2010年度卫生部全国细菌耐药监测报告：0-14岁儿童细菌耐药监测分析

Mohnarin annual report 2010:surveillance for bacterial resistance among children 0-14 years of age

目的了解我国2010年度0～14岁细菌感染患儿病原菌构成及耐药性。方法收集2010年1-12月129所成员单位医院的儿科及成都市妇女儿童中心医院、山东大学齐鲁儿童医院0～14岁住院患儿细菌感染的临床分离菌株,依据2010年CLSI标准的常规鉴定和纸片扩散法(K-B),测定菌株对抗菌药物的敏感性,采用WHO-NET软件对收集到的细菌监测资料进行统计分析。结果共收集细菌25 110株,其中革兰阴性菌14 910株占59.4%,革兰阳性菌10 200株占40.6%;分离细菌在前5位的依次为大肠埃希菌占15.1%、凝固酶阴性葡萄球菌占14.4%、金黄色葡萄球菌占11.9%、肺炎克雷伯菌占11.3%、铜绿假单胞菌占7.6%;耐甲氧西林金黄色葡萄球菌(MRSA)、耐甲氧西林凝固酶阴性葡萄球菌(MRSCN)检出率分别为21.9%、83.1%,未发现对万古霉素、利奈唑胺耐药和中介的金黄色葡萄球菌及凝固酶阴性葡萄球菌;链球菌属未发现对利奈唑胺、万古霉素、替考拉宁中介和耐药株;产ESBLs大肠埃希菌占27.6%、肺炎克雷伯菌占36.0%、阴沟肠杆菌占33.4%;肠杆菌科均出现耐碳青霉烯类抗菌药物,奇异变形菌对亚胺培南的耐药率达25.3%。结论 4年儿童细菌耐药监测结果提示了细菌耐药趋势,对儿童细菌感染性疾病合理使用抗菌药物有重要指导意义。

OBJECTIVE To investigate the bacterial distribution and resistance in patients form 0 to 14 years of age. METHODS Under the unified program of Mohnarin,the clinical isolates were collected from the children at 0 to 14 years of age from department of pediatrics of 129 Mohnarin member hospitals and Chengdu Woman and Children Central Hospital; the drug susceptibility testing was carried out according to K-B recommended by CLSI 2010, and the statistical analysis of the data of surveillance for the collected bacteria was performed with use of WHO- NET 5.5. RESULTS There were totally 25 110 strains of bacteria collected which included 14910 （59.4%） strains of gram-negative bacteria and 10 200 （40.6%） strains of gram-positive bacteria; the isolated bacteria ranking for the top 5 were as the following ： Escherichia coli （ 15.1% ）, coagulase-negative Staphylococus （ 14.4 % ）, S. aureus （11. 9%）, Klebsiellia pneumonia （11. 3%）, and Pseudoznonas aeruginosa （7. 6%）; the detection rates of methicillin-resistant S. aureus （MRSA） and coagulase-negative Staphylococcus （MRSE） were 21.9 % and 83.1%, respectively. No S. aureus or MRSE isolates resistant or intermediate to vancomycin and linezolid were found. No Streptococcus isolates were found resistant or intermediate to linezolid, vancomycin, or teicoplanin; ESBLsproducing E. coli accounted for 27.6%, ESBLs-producing K. pneumoniae 36.0%, Enterobacter cloacae 33.4 % ; Enterobacteriaceae were resistant to carbopenems, the drug resistance rate of Proteus mirabilis to imipenem was 25.3 %. CONCLUSION The result of the surveillance for bacterial resistance in 4 years shows the trend of bacterial resistance , which has important guiding significance in rational use of antibiotics in treatment of bacterial infectious diseases in children,