卫生部全国细菌耐药监测网2010年女性尿标本细菌耐药监测

Ministry of Health National Antimicrobial Resistant Investigation Net 2010 annual report: Bacterial resistances monitor of women urine samples

目的总结我国2010年临床女性患者尿标本来源细菌耐药状况。方法用常规方法,培养分离卫生部全国细菌耐药性监测网(Mohnarin)所属129家医院2010年度女性尿标本中的细菌,用自动化临床微生物测定方法、纸片法或E-test法,测定细菌药物敏感性,用WHONET 5.6软件进行分析。结果共分离细菌21904株。其中排在前5位的依次为大肠埃希菌(51.47%)、粪肠球菌(7.66%)、屎肠球菌(7.59%)、肺炎克雷伯杆菌(6.82%)及奇异变形杆菌(3.55%)。对大肠埃希菌耐药率较低的抗生素,依次为碳青霉烯类(≤1.5%)、磷霉素(2.4%)、哌拉西林/他唑巴坦(3.5%)、头孢哌酮/舒巴坦(4.7%)、阿米卡星(7.4%)、呋喃妥因(6.9%)、头孢西丁(12.6%)及阿莫西林/克拉维酸(21.1%)。对肠球菌耐药率较低的抗生素,依次为利奈唑胺(0)、糖肽类(0.4%～5.1%)、磷霉素(6.7%～17.2%)及呋喃妥因(6.6%～47.9%)。结论泌尿系统感染的主要致病菌仍为大肠埃希菌;但肠球菌的比例明显升高。

Objective To summarize bacterial resistance in the women clinical urine culture samples collected in 2010 from 129 hospitals of Ministry of Health Antibiotic Resistance Monitoring Network （ Mohnarin）. Methods Conventional culture, automatic clinical microbiological system, disk diffusion and E - test methods were used for antibacterial activity of antimicrobial agents and resistances and sensitivity were calculated by using WHONET 5.6 software. Results A total of 21904 strains of bacteria were isolated, of which 51.47% of E. coli, Enterococcus faecalis （ 7.66% ）, Enterococcus faecium （ 7.59% ）, Klebsiella pneumonia （6. 82% ） and Proteus mirabilis （3.55%）, respectively. The antimicro- bial agents with lower antibiotic resistance rates of E. coli were carbapen- ems （ ~〈 1.5%）, fosfomycin （ 2. 4%）, piperacillin / tazobactam （3.5%） , cefoperazone/sulbactam （4. 7% ） , amikacin （7.4%） , nitro- furantoin （ 6.9% ） , cefoxitin （ 12.6% ） , and amoxicillin/clavulanic acid （21.1%）, respectively. That of Enterococcus spp. were linezolid （0）, glycopeptides （0. 4% - 5.1% ）, fosfomycin （6. 7% - 17.2% ） and nitrofurantoin （ 6. 6% - 47.9% ） , respectively. Conclusion E. coli remains the urinary tract infection major pathogen but the proportion of Enterococci was significantly increased.