Mohnarin 2008年度报告:非发酵革兰阴性杆菌耐药性监测

2008 Mohnarin report:Antibiotics resistance of non-fermenting Gram-negative bacilli

目的了解2008年度全国89家医院中非发酵革兰阴性杆菌的分布情况及对各类抗菌药物的耐药性。方法药物敏感性试验采用纸片扩散法,耐药性数据分析采用WHONET5.4软件进行统计分析。结果共收集非发酵革兰阴性杆菌分离株41956株,菌株数列前6位的菌种分别为假单胞菌属(46.8%)、不动杆菌属(35.1%)、嗜麦芽寡养单胞菌(10.3%)、伯克霍尔德菌属(2.8%)、金黄杆菌属(1.7%)和产碱杆菌属(1.3%)。铜绿假单胞菌对左氧氟沙星、头孢哌酮/舒巴坦、哌拉西林、环丙沙星、头孢吡肟、亚胺培南、哌拉西林/三唑巴坦、头孢他啶、美罗培南和阿米卡星的敏感性范围分布为从56.8%至72.8%。对碳青霉烯类不敏感的铜绿假单胞菌除对多黏菌素B、阿米卡星、头孢他啶和哌拉西林/三唑巴坦的敏感性分别为93.3%、51.8%、45.4%和41.1%外,其它抗菌药物的敏感率大多在40%以下。不动杆菌对亚胺培南和美罗培南的敏感率分别为60.1%和56.6%;头孢哌酮/舒巴坦为61.1%,米诺环素为66.7%。不动杆菌对本次研究中的其他抗菌药物耐药率高于46.5%。对碳青霉烯类不敏感鲍曼不动杆菌对其它所有药物的敏感性都很低,其中敏感性最高的米诺环素和头孢哌酮/舒巴坦的敏感性分别为54.6%和33.2%。嗜麦芽寡养单胞菌对米诺环素、复方磺胺甲噁唑和左氧氟沙星的敏感性分别为91.6%、81.7%和81.2%;洋葱伯克霍尔德菌对米诺环素、复方磺胺甲噁唑、头孢他啶和美罗培南的敏感性分别为66.1%、67.4%、65.2%和58.8%。结论全国细菌耐药性监测数据,为临床合理应用抗菌药物提供参考数据。

Objective To investigate the distribution and antibiotic resistance of clinical isolates nonfermenting Gram-negative bacilli in 89 China hospitals during 2008. Methods Antimicrobial susceptibility testing of clinical isolates was carried out by Kirby-bauer methods and data was analysed by WHONET5.4. Results A total of 41,958 clinical isolates of non-fermenting Gram-negative bacilli were collected in 2008. The top 6 pathogens were Pseudomonas spp.（46.8%）, Acinetobacter spp.（35.1%）, Stenotrophomonas maltophilia（10.3%）, Burkholderia spp. （2.8%）, Chryseobacterium spp.（1.7%）, Alcaligenes spp.（1.3%）. The susceptibility rates of Pseudomonas aeruginosa to levofloxacin, cefoperazone/sulbactam, piperacillin, ciprofioxacin, cefepime, ceftazidime, imipenem, piperacillin/ tazobactam, ceftazidime, meropenem and amikacin ranged from 56.8 % to 72.8%. The susceptibility rate of nonsusceptible to carbapenems Pseudomonas aeruginosa to other Antimicrobial agents was lower than 40%, except to polymyxin B, amikacin, ceftazidime, piperacillin/tazobactam was 93.3%, 51.8%, 45.4%, 41.1%. The susceptibility rate of Acinetobacter baumannii to imipenem and meropenem was 60.1% and 56.6%, cefoperazone/sulbactam 61.1%, Minocycline 66.7%, the resistance to other antimicrobial agents in this study was higher than 46.5%. The susceptibility rate of non-susceptible to carbapenems Acinetobacter baumannii was poor to all antimicrobial agents, the higher susceptibility rates of minocycline, cefoperazone/sulbactam was 54.6%, 33.2%. The susceptibility rate of Stenotrophomonas maltophilia to minocycline, trimethoprim/sulfamethoxazol and levofloxacin was 91.6%, 81.7% and 81.2%, respectively. The susceptibility rates of Burkholderia cepacia to minocycline, trimethoprim/sulfamethoxazol, ceftazidime and meropenem was 66.1%, 67.4%, 65.2% and 58.8%, respectively. Conclusion A nationwide surveillance data of bacterial resistance is most important and provided valuable reference data for rational selection of antimicrobial agents.