摘要
目的了解2008年全国非ICU住院患者中临床分离的细菌对抗菌药物的耐药性。方法全国细菌耐药性监测网中各成员单位按方案规定收集所有的目标细菌,采用纸片法、MIC法或E-test法进行药物敏感性试验,依据2007年CLSI标准,采用WHONET5.4软件对数据进行分析。结果 2008年1-12月在非ICU住院患者中共收集到细菌9273株,其中革兰阴性菌株6155株(66.4%),革兰阳性菌3118株(33.6%),前5位细菌为大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌、凝固酶阴性葡萄球菌、肺炎克雷伯菌,分别占17.1%、11.7%、11.6%、10.5%、10.1%;金黄色葡萄球菌和凝固酶阴性葡萄球菌中耐甲氧西林菌株分别占59.7%和85.2%,金黄色葡萄球菌中未发现对万古霉素、替考拉宁耐药株,凝固酶阴性葡萄球菌出现少量替考拉宁中介和耐药株;粪肠球菌和屎肠球菌分别有4.2%和0.9%对万古霉素耐药,3.0%和0.5%对替考拉宁耐药,大肠埃希菌、肺炎克雷伯菌中产ESBLs菌株检出率分别为31.4%和17.4%,各种肠杆菌科细菌对亚胺培南和美罗培南均高度敏感,除褪色沙雷菌外,平均耐药率<6.0%,大肠埃希菌对喹诺酮药物的耐药率>60.0%;嗜麦芽寡养单胞菌对喹诺酮类、米诺环素的耐药率<20.0%。结论我国住院非ICU患者细菌以肠杆菌科、葡萄球菌属为主,耐药性明显,且呈增长趋势,监测结果对合理使用抗菌药物非常重要。
OBJECTIVE To investigate the antibacterial drug resistance of clinical isolates from non-ICU inpatients in China.METHODS Clinical isolates were collected by member hospitals of Mohnarin according to the unified protocol.Drug sensitivity test was carried out by using Kirby-Bauer（K-B）,MIC or E-test methods according to CLSI 2007.The data were analyzed by WHONET 5.4 software.RESULTS A total of 9273 clinical isolates from inpatients of non-ICU department in Mohnarin member hospitals were collected from Jan to Dec 2008,among which Gram-negative bacteria accounted for 6155（66.4%）,and Gram-positive cocci 3118（33.6%）.The Escherichia coli （17.1%）,Pseudomonas aeroginosa （11.7%）,Staphlococci aureus （11.6%）,coagulase-negative staphylococci（10.5%） and Klebsiella pneumoniae were the most common isolates.Meticilli-resistant strains in Staphlococci aureus（MRSA） and coagulase-negative staphylococci （MRCNS） accounted for 59.7% and 85.2%,respectively.There was no glycopeptide-resistant staphylococcus to be found,but a small part of coagulase-negative staphylococcus were teicoplanin-intermediate or drug-resistant strains.4.2% and 0.9% of respective Enterococcus faecalis and E.faecium isolates were resistant to vancomycin,3.0% and 0.5% resistant to teicoplanin.The detected rates of ESBLs-producing E.coli and K.pneumoniae were 31.4% and 17.4%,respectively,Enterobacteriaceae isolates were still highly sensitive to imipenem and meropenem,the average resistant rate was less than 6%,and more than 60.0% of E.coli isolates resistant to quinolones.The drug resistant rates of Stenotrophomonas maltophilia to quinolones and minocycline were below 20.0%.CONCLUSION Enterobacteriaceae and Staphylococcus are the predominant pathogens in non-ICU inpatients.Bacterial drug resistance is severe and shows an upward tendency.The surveillance result is very important for the rational application of antimicrobial agents.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2010年第16期2389-2392,共4页
Chinese Journal of Nosocomiology
