2010年度卫生部全国细菌耐药监测报告:血流感染细菌耐药监测

Mohnarin report 2010:surveillance for resistance of bacteria causing bloodstream infection

目的了解血流感染病原菌分布及其耐药性。方法监测2010年度全国129所医院血标本,来源细菌药敏结果采用CLSI 2010年标准判读,利用WHONET5.6软件进行药物敏感性分析。结果共获得22 747株病原菌,其中革兰阳性菌11 356株,占49.9%,革兰阴性菌11 391株,占50.1%;最常见细菌依次为凝固酶阴性葡萄球菌、大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球及鲍氏不动杆菌;耐甲氧西林金黄色葡萄球菌和凝固酶阴性葡萄球菌的检出率分别为46.6%和80.1%,未发现耐万古霉素葡萄球菌;粪肠球菌和屎肠球菌对万古霉素耐药率分别为0.7%和5.0%,未发现耐利奈唑胺肠球菌属;耐青霉素肺炎链球菌检出率为7.0%;大肠埃希菌和肺炎克雷伯菌对亚胺培南耐药率为4.6%和9.1%,对美罗培南耐药率为1.4%和5.8%;铜绿假单胞菌对碳青霉烯类的耐药率约为20.0%,鲍氏不动杆菌耐药率超过铜绿假单胞菌。结论 2010年度血培养分离细菌耐药现象较为普遍,但较上年度无明显上升趋势。

OBJECTIVE To get information about bacterial distribution and resistance of bacteria causing bloodstream in{ection. METHODS Totally 129 hospitals in China here kept under surveillance in 2010 , the results of drug susceptibility of the bacteria from blood samples were judged by CLSI 2010, the drug susceptibility was analyzed by software WHONET 5.6. RESULTS A total of 22 747 bacterial isolates were obtained, which included 11 391 （50. 1%） Gram-negative bacterial isolates and 11 356 （49. 9~） Gram-positive bacteria[ isolates. Coagulase-negative Staphylococcus, Escherichia col[, Klebsiella pneumoniae, Staphylococcus aureus and Acineto- bacter baurnannii were the most common isolates. The detection rates of meticillin-resistant S. aureus（MRSA） and coagulase-negative Staphylococeus（MRSCN） were 46.6 ~ and 80.1 ~, respectively; No vancomycin-resistant Staphylococcus strains were found. The resistance rates of Enterococcus faecalis and Enterococcus faecium to vancomycin were 0. 7~~ and 5. 0N, respectively. No linezolid-resistant Enterococcus were found; the detection rate of penicillin-resistant S. pneumoniae （PRSP） was 7.0 ~; the resistance rates to imipenem and mero＇penem of E. col[ and K. pneumoniae isolates were 4.6~//0, 1.4~//an and 9.1~~, 5.8~~0, respectively; the resistance rate of Pseudomonas aeruginosa to carbapenems was around 20.0% ,while the drug resistance rate of A. baumannii was higher than that of P. aeruginosa. CONCLUSION Drug resistance of bacteria isolated from blood culture is universal, but there is no significant upward tendency compared with that of last year.