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山东大学学报 (医学版) ›› 2022, Vol. 60 ›› Issue (12): 88-93.doi: 10.6040/j.issn.1671-7554.0.2022.0752

• • 上一篇    

2016—2021年山东省11个地区摩根摩根菌的抗生素耐药变迁

孙薏丰1,17,李伟1,孙士营2,顾安曼3,谭胜楠4,傅勋业5,王海志6,纪建粉7,关于旺8,吴向前9,贺志成10,温招阳11,于尚嘉12,李世易13,刘兴红14,陈英15,王婷婷16,孙允东17   

  1. 1.山东大学齐鲁医院检验科, 山东 济南 250012;2.山东大学齐鲁医院青岛院区检验科, 山东 青岛 266035;3.山东第一医科大学附属省立医院感染管理办公室, 山东 济南 250021;4.乳山市人民医院检验科, 山东 乳山 264599;5.淄博市中西医结合医院检验科, 山东 淄博 255020;6.潍坊市第二人民医院检验科, 山东 潍坊 261041;7.临沭县人民医院检验科, 山东 临沭 276799;8.梁山县人民医院检验科, 山东 梁山 272699;9.北大医疗鲁中医院检验科, 山东 淄博 255499;10.北大医疗鲁中医院骨外二科, 山东 淄博 255499;11.滨州医学院第一临床医院检验科, 山东 滨州 256699;12.栖霞市人民医院检验科, 山东 栖霞 265399;13.荣成市中医院检验科, 山东 荣成 264399;14.招远市人民医院检验科, 山东 招远 265499;15.日照市人民医院检验科, 山东 日照 276827;16.宁津县人民医院检验科, 山东 宁津 253499;17.山东大学齐鲁医学院基础医学院病原生物学系, 山东 济南 250012
  • 发布日期:2022-12-01
  • 通讯作者: 孙允东. E-mail:syd@sdu.edu.cn
  • 基金资助:
    国家自然科学基金(82172313);山东省重点研发计划(2019GSF108130);山东省重大创新项目(2021GXGC011305)

Changes of antibiotic resistance rates of Morganella morganii in 11 regions of Shandong Province from 2016 to 2021

SUN Yifeng1,17, LI Wei1, SUN Shiying2, GU Anman3, TAN Shengnan4, FU Xunye5, WANG Haizhi6, JI Jianfen7, GUAN Yuwang8, WU Xiangqian9, HE Zhicheng10, WEN Zhaoyang11, YU Shangjia12, LI Shiyi13, LIU Xinghong14, CHEN Ying15, WANG Tingting16, SUN Yundong17   

  1. 1. Department of Clinical Laboratory, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;
    2. Department of Clinical Laboratory, Qilu Hospital(Qingdao)of Shandong University, Cheeloo College of Medicine, Qingdao 266035, Shandong, China;
    3. Department of Infection Management Office, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China;
    4. Department of Clinical Laboratory, Rushan Peoples Hospital, Rushan 264599, Shandong, China;
    5. Department of Clinical Laboratory, Zibo Integrative Medicine Hospital, Zibo 255020, Shandong, China;
    6. Department of Clinical Laboratory, Weifang No.2 Peoples Hospital, Weifang 261041, Shandong, China;
    7. Department of Clinical Laboratory, Linshu County Peoples Hospital, Linshu 276799, Shandong, China;
    8. Department of Clinical Laboratory, Liangshan County Peoples Hospital, Liangshan 272699, Shandong, China;
    9. Department of Clinical Laboratory, PKU Care Luzhong Hospital, Zibo 255499, Shandong, China;
    10. Department of Orthopedic Surgery, PKU Care Luzhong Hospital, Zibo 255499, Shandong, China;
    11. Department of Clinical Laboratory, The First School Clinical Medicine of Binzhou Medical University, Binzhou 256699, Shandong, China;
    12. Department of Clinical Laboratory, Qixia City Peoples Hospital, Qixia 265399, Shandong, China;
    13. Department of Clinical Laboratory, Rongcheng Hospital of Traditional Chinese Medicine, Rongcheng 264399, Shandong, China;
    14. Department of Clinical Laboratory, The Peoples Hospital of Zhaoyuan City, Zhaoyuan 265499, Shandong, China;
    15. Department of Clinical Laboratory, Peoples Hospital of Rizhao, Rizhao 276827, Shandong, China;
    16. Department of Clinical Laboratory, Ningjin County Peoples Hospital, Ningjin 253499, Shandong, China;
    17. Department of Pathogenic Biology, School of Basic Medical Science, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China
  • Published:2022-12-01

