2010年中国CHINET肠杆菌属细菌耐药性监测

CHINET 2010 surveillance of antibiotic resistance in Enterobacter spp.in China

目的了解2010年我国不同地区14所医院肠杆菌属细菌的临床分布和耐药状况。方法全国14所教学医院2010年1—12月临床分离的1 961株肠杆菌属细菌,采用K-B法或自动化仪器进行药敏试验,试验结果以CLSI 2010年版判断标准。结果 1 961株肠杆菌属细菌临床分离株来自呼吸道分泌物1 146株(58.4%),尿液标本229株(11.7%),血液标本108株(5.5%),其他标本478株(24.4%)。肠杆菌属细菌对氨苄西林、头孢唑林和头孢西丁的耐药率高(大于93%),对头孢他啶和头孢噻肟的耐药率较高(38.6%、51.2%),对哌拉西林-他唑巴坦、头孢吡肟、头孢哌酮-舒巴坦、厄他培南、阿米卡星、环丙沙星的耐药率均在20%以下,对亚胺培南和美罗培南的耐药率最低(分别为5.2%和4.8%)。不同医院间、住院患者与门诊患者分离株耐药率之间存在差异。8株对碳青霉烯类抗生素耐药株为泛耐药株。结论肠杆菌属细菌对抗菌药物的耐药情况严重,采取有效感染控制措施为当务之急。

Objective To investigate the distribution and antibiotic resistance of clinical Enterobacter isolates.Methods A total of 1 961 clinical strains of Enterobacter spp.were collected from 14 hospitals during January 1 through December 31,2010.Antimicrobial susceptibility testing was performed with Kirby-Bauer method or determination of minimum inhibitory concentration.The results were analyzed according to CLSI 2010 standards.Results The main source of isolates was sputum（n=1 146,58.4%） and urine（n=229,11.7%）,blood（n=108,5.5%）,and others（n=478,24.4%）.The resistance rate of Enterobacter strains was the highest to ampicillin,cefazolin and cefoxitin（93%）,relatively higher to ceftazidime and cefotaxime（38.6% and 51.2%,respectively）,and relatively lower to piperacillin-tazobactam,cefepime,cefoperazone-sulbactam,ertapenem,amikacin,or ciprofloxacin（generally 20%）,and the lowest to imipenem and meropenem（5.2% and 4.8%,respectively）.The resistance rate varied with hospitals and the clinical setting（inpatients or outpatients）.Eight strains were identified as pan-drug resistant including resistance to carbapenem antibiotics.Conclusions Antibiotic resistance in clinical Enterobacter isolates is serious in China.Every hospital should take effective control measures to curb the growth of resistant strains.