2010年度卫生部全国细菌耐药监测报告:肠杆菌科细菌耐药监测

Mohnarin report 2010:surveillance for antimicrobial resistance in Enterobacteriaceae

目的了解2010年度全国临床分离的肠杆菌科细菌对常用抗菌药物的耐药性。方法卫生部全国细菌耐药监测网成员单位,按照监测方案要求,收集临床分离肠杆菌科细菌,进行药物敏感性测试;根据CLSI 2010标准,判断敏感性,用Whonet 5.6软件处理数据。结果 2010年度全国6大地区129所医院参加了监测,共收集肠杆菌科细菌105 782株,分离量居前3位的依次为大肠埃希菌、肺炎克雷伯菌及阴沟肠杆菌,分别占44.7%、28.5%及9.2%;敏感性最高的抗菌药物为碳青霉烯类,亚胺培南对绝大多数细菌的耐药率均<10.0%;另外除志贺菌对美罗培南耐药率为8.8%外,其余各菌种对美罗培南耐药率均<5.0%;头孢噻肟不敏感的大肠埃希菌和肺炎克雷伯菌对各类抗菌药物的耐药率多高于敏感株。结论肠杆菌科细菌对抗菌药物呈现不同程度的耐药,碳青霉烯类抗菌药仍然是活性最高的药物,但已经出现耐药菌株,应引起足够的重视。

OBJECTIVE To investigate the antiraicrobial resistance of Enterobacteriaceae to antibiotics in China in 2010. METHODS All the clinical isolates of Enterobacteriaceae were collected and the Susceptibility tests of the isolates were performed by 129 hospitals around China from 1st Jan. 2010 to 31st Dec. 2010. The susceptibilities of the isolates to antimicrobial agents were determined by using CLSI （2010） guideline and the susceptibility data were processed with Whonet 5. 6 software . RESULTS A total of 105 782 Enterobacteriaceae isolates were collected by 129 hospitals from 6 parts of China in 2010, among all the isolates,the top 3 isolated pathogens were Escherichia coli （44.7 %）, followed by Klebsiella pneumonia （28.5 %）, and Enterobacter clacaer （ 9.2 ~//00 ）. The most sensitive antimicrobials were carbapenems. The resistant rates to imipenem of most bacteria were less than 10.0% ; the resistance rates to meropenem of other bacteria were less than 5.0~//0 except t^at the resistance rate to meropenem of Shigella was 8.8~/oo ; the resistant rates of cefotaxime-susceptible E. coli and If. pneumonia isolates to most tested antibiotics were lower than those of cefotaxime non-susceptible strains. CONCLUSION Enterobacteriaceae present various degrees of resistance to antimicrobial agents. Carbapenems remain to have the highest activity against Enterobacteriaceae, the emergence of drug resistant isolates should be attached great importance.