Mohnarin 2011年度全国细菌耐药监测

Mohnarin report of 2011:monitoring of bacterial resistance in China

目的掌握我国临床分离菌对常用抗菌药物的耐药性,指导抗菌药物临床应用。方法监测2011年1月1日-12月31日全国49所医院临床分离细菌耐药性,细菌敏感性测定采用纸片扩散法或自动化临床微生物测定方法,以Whonet 5.6软件进行数据分析。结果 49所医院按照监测方案共获得临床分离118 868株细菌,其中革兰阳性菌34 208株占28.8%,包括:葡萄球菌属20 894株,肠球菌属7977株和链球菌属4058株;革兰阴性菌84 660株占71.2%,其中大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌和不动杆菌分别为21 780、15 097、13 928株和12 165株;金黄色葡萄球菌、表皮葡萄球菌及溶血葡萄球菌耐甲氧西林的检出率分别为50.5%、82.6%及87.3%;在肠球菌属中屎肠球菌分离率已超过粪肠球菌,对糖肽类药物的耐药率基本与去年监测相似;对青霉素敏感肺炎链球菌为85.4%;大肠埃希菌和肺炎克雷伯菌中产ESBLs的检出率分别为71.2%和50.3%,肠杆菌科细菌对碳青霉烯类仍保持较高的敏感率,但与2010年相比略有下降;非发酵菌对碳青霉烯类的耐药率较高,鲍氏不动杆菌耐药率进一步增加。结论我国临床分离细菌耐药性较为严重,特别是产ESBLs肠杆菌科细菌、多药耐药非发酵菌等十分普遍。

OBJECTIVE To investigate the resistance of clinical isolates from hospitals in China so as to provide clinical reference in the use of antibacterial agents.METHODS All the bacterial susceptibility results from 49 tertiary hospitals around China from 1st Jan,to 31st Dec,2011 were collected by unified protocol and the data was processed with software WHONET 5.6.The sensitive results from both disc diffusion and automatic microbiological system methods were acceptable.RESULTS A total of 118 868 bacterial isolates and their antibacterial susceptibility data were collected during the survey period,which included 34 208（28.8%） strains of gram-positive bacteria and 84 660（71.2%） strains of gram-negative bacteria.Staphylococcus（20 894 strains）,Enterococcus（7977strains） and Streptococcus（4058 strains） were the top three gram-positive isolates,while Escherichia coli（21 780 strains）,Klebsiella spp（15 097 strains）,Pseudomonas aeruginosa（13928 strains） and Acinetobacter spp（13 592 strains） were the most common gram-negative isolates.The methicillin-resistant S.aureus,S.epidermidis and S.haemolyticus were 50.5%,82.6%,and 87.3%,respectively.The isolation rate of E.faecium was higher than that of E.faecalis,the drug resistance to the glycopeptide class of drugs was similar to the last monitoring;85.4% of S.pneumoniae strains were sensitive to penicillin.The detection rates of ESBLs-producing E.coli and K.pneumoniae were 71.2% and 50.3%,respectively.Enterobacteriaceae maintained the higher susceptibility to carbapenems,the drug susceptibility rate declined as compared with 2010.The non-fermenting bacteria were highly resistant to carbapenems,and the drug resistance rate of A.baumannii was increased.CONCLUSION The bacterial resistance of the clinical isolates is severe in China,especially the ESBLs-producing Enterobacteriaceae,and multidrug-resistant non-fermenting bacteria are prevalent.