2011年中国CHINET肠球菌属细菌耐药性监测

CHINET 2011 surveillance of antibiotic resistance in Enterococcus in China

目的了解2011年中国主要地区临床分离肠球菌属细菌对各类抗菌药物的耐药性。方法国内主要地区15所教学医院(13所综合性医院,2所儿童医院)按统一方案、采用统一的材料、方法(K-B法)和判断标准(CLSI 2011年版)进行肠球菌属细菌的耐药性监测。结果共分离到4 593株非重复肠球菌属细菌,最常见菌种为屎肠球菌2 073株(45.1%),粪肠球菌2 062株(44.9%),鹑鸡肠球菌102株(2.2%),鸟肠球菌52株(1.1%)。肠球菌属细菌对利奈唑胺、万古霉素、替考拉宁仍极敏感,耐药率均<4.0%,万古霉素耐药粪肠球菌和屎肠球菌检出率分别为0.1%及3.6%。粪肠球菌对呋喃妥因、磷霉素和氨苄西林耐药率较低,分别为4.1%、4.2%和11.5%,对高浓度庆大霉素耐药率为43.1%;屎肠球菌对抗菌药物的耐药率明显高于粪肠球菌,对氨苄西林耐药率为92.4%,对高浓度庆大霉素耐药率为67.9%,对氯霉素耐药率仅为8.3%。结论中国CHINET临床分离的肠球菌属细菌中屎肠球菌的所占比率有上升趋势,甚至略超粪肠球菌。肠球菌属细菌对利奈唑胺、万古霉素、替考拉宁依然保持极高的敏感率。

Objective To investigate the antimicrobial resist- ance in Enterococcus species isolated from hospitals in several regions of China during 2011. Methods Thirteen general hospitals and 2 children＇s hospitals were involved in this program. Antimicrobial susceptibility testing was carried out by means of Kirby-Bauer method according to a unified pro- tocol. The data were analyzed by WHONET 5.6 software based on CLSI 2011 breakpoints. Results A total of 4 593 nonduplicate Enterococcus isolates were collected. The most common isolates were E. faecium （2 073, 45.1%）, E. faecalls （2 062, 44.9%）, E. gallinarum （102, 2.2%） and E. avium （52, 1. 1%）. The strains of Enterococcus were still highly susceptible to linezolid, vancomycin and teicoplanin. The overall resistance rates were 〈4.0 %. The prevalence of vancomycin-resistant E. faecalis and E. faeciurn was 0. 1% and 3.6%, respectively. The percentage of E. faecalis strains resistant to nitrofurantoin, fosfomycin and ampicillin was 4.1 %, 4. 2% and 11.5 %, respectively. About 43.1 of E. faecalis isolates were resistant to gentamicin（high level）. The E. faecium strains were more resistant to most drugs tested than E. Jaecalis. Nearly 92.4% and 67.9~ E. faecium strains were resistant to ampicillin and gentamicin（high level）, respectively. But only 8.3% of these strains were resistant to chloramphenicol. Conclusions The prevalence of E. faecium is increasing progressively. Linezolid, vancomycin and teicoplanin are still active against Enterococcus isolates.