卫生部全国细菌耐药监测网2011年门诊来源细菌耐药监测

Ministry of Health National Antimicrobial Resistance Investigation Net annual report of 2011: bacterial drug resistance surveillance of outpatients

目的总结我国门诊患者分离细菌的分布和耐药状况。方法所属149家医院门诊患者临床致病菌用标准纸片扩散法或自动化临床微生物测定方法测定细菌敏感性,依据CLSI 2011年标准判读,以WHONET 5.6软件进行数据分析。结果共获得临床分离菌21720株,其中革兰阴性菌13332株,占61.4%,革兰阳性菌8388株,占38.6%。耐甲氧西林金黄色葡萄球菌及凝固酶阴性葡萄球菌检出率分别为31.7%和69.9%;未发现万古霉素耐药葡萄球菌。粪肠球菌和屎肠球菌对万古霉素耐药率分别为0.3%和0.7%,未发现利奈唑胺耐药肠球菌。肠杆菌科对亚胺培南较为敏感,耐药率小于5%。铜绿假单胞菌对碳青酶烯类的耐药率20%左右。鲍曼不动杆菌对头孢哌酮/舒巴坦耐药率为27.4%,对米诺环素耐药率为40.6%,其它抗菌药物耐药率45%～80%。结论我国门诊来源分离菌株较2009年和2010年增加,耐药情况与2010年相似。

Objective To explore the bacterial drug resistance and its epidemic trend in outpatients in China. Methods All of the bacterial susceptibility results from 149 hospitals in Mohnarin from Jan 1 to Dec 31, 2011 were collected by unified protocol and the data were analyzed by software WHONET 5.6. The disc - diffusion or automatic clinical microbiological system method was used for the bacterial sensitivity, Re- sults A total of 21720 bacterial isolates which included 13332 （61.4%） gram -negative bacterial strains and 8388 （38.6%） gram - positive bacterial strains. The incidences of methicillin - resistant S. aureus （ MRSA ） and S. epidermidis （ MRSCN ） were 31.7% and 69. 9%, respectively, No vancomycin resistant Staphylococcus strains were found. There were 0. 3% of E. faecalis and 0. 7% of E. faecium resistant to vancomycin. No linezolid resistant Enterococcus strains were found. Isolates of Enterobacteriaceae were still highly sensitive to imipen- em and meropenem. About 20% of P. aerugmosa strains were resistant to the two carbapenems. 40. 6% and 27.4% of A. baumannii were resistant to minocycline and cefoperazone/sulbactam, while 45% -80% to the other drugs. Conclusion Bacterial resistance in outpatients was common and bacterial resistance rate was similar to that in last year.