2009年中国CHINET铜绿假单胞菌细菌耐药性监测

CHINET 2009 surveillance of antimicrobial resistance in Pseudomonas aeruginosa in China

目的了解2009年我国不同地区铜绿假单胞菌临床分离株的耐药性和耐药特征,指导临床合理使用抗菌药物。方法对全国14所教学医院临床分离的4912株铜绿假单胞菌采用纸片扩散法(K-B法)进行药敏试验,按CLSI2009年标准判定药敏试验结果,并用WHONET5.4软件进行数据分析。结果 2009年14所医院从临床标本中共分离出4912株铜绿假单胞菌,其中91.9%分离自住院患者,73.6%的菌株分离自呼吸道标本。铜绿假单胞菌对阿米卡星的耐药率最低,为14.8%,对其他抗菌药物的耐药率均高于18%。昆明医学院第一附属医院分离株对各抗菌药物的耐药率均高于30%,除对头孢哌酮-舒巴坦、哌拉西林-他唑巴坦和头孢哌酮外,对其他10种抗菌药物的耐药率在14所医院中均为最高;北京医院和安徽医科大学第一附属医院分离的菌株对大多数抗菌药物的耐药率在35%左右,甘肃省人民医院分离株对抗菌药物(除庆大霉素和环丙沙星外)耐药率均低于10%;上海复旦大学附属儿科医院对各抗菌药物的耐药率均低于10%。泛耐药铜绿假单胞菌的检出率为1.7%。结论我国铜绿假单胞菌的耐药性与2007年相比基本相仿,略有减低,但总体仍处于较高水平。不同医院抗菌药物的耐药性相差较大。ICU仍是监控重点。我们应加强监测,指导临床合理使用抗菌药物并控制院内耐药菌的流行。

Objective To investigate the antimicrobial resistance of P.aeruginosa in China during 2009.Methods Clinical isolates of P.aeruginosa were collected from 14 teaching hospitals in China.Antimicrobial susceptibility was tested by Kirby-Bauer method.The data were analyzed by WHONET 5.4 software.Results Of the 4 912 clinical P.aeruginosa isolates,91.9% strains were isolated from hospitalized patients,and 73.6% were isolated from respiratory tract.The isolates showed the lowest resistance rate(14.8%)to amikacin.The resistance rates to other antimicrobial agents were above 18%.The resistance rates of the P.aeruginosa strains from Kunming Hospital were higher than 30% to most antibiotics,except cefoperazone-sulbactam,cefotaxime,cefoperazone and piperacillin-tazobactam.For the strains from Shanghai Pediatric Hospital,the resistance rate was less than 10% to each antimicrobial agent.The pan-resistant P.aeruginosa strains(only sensitive to colistin)accounted for 1.7%.Conclusions The antimicrobial resistance of P.aeruginosa is still a serious problem in China.The antimicrobial susceptibility pattern varied in different hospitals.ICU is still the focus of antibiotic resistance monitoring.The surveillance of antimicrobial resistance is very important for rational antimicrobial therapy.