四川省细菌耐药监测网2011年川东地区细菌耐药性监测数据分析

Sichuan Provincial of antimicrobial Resistant Investigation Net 2011 annual report:Bacterial drug resistance surveillance in East Sichuan

目的了解川东地区2011年临床分离菌株的耐药情况,指导临床更加合理使用抗菌药物。方法应用法国生物默里埃半自动(API)、全自动(VITEK)微生物分析系统或手工方法进行菌株鉴定和药敏试验,以美国实验室与标准化研究所(CLSI)2010年折点标准判定药物敏感性,用WHO NET 5.5软件进行数据分析。结果 2011年1～12月川东地区6家医院临床共收集3810株非重复菌株,其中革兰阴性菌2771株(占72.7%),革兰阳性菌1039株(占27.3%)。耐甲氧西林金葡菌和耐甲氧西林凝固酶阴性葡萄球菌的检出率分别为31.2%和84.4%。未发现万古霉素、利奈唑胺中介株或耐药株。有3株万古霉素耐药屎肠球菌及2株万古霉素耐药粪肠球菌。产ESBI的大肠埃希菌、克雷伯菌属在各菌属中分别占53.5%、33.5%。铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别为13.8%和15.6%。不动杆菌属对亚胺培南和美罗培南的耐药率分别为37.6%和42.7%。结论细菌耐药性不断增强,已出现多重耐药菌株。加强对细菌耐药性的定期监测,对正确选用抗菌药和控制耐药菌所到致感染十分重要。

Objective Investigate the distribution and the drug resistance of the pathogenic bacteria isolates from clinical specimen in East Sichuan and provide the reasonable usage of antibiotics in clinical treatment. Methods Using French Bio-Merieux semi-antomatic API, automatic microbiology analysis system VITEK or manual methods for strain identification and drug sensitive test to CLSI 2010 edition as standard ,with WHO NET5.5 software for data analysis. Results A total of 3810 bacterial isolates and their anti- bacterial susceptibility data were collected, which included 2771 （72.7%） Gram-negative bacterial strains and 1039 （27.2%） Gram- positive bacterial strains. Results Resistant Staphylococcus aureus （MRSA） and methieillin resistant coagulase negative Staphylococ- cus aureus（MRCNS） detection rates were 31.2% and 84.4% respectively. No vancomycin and linezolid . intermediary or resistant strains were found. There were 3 strains of Enterococcus faecalis and 2 strains of Enterocoecus faecium resistant to vancomycin. 53.5% of Eseheriehia eoli and 33.5% of Klebsiella pneumoniae isolates were the strains producing extended spectrum-13-1actamases （ ES- BLs）. Pseudomonas aeruginosa to imipenem and meropenem resistance rates werel3.8% andl5.6% respectively. Acinetobacter to imi- penem and meropenem resistance rates were 37.6% and 42.7% respectively. Conclusion Bacterial resistance was increasing in East Sichuan. Enhanced antimicrobial resistance surveillance need to be strengthened for understanding the trend of antimicrobial resistance and providing the guidance for clinical choosing of antimicrobial agents.