四川省细菌耐药监测网2012年细菌耐药性监测

Sichuan Provincial Antimicrobial Resistant Investigation Net 2012 annual report: Bacterial drug resistance surveillance in Sichuan

目的统计分析四川省细菌耐药监测网成员单位2012年细菌分布及耐药情况,为我省抗菌药物合理应用提供依据。方法各成员单位按照监测方案要求,进行目标细菌鉴定、药敏试验,依据CLSI2012年标准,用WHONET 5.6软件进行数据分析。结果按患者首次分离菌株进行统计分析,共收集细菌98571株,其中革兰阴性菌72340株,占73.4%,革兰阳性菌26231株,占26.6%。革兰阳性菌中,分离出葡萄球菌属细菌16435株,占阳性菌62.7%,其中金黄色葡萄球菌9315株,占葡萄球菌属56.7%;革兰阴性菌中分离率排列前三位的分别是大肠埃希菌26.8%、肺炎克雷伯菌16.2%、铜绿假单胞菌11.9%。耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率分别为31.1%和70.6%,未发现万古霉素、利奈唑胺耐药的葡萄球菌。万古霉素耐药粪肠球菌和屎肠球菌分别占1.0%和5.1%,耐青霉素肺炎链球菌为4.5%,革兰阴性杆菌中,大肠埃希菌耐药比较突出,对喹诺酮类耐药率在40.0%以上,对头孢噻肟和头孢曲松的耐药率均在60.0%以上,肠杆菌科细菌对碳青酶烯类抗生素耐药率<10.0%。鲍曼不动杆菌对包括亚胺培南在内的大多数监测药物耐药率超过50.0%,而铜绿假单胞菌对大多数药物保持了较高的抗菌活性。结论我省细菌耐药情况较为严重,应充分利用本地细菌耐药监测结果进行监督管理,促进抗菌药物合理应用。

Objective To explore the bacterial drug resistance and its epidemic tendency in 2012 from the members of Antimicrobial Resistant Investigation Net of Sichuan province, and to guide the clinicians to use antimicrobial drugs rationally. Methods All the objective bacterial isolates were collected and identified susceptibility date by software WHONET 5.6. Results 98,571 bacterial isolates and their antibacterial susceptibility data were collected which included 72340（73.4%） Gram-negative bacterial isolates and 26,231 （26.6%） Gram-positive bacterial isolates. Staphylococcus was the primary population（16435 isolates, 62.7%） in Gram-positive bacterial isolates, and S. aureus was the primary population（9315 isolates, 56.7%） of Staphylococcus. The top three populations of Gram-negative bacterial isolates were E. coli（26.8%）, K. pneumoniae（16.2%）, P. aeruginosa（11.9%）. The isolating rates of methicillin-resistant Staphylococcus aureus （MRSA） and methicillin-resistant coagulase negative Staphylococcus（MRCNS） were 31.1% and 70.6%, respectively. No vancomycin and linezolid resistant Staphylococcus isolates were found. There were 1.0% E. faecalis and 5.1% E. faecium vancomycin- resistant isolates, 4.5% penicillin-resistant Streptococcus pneumoniae were found. The most outstanding resistance rates of Gram-negativebacterial isolates was E. coli whose resistance rate to quinolones was above 40.0%, and the rate to cefotaxime and ceftriaxone was above 60.0%.The isolates of Enterobacteriaceae were still h!ghly susceptible to carbapenem, whose total resistance rate was below 10.0%. The resistance rates of A. baumannii to most surveillance drugs including imipenem were above 50.0% and the isolates of P. aeruginosa were still highly susceptible to most surveillance drugs. Conclusion It is severe that the situation of bacterial drug resistance in Sichuan province. We should fully use bacterial drug resistance surveillance results for supervision and administration, and take effective measures for controlling the spread of resistant isolates.