摘要
目的掌握全国细菌耐药状况与发展趋势,指导抗菌药物临床应用。方法方法监测2010年1月1日-12月31日全国59所医院临床分离细菌耐药性;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。结果按照监测方案,59所医院共获得131 668株细菌对抗菌药物的药物敏感结果,其中革兰阳性菌39 506株,占30.0%,包括24 672株葡萄球菌属、9942株肠球菌属及4439株链球菌属;革兰阴性菌92 162株,占70.0%,其中大肠埃希菌、克雷伯菌属及不动杆菌属分别为22 955、16 167株及15 505株;耐甲氧西林金黄色葡萄球菌与耐甲氧西林表皮葡萄球菌的检出率分别为53.4%、68.3%,较2008年度有所减少;对青霉素敏感的肺炎链球菌的检出率为89.4%;肠杆菌属细菌对大多数被测抗菌药物的敏感率<50.0%,其中大肠埃希菌对头孢曲松耐药率67.6%,对喹诺酮类抗菌药物的耐药率>65.0%;非发酵菌对碳青霉烯类抗菌药物的耐药率为16.8%～56.5%,鲍氏不动杆菌对抗菌药物的耐药率进一步增加。结论全国临床分离细菌的耐药现象较为普遍且耐药率仍呈上升趋势,特别是产ESBLs肠杆菌科细菌、多药耐药非发酵菌等十分普遍,但耐甲氧西林葡萄球菌的检出率有下降趋势。
OBJECTIVE To get information about bacterial resistance and its epidemic trend for clinical reference in the use of antibacterial agents. METHODS All the bacterial susceptibility results from 59 tertiary hospitals around China from 1st Jan,to 31st Dec,2010 were collected by unified protocol and the data was processed with software WHONET 5.4.The sensitive results from both disc-diffusion and automatic microbiological system methods were acceptable. RESULTS A total of 131 668 bacterial isolates and their antibacterial susceptibility data were collected during the survey period,which included 39 506（30.0%） Gram-positive and 92 162（70.0%） Gram-negative bacterial strains.Staphylococcus（24672 strains）,Enterococcus（9942 strains） and Streptococcus（4439 strains） were the top three Gram-positive isolates,while Escherichia coli（22 955 strains）,Klebsiella spp（16 167 strains） and Acinetobacter spp（15 505）were the most common Gram-negative isolates.Methicillin-resistant Staphylococcus aureus（MRSA） and S.epidermidis were 53.4% and 68.3%,respectively,which were less than those of 2008.89.4% of S.pneumoniae was penicillin sensitive.Glycopeptides-resistant Enterococcus was rare.Less than 50% of E.coli and other Enterobacteria were susceptible to most of the agents monitored;quinolone-resistant E.coli was over 65.0% and the resistance of E.coli to ceftriaxone was 67.6%.the resistance rates of glucose non-fermented bacteria to meropenem and imipenem were 16.8%-56.5%,and the resistant rate of A.baumannii kept an increasing trend. CONCLUSION The resistance of clinical isolates in China is severe and keeps an upward tendency.ESBLs-producing Enterobacteriaceae and multidrug-resistant non-fermented bacteria,in particular,are dominont problems but the detection rate of methicillin-resistant Staphylococcus is at a downward trend.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2011年第23期4896-4902,共7页
Chinese Journal of Nosocomiology
