2007年中国CHINET铜绿假单胞菌耐药性监测

CHINET 2007 surveillance of antimicrobial resistance in Pseudomonas aeruginosa in China

目的了解2007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12所教学医院临床分离的3988株铜绿假单胞菌采用纸片扩散法(K-B法)进行药敏试验,按CLSI2007年标准判定药敏结果,并用WHONET 5.4软件进行数据分析。结果2007年12所医院从临床标本中共分离出3988株铜绿假单胞菌,其中94.3%自住院患者中分离,76.2%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18.7%,对其他抗菌药物的耐药率均高于20%。上海华山医院的临床分离株除头孢哌酮-舒巴坦外,对其他抗菌药物的耐药率均高于30%,北京医院除对阿米卡星和环丙沙星外,对其他各抗菌药物的耐药率均高于39%,上海儿科医院对各抗菌药物的耐药率均低于10%,甘肃省人民医院除庆大霉素和环丙沙星外,对其他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3.2%。结论我国铜绿假单胞菌的耐药性仍处于较高水平,不同医院抗菌药物的耐药性相差较大,应加强监测,指导临床合理使用抗菌药物并控制医院耐药菌感染的流行。

Objective To investigate the antimicrobial resistance of P. aeruginosa in China during 2007. Methods Clinical isolates of P. aeruginosa from 12 teaching hospitals in China were collected and antimicrobial susceptibility were tested by K-B method. The data were analyzed by WHONET 5. 4 software. Results Of 3 988 clinical P. aeruginosa isolates, 94.3% were from the hospitalized patients, 76.20/00 from respiratory tract. The P. aeruginosa isolates showed the lowest resistance rate （18. 7%） to amikacin. The resistance rates to other antimicrobial agents were higher than 20%. The resistance rates of the P. aeruginosa strains from Shanghai Huashan Hospital were higher than 30% to most antibiotics except cefoperazone-sulbactam. For the strains from Shanghai Pediatric Hospital, the resistance rates to each of the antimicrobial agents were lower than 10%. The pan-resistant P. aeruginosa strains （only sensitive to colistin） accounted for 3.2%. Conclusions The antimicrobial resistance of P. aeruginosa is still a serious problem in China. The antimicrobial susceptibility pattern varied in different hospitals. The surveillance of antimicrobial resistance is very important for guiding rational antimicrobial therapy.