卫生部全国细菌耐药监测网2010年广东地区细菌耐药监测

Ministry of Health National Antimicrobial Resistant Investigation Net 2010 report:Bacterial distribution and resistance analysis in Guangdong of China

目的总结2010年广东地区细菌耐药性监测网所属25所医院临床分离株的耐药情况,明确广东地区的耐药特点。方法各单位采用纸片扩散法和MIC检测方法对48365株临床分离株作药敏试验,并以CLSI 2010年标准判断结果。结果 48365株细菌中革兰阳性菌占42.1%,革兰阴性菌占57.9%。耐甲氧西林金葡菌(MRSA)和耐苯唑西林凝固酶阴性葡萄球菌(MRSCoN)的检出率分别为57.2%和81.9%。未发现万古霉素中介株(VISA)或耐药株(VRSA)。肺炎链球菌(非脑膜炎分离株)对青霉素耐药率为0。肠杆菌科细菌对碳青霉烯类保持最低耐药性。对铜绿假单胞菌耐药率最低的依次是妥布霉素(8.8%)、左氧氟沙星(13.4%)和阿米卡星(15.2%)。对不动杆菌属耐药率最低的依次是米诺环素(17.3%)和头孢哌酮/舒巴坦(22.8%)。结论大肠埃希菌和克雷伯菌属对碳青霉烯类抗生素、头孢哌酮/舒巴坦和哌拉西林/他唑巴坦仍保持高度敏感性。不动杆菌属对碳青霉烯类耐药问题仍需注意。

Objective To investigate antimicrobial resistance of clinical isolates from 25 hospitals submitted to Guangdong surveillance of antimicrobial resistance in 2010. To learn the feature of bacterial resistance in Guangdong compared with the early local data and other districts in Chi- na. Methods Disc diffusion test （K -B methods） and MIC detection methods were employed to study the antimicrobial resistance. WHONET 5.4 was applied for analysis according to 2010 CLSI standard. Results Of 48365 clinical isolates, Gram negative bacilli and Gram positive cocci accounted for 57.9% and 42. 1% , respectively. The detection rates of methicillin resistant Staphylococcus aureus （ MRSA ） was 57.2% in S. aureus and 81.9% in coagulase negative Staphylococcus. No VISA or VRSA isolate was found. No penicillin - resistant isolate of S. pneumoni- ae isolates was detected according to 2010 CLSI criterion. All the isolates of Enterobacter kept the lowest resistance to carbapenem. The resistance rates of P. aeruginosa to tobramycin, levofloxacin and amikacin were 8. 8%, 13.4% and 15.2%. The resistance rates of A cinetobacter spp. to minocycline and cefoperazone/sulbactam were 17. 3% and 22. 8% respectively. Conclusion Carbapenems, cefoperazone/sulbactam and piperacillin/tazobactam are still highly active against Enterobacteriaceae. Emergence and spread of carbapenem - resistant isolates of Acinetobacter,is an area of great concern. It is urgent to enhance the community hospitals surveillance of bacterial resistance and various infection control measures.