Mohnarin 2008年度报告:关节感染病原菌分布及耐药监测

2008 Mohnarin report:Bacterial distribution and resistance in joint infections

目的了解我国关节感染的细菌分布及耐药状况。方法采用纸片法、MIC法或E-test法,使用WHONET5.4软件进行分析,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日至2008年12月31日从关节感染标本中分离的菌株进行分析。结果共分离菌株523株,其中革兰阳性菌256株(48.9%),革兰阴性菌267(51.1%)株。位于前5位的病原菌为大肠埃希菌(16.8%)、表皮葡萄球菌(14.0%)、金黄色葡萄球菌(11.5%)、溶血葡萄球菌(7.3%)和粪肠球菌(7.3%);未发现对万古霉素中介或耐药的金黄色葡萄球菌;但发现3株万古霉素耐药粪肠球菌(VRE),粪肠球菌对万古霉素的中介率为4.2%。大肠埃希菌和肺炎克雷伯菌超广谱β-内酰胺酶(ESBLs)阳性检出率分别为65.9%与10%。结论我国关节感染主要致病菌为大肠埃希菌为代表的肠杆菌科细菌和葡萄球菌属。

Objective To determine the bacterial distribution and resistant to antibiotic in joint infections in China. Methods Disc diffusion test, MIC test and E-test were used to study the antimicrobial resistance. WHONET 5.4 was applied for analysis the antibacterial sensitive data from 89 tertiary hospitals of Mohnarin at different area in China from Jan 1, 2008 to Dec 31, 2008. Results A total of 523 pathogenic strains were collected from joint infections, with Gram-positive cocci 256 strains（48.9%） and Gram-negative bacilli 267（51.1%）. The top five pathogens were E. coli（16.8%）, S. epidermidis（14.0%）, S. aureus（11.5%）, S. haemolyticus（7.3%） and E. faecalis（7.3%）. No S. aureus strain was intermediate or resistant to vancomycin. Three E. faecalis strains were resistant to vancomycin, 4.2% was intermediate to vancomycin. 65.9% of E. coli and 10.0% K. pneumonia were ESBLs producers. Conclusion Staphylococcus and Enterobacteriaceae such as E. coli were predominant organisms in joint infections in China.