2011年度卫生部全国细菌耐药监测报告:0至14岁儿童细菌耐药监测

Ministry of Health National Antimicrobial Resistant Investigation Net report of 2011: Bacterial resistance surveillance in patients under 14 years old

目的 了解我国2011年0~14岁细菌感染患儿病原菌构成及对常用抗菌药物的耐药性.方法 收集2011年149家成员单位医院的儿科和数家儿童医院0~14岁住院患儿细菌感染的临床分离病原菌,依据2011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,用WHONET 5.5软件进行统计分析.结果 共收集33035株细菌,其中革兰阴性菌17448株（占52.8%）,革兰阳性菌15587株（占47.2%）.分离细菌在前5位的是凝固酶阴性葡萄球菌、大肠埃希菌、金黄色葡萄球菌、肺炎克雷伯菌、铜绿假单胞菌.33.5%的菌株来源于痰标本.用头孢西丁测定耐甲氧西林金黄色葡萄球菌（MRSA） 为28.8%和耐甲氧西林凝固酶阴性葡萄球菌（MRSCN）为77.6%以上.未发现对万古霉素、利奈唑胺耐药的葡萄球菌属和链球菌属.肠杆菌科对头孢他啶仍保持较高敏感率,对头孢曲松、头孢噻肟的耐药率除奇异变形杆菌外,耐药率在50.7%~80.0%.肠杆菌科均出现对碳青霉烯类耐药,粘质沙雷菌对亚胺培南、美罗培南的耐药率分别高达15.9%,8.8%.结论 儿童部分细菌耐药有上升趋势,提示了儿童细菌耐药监测应该继续重点监测.

Objective To investigate the bacterial distribution and re- sistance in patients under 14 years old in domestic in 2011, Methods Bacterial isolates from the admission patients （age range 0 to 14 years old） of pediatric department of 149 Mohnarin member hospitals. The bacterial susceptibility testing was carried out according to Kirby - bauer （K- B） recommended by CLSI 2011, and the data were analyzed by WHONET 5.5 software. Results A total of 33035 clinic strains were collected from 149 hospitals, of which Gram negative bacteria （n = 17448） accounted for 52. 8%, and Gram positive bacteria （n = 15587 ） accounted for 47.2%. The top five strains were coagulase -negative Staphylococci, Escherichia coli, Staphylococcus aureus Klebsiella pneumo- nia, and Pseudomonas aeruginosa, respectively. There were 33.5% of the strains isolated from sputum specimens. Methicillin resistant Staphy- lococcus aureus （MRSA） accounted for 28.8% and methicillin resistant coagulase negative Staphylococci accounted for 77.6%. No vancomycin or linzolid resistant Staphylococcus spp. and Streptococcus spp. isolates were found. Enterobacteriaceae remained highly sensitive to ceftazidime.