摘要
目的了解我国门急诊患者分离菌对抗菌药物的耐药状况。方法采用纸片、MIC或E-test法测定细菌药物敏感性,使用WHONET5.4软件进行数据分析,对卫生部全国细菌耐药性监测网(Mohnarin)所属89所三级甲等医院2008年1月1日-12月31日门急诊来源的细菌药物敏感性进行分析。结果共分离病原菌10415株,包括革兰阳性菌4233株(41.0%)、革兰阴性菌6182株(59.0%),其中大肠埃希菌分离最多为2369株(22.7%),其次为凝固酶阴性葡萄球菌1674株(16.1%)、肠球菌属细菌853株(8.2%)、金黄色葡萄球菌807株(7.7%)和铜绿假单胞菌780株(7.6%);耐甲氧西林金黄色葡萄球菌和凝固酶阴性葡萄球菌的检出率分别为66.9%和74.0%,未发现耐万古霉素金黄色葡萄球菌和凝固酶阴性葡萄球菌;粪肠球菌和屎肠球菌中分别有0.7%和3.8%对万古霉素耐药,0.8%的屎肠球菌对替考拉宁耐药;链球菌属主要对大环内酯类与克林霉素耐药,酿脓链球菌对左氧氟沙星耐药率>30.0%;嗜血菌属对氨苄西林耐药率>30.0%;大肠埃希菌和肺炎克雷伯菌产ESBLs的阳性率分别为27.1%和14.5%,低于同期整体监测水平;铜绿假单胞菌对各种抗菌药物的耐药率低于同期整体监测水平。结论我国门急诊来源致病菌以葡萄球菌属、大肠埃希菌、肠球菌属和金黄色葡萄球菌多见;儿童以革兰阳性菌为主,成人则以革兰阴性菌为主;门急诊来源的大肠埃希菌和肺炎克雷伯菌产ESBLs阳性率均较同期整体水平偏低。
OBJECTIVE To explore the bacterial drug resistance in outpatients and emergency patients in China.METHODS Disc diffusion test,MIC test and E-test were used to detect the antimicrobial sensitivity of bacterial isolates from outpatients and emergency patients.WHONET 5.4 was applied for analyzing the bacterial sensitive data from 89 tertiary care Mohnarin member hospitals in China from Jan 1,2008 to Dec 31,2008.RESULTS A total of 10 415 strains of pathogens were isolated in the survey period,which included 4233 （41.0%） Gram-positive strains and 6182 （59.0%） Gram-negative strains.Escherichia coli （2369 strains,22.7%）,coagulase-negative staphylococci （1674 strains,16.1%）,Enterococcus （853 strains,8.2%）,Staphylococcus aureus （807 strains,7.7%） and Pseudomonas aeruginosa （780 strains,7.6%） were the most common isolates.The detected rates of the meticillin-resistant S.aureus and coagulase-negative staphylococci were 66.9% and 74.0%,respectively;no glycopeptides-resistant Staphylococcus were detected.The resistant rates of Enterococcus faecalis and E.faecium to vancomycin were 0.7% and 3.8%,respectively,0.8% of E.faecium were resistant to teicoplanin.Streptococcus were mainly resistant to macrolides and clindamycin and the resistant rates of β-hemolytic streptococcus and Streptococcus pyogenes to levofloxacin were over 30.0%;The resistant rates of Hamophilus influenzae to ampicillin were over 30.0%;The ESBLs positive rates of E.coli and K.pneumoniae were 27.1% and 14.5%,respectively,and were lower than the results of overall bacteria survey.The resistant rates of P.aeruginosa were lower than the results of overall bacteria collection survey.CONCLUSION E.coli,coagulase-negative staphylococci,Enterococcus and S.aureus are the predominant pathogens isolated from outpatients and emergency patients in China;Grampositive bacteria are most common in children,while Gram-negative in adults.ESBLs positive rates ofE.coliandK.pneumoniaeare lower than that of the overall bacteria collection surveillance.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2010年第16期2393-2398,共6页
Chinese Journal of Nosocomiology
关键词
全国细菌耐药性监测网
门急诊
细菌分布
耐药
抗菌药物监测
Mohnarin
Outpatients and emergency patients
Bacterial distribution
Resistance
Antibacterial agents
Surveillance
