迁，为海南省医疗机构临床抗菌药物的合理应用提供依据。方法 按照全国细菌耐药监测网技术方案分析参考折点和药物种类，利用WHONET 5.6软件对海南省32家全国细菌耐药监测网成员单位上报的数据进行分析。结果 2014—2021年海南省临床分离菌株中，革兰阳性菌占首位的为金黄色葡萄球菌，革兰阴性菌占首位的为大肠埃希菌。耐甲氧西林金黄色葡萄球菌的检出率呈现稳中有降的趋势，其对不同抗菌药物的耐药率分别为阿米卡星2.1%～22.6%、庆大霉素8.7%～27.6%、红霉素70.6%～84.3%、克林霉素46.3%～60.5%和利福平9.5%～18.5%，分别高于甲氧西林敏感金黄色葡萄球菌对应的耐药率（阿米卡星0.3%～2.3%、庆大霉素2.9%～6.2%、红霉素33.8%～45.1%、克林霉素16.1%～24.9%和利福平2.8%～6.1%）。耐万古霉素粪肠球菌和屎肠球菌检出率均呈下降的趋势；耐青霉素肺炎链球菌和耐亚胺培南铜绿假单胞菌的检出率均呈现下降的趋势；鲍曼不动杆菌对常规抗菌药物的耐药率呈现上升的趋势，尤其对头孢哌酮钠舒巴坦钠的耐药率增长最快（4.5%～35.0%）；类鼻疽伯克霍尔德菌对常规抗菌药物的耐药率较低。结论 2014—2021年海南省细菌谱的分布与国家监测的数据呈现不尽相同的特点，革兰阳性菌占首位的为金黄色葡萄球菌；革兰阴性菌对碳青霉烯类抗菌药物均有一定范围的耐药率；类鼻疽伯克霍尔德菌对常规抗菌药物呈现较高的敏感率。

• Objective To understand the changes in the distribution and drug resistance of common pathogens isolated from clinical specimens in Hainan province from 2014 to 2021, so as to provide a scientific basis for the rational application of clinical antibiotics. Methods  According to the technical plan of the China Antimicrobial Resistance Surveillance System, reference points and drug types were analyzed, and data reported by 32 members of the China Antimicrobial Resistance Surveillance System in Hainan province were analyzed using the WHONET 5.6 software. Results Among the clinical isolated strains in Hainan province from 2014 to 2021, Staphylococcus aureus was the most common Gram-positive bacteria, and Escherichia coli was the most common Gram-negative bacteria. The detection rate of methicillin resistant Staphylococcus aureus showed a steady downward trend. The drug resistance rates to amikacin, gentamicin, erythromycin, clindamycin and rifampicin were 2.1%-22.6%, 8.7%-27.6%, 70.6%-84.3%, 46.3%-60.5% and 9.5%-18.5%, respectively, which were higher than those of methicillin-sensitive Staphylococcus aureus (amikacin 0.3%-2.3%, gentamicin 2.9%-6.2%, erythromycin 33.8%-45.1%, clindamycin 16.1%-24.9% and rifampicin 2.8%-6.1%). The detection rates of vancomycin resistant Enterococcus faecalis and Enterococcus faecalis showed a downward trend; the detection rates of penicillin resistant Streptococcus pneumoniae and imipenem resistant Pseudomonas aeruginosa showed a downward trend; the resistance rate of Acinetobacter baumannii to conventional antibacterial drugs has shown an upward trend, especially to cefoperazone sodium and sulbactam sodium, with the fastest growth rate(4.5%-35.0%); Burkholderia pseudomallei has a low drug resistance rate to conventional antimicrobial agents. Conclusions    The distribution of bacterial spectrum in Hainan province from 2014 to 2021 was different from the national surveillance data. The most common Gram-positive bacteria was Staphylococcus aureus. Gram-negative bacteria had a certain range of drug resistance to carbapenems. Burkholderia pseudomallei showed high sensitivity to conventional antibiotics.