摘要
目的掌握我国细菌耐药状况与发展趋势,指导抗菌药物临床应用。方法监测2008年1月1日-12月31日全国89所医院临床分离细菌耐药状况,细菌敏感性测定采用标准纸片扩散法或自动化临床微生物测定方法 ,以Whonet5.4软件进行数据分析。结果 89所医院按照监测方案共获得临床分离157813株细菌敏感性结果 ,其中革兰阳性菌50856株,占31.7%,包括葡萄球菌属32378株,肠球菌属12127株和链球菌属5138株;革兰阴性菌106957株,占68.3%,其中大肠埃希菌、铜绿假单胞菌和肺炎克雷伯菌分别为26957、18347、16396株,耐甲氧西林金黄色葡萄球菌与表皮葡萄球菌的发生率分别为67.6%和83.2%;耐青霉素肺炎链球菌比率为3.8%;大肠埃希菌、肠杆菌属对大多数被测药物耐药率>40.0%,其中大肠埃希菌对三代(包括头孢他啶)、四代头孢菌素耐药率>60.0%,对喹诺酮类耐药率>70.0%,产超广谱β-内酰胺酶比率为56.0%;非发酵菌对碳青酶烯类的耐药率24.8%～41.7%,鲍氏不动杆菌耐药率超过铜绿假单胞菌。结论我国临床分离细菌耐药现象较为普遍且耐药率仍呈上升趋势,特别是耐甲氧西林葡萄球菌、产超ESBLs肠杆菌科细菌、多药耐药非发酵菌等十分普遍。
OBJECTIVE To get information about bacterial resistance and its epidemic trend for clinical reference in the use of antibacterial agents.METHODS All of the bacterial susceptibility results from 89 tertiary care hospitals around China from Jan 1 to Dec 31,2008 were collected by unified protocol and the data were analyzed by software WHONET 5.4.The Disc-diffusion or automatic clinical microbiological system method was used for the bacterial sensitivity.RESULTS A total of 157 813 bacterial isolates and their antibacterial susceptibility data were collected during the survey period in 89 tertiary hospitals,which included 50 856 （31.7%） Gram-positive bacterial strains and 106 957（68.3%） Gram-negative bacterial strains.Staphylococcus （32 378 strains）,Enterococcus （12 127 strains） and Streptococcus （5138 strains） were the top three Gram-positive isolates,while Escherichia coli （26 957 strains）,Pseudomonas aeruginosa （18 347 strains） and Klebsiella pneumoniae （16 396 strains） were the most common Gram-negative isolates.The incidences of meticillin-resistant Staphylococcus aureus （MRSA） and S.epidermidis were 67.6% and 83.2%,respectively;3.8% of S.pneumoniae were penicillin resistant.More than 40.0% of E.coli and other enterobacteria were resistant to most of the antibiotics,quinolone-resistant rate of E.coli was over 70.0% and 56.0% of the E.coli produced extended spectrum β-lactamases （ESBLs）,the drug resistance rates of E.coli against the third and fourth generation cephalosporin （including ceftazidime） were higher than 60.0%.The drug resistance rates of non-fermented bacteria to meropenem were 24.8%-41.7%,and the drug resistance rate of Acinetobacter baumannii was higher than that of P.aeruginosa.CONCLUSION The clinical isolation phenomenon of bacterial drug resistance is universal and the drug resistance rate keeps an upward tendency in China,especially MRSA,ESBLs-producing enterobacteria and multidrug-resistant non-fermented bacteria are most common.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2010年第16期2377-2383,共7页
Chinese Journal of Nosocomiology
