Mohnarin 2010年报告:脑脊液分离细菌的构成及耐药性

Mohnarin report of 2010:distribution and resistance of bacteria isolated from cerebrospinal fluid

目的了解我国中枢神经系统感染细菌的构成及耐药性。方法采用纸片法、MIC法或E-test法测定细菌药物敏感性,使用WHONET5.5软件进行分析,对卫生部全国细菌耐药性监测网(Mohnarin)成员医院2010年1月1日-12月31日分离的脑脊液标本菌株进行分析。结果共有59所医院从脑脊液标本分离出细菌771株,其中革兰阳性菌467株,占60.4%,革兰阴性菌304株,占39.6%;最常见的革兰阳性菌依次为凝固酶阴性葡萄球菌325株、肠球菌属60株、金黄色葡萄球菌43株和链球菌属22株;最常见的革兰阴性菌依次为不动杆菌属109株(主要来自于外科系统)、克雷伯菌属46株、大肠埃希菌35株和铜绿假单胞菌23株;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70.6%和64.5%,未发现耐万古霉素金黄色葡萄球菌,大肠埃希菌和肺炎克雷伯菌中产ESBLs的比率分别为87.5%和74.1%。结论我国中枢神经系统感染在外科组不动杆菌属所占比例明显高于内科组;脑脊液来源的MRSA发生率、大肠埃希菌和肺炎克雷伯菌中产ESBLs的检出率较高。

OBJECTIVE To explore the distribution and resistance of bacteria isolated from cerebrospinal fluid. METHODS The Disc diffusion test,MIC test and E-test were used to detect the antimicrobial susceptibility of bacterial isolates.WHONET 5.5 was applied for analyzing the bacterial susceptible data from Mohnarin member hospitals in China from Jan 1 to Dec 30 2010. RESULTS A total of 771 strains of bacteria were isolated from cerebral spinal fluid（CSF） in 59 hospitals,including 467（60.4%） gram-positive strains and 304（39.6%） gram-negative strains.Coagulase-negative Staphylococci（325）,Enterococcus（60）,S.aureus（43） and Streptococcus（22） were the most common gram positive bacteria,while Acinetobacter spp.（109）,Klebsiella spp.（46）,Escherichia coli（35）,and Pseudomonas aeruginosa（23） were the most common gram-negative bacteria.The detection rates of the meticillin-resistant S.aureus and coagulase-negative Staphylococci were 70.6% and 64.5%,respectively.Vancomycin-resistant S.aureus was not detected.Vancomycin-resistant E.faecium were detected.The ESBLs producing rates of E.coli and K.pneumoniae were 87.5% and 74.1%,respectively. CONCLUSION The rate of Acinetobacter spp.from neurosurgical patients is higher than that from medical patients.The incidence of MRSA from CSF and the rates of the ESBLs producing E.coli and K.pneumoniae are high.