Mohnarin 2009年度报告:非发酵革兰阴性杆菌耐药监测

Mohnarin 2009 report:surveillance of antimicrobial resistance in nonfermenting gram-negative bacteria in China

目的监测卫生部全国细菌耐药监测网(Mohnarin)成员单位2009年度临床分离非发酵革兰阴性杆菌对常用抗菌药物敏感性。方法各成员单位即全国114家医院,按照监测方案要求进行目标细菌的收集、鉴定和药物敏感性测定并上报。负责单位依据2009年CLSI标准,用WHONET 5.5对收集到的监测资料,进行复核、分析及总结。结果共收集到临床分离非发酵革兰阴性杆菌54566株。其中,第1位为铜绿假单胞菌(23525株),占43.1%;其次为鲍曼不动杆菌,19801株,占36.3%。对铜绿假单胞菌敏感率高于70%的药物有多粘菌素、阿米卡星、哌拉西林/他唑巴坦、美罗培南和妥布霉素。除多粘菌素(敏感率93.2%)和米诺环素(敏感率65.4%)外,鲍曼不动杆菌对其他被测药物敏感率低于55%;对碳青霉烯类耐药率在47%左右。结论非发酵革兰阴性杆菌多重耐药已成为世界问题;急需加强细菌耐药监测,控制耐药菌的发展与传播。

Objective To investigate the antimicrobial resistance of nonfermenting gram-negative bacteria in China in 2009.Methods All the clinical stains of gram-negative nonfermenters were isolated and the susceptibility tests of the isolates were performed by 114 tertiary hospitals around China from 1st Jan.2009 to 31st Dec.2009.The susceptibilities of isolates to antimicrobial agents were determined by using CLSI（2009） guideline and the susceptibility data were processed with WHONET 5.5 software by centre laboratory.Results In 2009,a total of 54566 nonfermenting gram-negative bacteria susceptibility data were obtained.Among all the isolates,P.aeruginosa（23525 strains） outnumbered the other bacteria,accounting for 43.1%,followed by A.baumannii（19801 strains,36.3%）.Against P.aeruginosa,colistin,amikacin,piperacillin/tazobactam,meropenem and tobramycin were the only agents to which 〉70% of isolates were susceptible.No antibiotics,except colistin（93.2%） and minocycline（65.4%）,were active more than 55% against of A.baumannii.Resistance rates of carbarpenem against A.baumannii were about 47%.Conclusion Multidrug resistance nonfermenting gram-negative bacterial has been a worldwide challenge for healthcare management.Enhanced antimicrobial resistance surveillance need to be strengthened to block the further development and spread of resistant bacteria,promote judicious antimicrobial use.