2010年度卫生部全国细菌耐药监测报告:非ICU住院感染患者细菌耐药监测

Mohnarin report 2010:surveillance of antimicrobial resistance of clinical isolates from Non-ICU inpatients

目的了解全国2010年非ICU住院患者临床分离细菌分布及耐药性。方法收集2010年1月1日-12月31日全国129所医院非ICU住院患者临床分离细菌药物敏感性试验数据,根据2010年美国临床实验室标准化研究所标准,用WHONET 5.6软件进行数据分析。结果共获得临床分离菌216 872株,其中革兰阴性菌152 351株,占70.2%;革兰阳性菌64 521株,占29.8%;最常见的细菌依次为大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、鲍氏不动杆菌和金黄色葡萄球菌;耐甲氧西林金黄色葡萄球菌与凝固酶阴性葡萄球菌的检出率分别为52.1%、83.8%;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0.6%和3.3%,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10.7%;有5.9%和1.8%大肠埃希菌及9.1%和3.5%肺炎克雷伯菌对亚胺培南和美罗培南耐药;铜绿假单胞菌对碳青霉烯类抗菌药物的耐药率约为20.0%,鲍氏不动杆菌耐药率超过铜绿假单胞菌。结论我国非ICU住院患者感染致病细菌耐药现象仍较为普遍,但同上年度相比,多数细菌耐药率未呈上升趋势。

OBJECTIVE To investigate the bacterial distribution and antimicrobial resistance of clinical isolates from non-ICU inpatients in China. METHODS The data of drug susceptibility testing of clinical isolates from non-ICU inpatients in 1-9 hospitals form Jan 1 to Dec 31, 2010 were collected. The susceptibilities of isolates to antimicrobial agents were determined by CLSI 2010 guideline and the data were analyzed by WHONET 5. 6 software. RESULTS A total of 216 872 clinical isolates were obtained, which included 152 315 （70.2%） gramnegative bacterial isolates and 64 521 （29. 8%） gram-positive bacteria isolates. Escheichia coli, Pseudomonas aeroginosa, Klebsiella pneurnoniae,Acinetobacter baumannii and Staphylococcus aureus were the most common isolates. The detection rates of methiciIlin-resistant S. aureus （MRSA） and coagulase-negative Staphylococcus （MRSCNS） were 52.1% and 83.8%, respectively; No vancomycin-resistant Staphylococcus strains were found, the resistance rates of E. faecalis and Enterococcus faecium to vancomyein were 0.6% and 3.3 %, respectively. No linezolid-resistant Enterococcus isolates were found; the detection rate of penicillin-resistant Streptococcus pneumoniae （PRSP） was 10.7% ; there were 5.9% and 1.8% of E. coli as well as 9.1% and 3.5% of K. pneumoniae isolates resistant to imipenem and meropenem. The resistance rate of P. aeruginosa to carbapenems was 20.0% ,while the drug resistance rate of A. baumannii was higher than that of P. aeruginosa. CONCLUSION Drug resistance of pathogenic bacteria from nonqCU inpatients is universal in China, but compared with that of last year, the drug resistance rate of most isolates does not present an upward trend.