摘要
目的统计分析广东省细菌耐药监测网2016年度细菌分布及耐药情况,为我省各单位合理应用抗菌药物提供依据。方法各单位严格按照监测要求,进行目标菌株鉴定,采用标准纸片扩散法或自动化仪器检测法测定监测药物对细菌敏感性,用WHONET 5.6软件进行数据分析。结果共有69家医院的218480株非重复细菌药敏试验信息纳入研究,包括革兰阴性菌150082株(68.7%)和革兰阳性菌68398株(31.3%)。革兰阳性菌中葡萄球菌属细菌占59.9%,其中耐甲氧西林金黄色葡萄球菌(methicillin-resistant Staphylococcus aureus, MRSA)检出率和耐甲氧西林凝固酶阴性葡萄球菌(methicillin resistant coagulasenegative staphylococci, MRCNS)菌株分离率分别为36.5%(8000/21906)和79.6%(13972/17535)。肠球菌属中粪肠球菌对多数测试抗菌药物(除了利奈唑胺和米诺环素外)的耐药率均显著低于屎肠球菌,两者对万古霉素耐药株分别为0.3%和1.5%。青霉素耐药的肺炎链球菌比例为2%。革兰阴性菌中分离率前3位分别为大肠埃希菌(31.1%)、克雷伯菌属(16.6%)和铜绿假单胞菌(15.2%)。大肠埃希菌对喹诺酮类药物耐药率高达44.6%以上,对头孢曲松和头孢噻肟的耐药率在52.3%以上。肺炎克雷伯菌对亚胺培南和美罗培南耐药率分别为3.8%和5.2%。铜绿假单胞菌对碳青酶烯类、氨基糖苷类、哌拉西林/三唑巴坦、头孢吡肟和头孢他啶等各种常用抗菌药物耐药率均在17%以下。鲍曼不动杆菌对大多数药物耐药率超过48.6%,其中对亚胺培南和美罗培南耐药率分别为60.4%和67.8%。2012—2016年本网各年监测数据比较,除耐药鲍曼不动杆菌(cabapemne resistant Acinetobacter baumannii,CRAB)呈缓慢上升外(从46.1%到60.4%),其余常见耐药菌保持稳定水平,肺炎克雷伯菌对亚胺培南耐药率呈低水平波动,介于2.3%~5.0%。结论近年我省细菌耐药菌的构成比以及常见临床分离菌株耐药水平基本持于平稳�
Objective To explore the bacterial drug resistance and its epidemic tendency in 2016 from the members of antimicrobial resistant surveillance of Guangdong province, and to guide the clinicians touse antimicrobial drugs rationally. Methods All the objective bacterial isolates were collected and identified by the unified protocol, and then the susceptibility data were analyzed by software WHONET 5.6. Results 218,480 bacterial isolates and their antibacterial susceptibility data were collected from all the 69 members of Antimicrobial Resistant Surveillance Network, which included 150,082 （68.7%） Gram-negative bacterial isolates and 68,398（31.3%） Gram-positive bacterial isolates. The detection rate of methicillin resistant Staphylococcus aureus （MRSA） and coagulase negative staphylococci （MRCNS） were 36.5% and 79.6% respectively. The prevalence of drug-resistant Enterococcusfaecalis was much lower than Enterococcusfaecium in most antimicrobial agents （except linezolid and minocycline）, while 0.3% E. faecalis and 1.5% E. faecium were resistant to vancomycin. 2.0% penicillin resistant Streptococcus pneumoniae were detected in this study. The top three populations of Gram-negative bacterial isolates were E. coli （31.1%）, Klebsiella （16.6%） and P. aeruginosa （15.2%）, respectively. E.coli had high resistance rates to quinolones （44.6%） and cefotaxime（52.7%）. The resistance rates of Klebsiella pneumoniae to imipenem and meropenem were 3.8% and5.2%, respectively. The resistant rates of P. aeruginosa to carbapenems, aminoglycosides, piperacillin/tazobactam, cefepime and ceftazidime were under 17.0%. The resistance rates of A. baumannii to most tested drugs were above 48.6%. The resistant rates of A. baumannii to imipenem and meropenem were 60.4% and 67.8%, respectively. Compared with the data from 2012 to 2016, most of organisms remained stable with low drug resistance except of CRAB, of which the resistant rate increased from 46.1% to 60.4%. Especially, the resistance rate of Klebsiel
作者
李晓雨
马明葱
谭云芳
唐翔
肖书念
卓超
Li Xiao-yu;Ma Ming-cong;Tan Yun-fang;Tang Xiang;Xiao Shu-nian;Zhuo Chao(The First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120)
出处
《中国抗生素杂志》
CAS
CSCD
2018年第10期1263-1270,共8页
Chinese Journal of Antibiotics
关键词
细菌耐药性监测
耐药率
细菌感染
Bacterial resistance surveillance
Resistance rate
Bacterial infection
