2009年中国CHINET鲍曼不动杆菌细菌耐药性监测

CHINET 2009 surveillance of antibiotic resistance in A. baumannii isolates in China

目的了解2009年我国不同地区14所医院临床分离鲍曼不动杆菌的耐药性。方法共收集14所教学医院临床分离的4163株鲍曼不动杆菌,按照统一方案,采用纸片扩散法进行药敏试验,结果按CLSI2010年版标准判读药敏试验结果,采用WHONET5.4软件进行数据分析。结果鲍曼不动杆菌对头孢哌酮-舒巴坦和米诺环素的耐药率最低,分别为26.3%和26.1%。对其他抗菌药物的耐药率均高于53.3%。对亚胺培南和美罗培南的耐药率分别为54.8%和57.2%。不同医院分离株对抗菌药物的耐药率不同,不同科室分离株对抗菌药的耐药率不同,其中以ICU分离株耐药率最高。出现较多多重耐药(44.4%,1848/4163)和泛耐药(17.0%,709/4163)鲍曼不动杆菌。结论鲍曼不动杆菌耐药性仍呈增长趋势,特别是多重耐药和泛耐药菌株。头孢哌酮-舒巴坦和米诺环素对鲍曼不动杆菌仍保持很好的抗菌活性。

Objective To investigate the antimicrobial resistance of A.baumanii strains isolated from patients in 14 hospitals(12 general hospitals and 2 children’s hospitals)in several regions of china during 2009.Methods A total of 4 163 clinical isolates of A.baumanii were collected from 14 teaching hospitals in China.Antimicrobial susceptibility testing was carried out by means of Kirby-Bauer method according to the unified protocol.The data were analyzed by WHONET 5.4 software according to CLSI 2009 breakpoints.Results A.baumanii isolates showed the lowest resistant rates(26.3% and 26.1% respectively)to cefoperazone-sulbactam and minocycline.The resistant rates to other antimicrobial agents were higher than 53.3%.The resistant rates to imipenem and meropenem were 54.8% and 57.2%,respectively.The antimicrobial resistant pattern varied in different hospital in china.The resistance of A.baumanii varied from one department to another.A number of pandrug-resistant(PDR)(17.0%,709/4 163)and multidrug-resistant(MDR)(44.4%,1 848/4 163)A.baumanii were found.Conclusions The antibiotic resistance of A.baumanii is still increasing,especially the MDR and PDR strains of A.baumanii.Cefo-perazone-sulbactam remains the most active agent against A.baumanii.