Mohnarin 2008年度报告:胸水来源细菌耐药监测

2008 Mohnarin report:Bacterial distribution and resistance of thorax cavity infections

目的了解我国胸腔感染病原菌的分布及耐药状况。方法采用纸片法、MIC法或E-test法测定病原菌药物敏感性,使用WHONET5.5软件对卫生部全国细菌耐药性监测网(Mohnarin)所属89家三级甲等医院2008年1月1日～2008年12月31日分离的胸水标本菌株进行分析。结果①共有50家医院从胸水标本分离出病原菌共621株,其中革兰阳性菌317株,占51.1%,革兰阴性杆菌304株,占48.9%。②分离量前五位的细菌是金黄色葡萄球菌(11.6%)、大肠埃希菌(9.7%)、铜绿假单胞菌(7.4%)、表皮葡萄球菌(6.8%)、鲍曼不动杆菌和肺炎克雷伯菌(各占5.0%)。③MRSA、MRSCN检出率分别为50%、47.7%;产ESBL大肠埃希菌、肺炎克雷伯菌、产酸克雷伯菌阳性率分别为84.1%、29%、14.3%;未检出VRSA/VISA、未检出VRE。④各菌属耐药状况与全国本年度细菌耐药监测一致。结论我国胸腔感染病原菌最常见为葡萄球菌属;ICU病区以鲍曼不动杆菌和葡萄球菌属比例最高;儿童最常见肺炎链球菌感染;胸水中产ESBL大肠埃希菌检出率高。

Abstract Objective To determine the bacterial distribution and resistant to antibiotic in thorax cavity infections in China. Methods Disc diffusion test, MIC test or E-test were used to detect the antimicrobial sensitivity of bacterial isolates from pleural effusion samples. WHONET 5.5 was applied for analysis of the bacterial sensitive data from 89 tertiary Mohnarin member hospitals at different areas in China from Jan 1, 2008 to Dec 31, 2008. Results @621 organisms from pleural effusion were collected from 50 hospitals in the survey period, which included 317 （51.1%） Gram-positive strains, 304 （48.9%） Gram-negative bacilli. @The top five bacteria were Staphylococcus aureus （11.6%）, Escherichia coli（9.7%）, Pseudomonas aeruginosa（7.4%）, Staphylococcus epdermidis（ 6. 7% ）, Klebsiella pneumoniae（ 5.0% ） and Acinetobacter baumannii （5.0%）.@ Methicillin resistant Staphyloccus aureus （MRSA）and coagulase-negative Staphylococcus （MRCNS） accounted for 50% and 47.7% respectively. No Staphylococcus was found resistant or intermediary to vancomycin. No Enterococcus was found resistant to vancomycin. About 84.1% of Escherichia coli and 29% of Klebsiella pneumoniae, 14.3% of Klesiellia oxytoca were ESBL-producing strains. @ Antibiotic resistance in the organisms with the same national antimicrobial resistance monitoring during the year. Conclusions Staphylococcus spp. was the predominant organisms from pleural effusiom the proportion ofA. baumannii and Staphylococcus spp. were more common in intensive care unit （ICU）. S. pneumoniaee is the most proportion bacteria in department of pediatrics. The higher positive rate of ESBLsproducing E. coli was found in pleural effusion.