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摘要： 目的 分析山东省2016—2021年摩根摩根菌的抗生素耐药变迁趋势,了解摩根摩根菌耐药特征,为临床合理用药提供数据支持。 方法 回顾性分析2016—2021年山东省11个地区14家医院838株摩根摩根菌临床分离株的耐药数据。根据分离标本的组织来源不同,将摩根摩根菌分为泌尿系统(UT)组(n=271)、呼吸系统(RT)组(n=161)、皮肤软组织(SST)组(n=294)和其他组(n=112)。采用线性回归方法分析耐药率随时间的变化。采用Pearson χ2检验或Fisher精确检验分析组间差异。 结果 2016—2021年山东省摩根摩根菌对氨苄西林/舒巴坦的耐药率呈线性下降趋势(P=0.005),对头孢哌酮/舒巴坦的耐药率呈线性上升趋势(P=0.006)。2017—2020年山东省摩根摩根菌对左氧氟沙星的耐药率均高于全国水平(P<0.05)。UT组摩根摩根菌对阿米卡星、庆大霉素、妥布霉素、氨曲南、氨苄西林/舒巴坦、哌拉西林/他唑巴坦、复方新诺明、环丙沙星、左氧氟沙星的耐药率高于RT组(P均<0.05);对庆大霉素、头孢吡肟、氨曲南、哌拉西林/他唑巴坦、环丙沙星、左氧氟沙星的耐药率高于SST组(P均<0.05)。 结论 山东省摩根摩根菌对多种抗生素的耐药性普遍较高,其中对喹诺酮类抗生素的耐药性最高,各级医疗机构应加强对喹诺酮类药物的合理应用。推荐使用头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、头孢吡肟和阿米卡星作为治疗摩根摩根菌感染的一线药物。

关键词: 摩根摩根菌, 抗生素耐药, 氨基糖苷类, 喹诺酮类, 合理用药, 山东省

Abstract: Objective To investigate the changing trend of antibiotic resistance of Morganella morganii in Shandong Province from 2016 to 2021, and to explore the drug resistance characteristics, in order to provide data support for rational clinical use. Methods The drug resistance data of 838 clinical isolates of Morganella morganii from 14 hospitals in 11 regions of Shandong Province from 2016 to 2021 were retrospectively analyzed. According to the tissue sources, the isolated specimens were divided into urinary tract(UT)group(n=271), respiratory tract(RT)group(n=161), skin soft tissue(SST)group(n=294)and other groups(n=112). Linear regression was used to analyze the trend of drug resistance, and Pearson χ2 or Fishers exact test were used to analyze the differences among groups. Results From 2016 to 2021, the resistance rate of Morganella morganii to ampicillin/sulbactam showed a linear downward trend(P=0.005), while the resistance rate to cefoperazone/sulbactam showed a linear upward trend(P=0.006). The drug resistance rate of Morganella morganii to levofloxacin in Shandong Province from 2017 to 2020 was higher than that of the national level(P<0.05). The drug resistance rates of Morganella morganii in the UT group to amikacin, gentamicin, tobramycin, aztreonam, ampicillin/sulbactam, piperacillin/tazobactam, compound sulfamethoxazole, ciprofloxacin and levofloxacin were higher than those in RT group(all P<0.05). The resistance rates of Morganella morganii to gentamicin, cefepime, aztreonam, piperacillin/tazobactam, ciprofloxacin and levofloxacin in the UT group were higher than those in the SST group(all P<0.05). Conclusion In Shandong Province, the drug resistance of Morganella morganii to a variety of antibiotics is generally high, and the drug resistance to quinolones is the highest. Medical institutions at all levels should strengthen the rational application of quinolones. The use of cefoperazone/sulbactam, piperacillin/tazobactam, cefepime, and amikacin as first-line agents for the treatment of Morganella morganii infection is recommended.

Key words: Morganella morganii, Antibiotic resistance, Aminoglycosides, Quinolones, Rational drug use, Shandong Province

中图分类号: 

  • R446.5
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