Mohnarin2012年云南省革兰阳性球菌耐药性监测

Survey of antimicrobial susceptibility of Gram positive coccus isolated in Yunnan of China Mohnarin in 2012

目的了解2012年中国云南省临床分离革兰阳性球菌分布及耐药监测情况。方法收集2012年1月至12月卫生部全国细菌耐药监测网云南省28所医院的革兰阳性球菌,各医院按统一的方法进行细菌培养、分离、鉴定和药敏试验,按CLSI 2012M100-S22判读结果。结果共收集到各医院分离的非重复革兰阳性球菌10845株,其中葡萄球菌65.0%,肠球菌23.8%,链球菌11.2%。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)分别为38.4%和80.6%。葡萄球菌属中甲氧西林耐药株(MR)对β-内酰胺类抗生素和其他测试药的耐药率显著高于甲氧西林敏感株(MS),未发现万古霉素和利奈唑胺耐药株。肠球菌属中粪肠球菌对多数测试药物的耐药率低于屎肠球菌。肠球菌中有少数万古霉素耐药、替考拉宁和利奈唑胺耐药株。非脑膜炎肺炎链球菌PISP和PRSP比例较低,小于5%,未发现万古霉素耐药株。结论革兰阳性球菌对利奈唑胺、万古霉素、替考拉宁依然保持极高的敏感性,但其分离率和耐药性仍呈增长趋势,对临床构成严重威胁,加强感染控制措施是当务之急。

Objective To investigate the distribution and antibiotic resistance of clinical Gram-positive cocci in Yunnan Surveillance of China （2012）.Methods Gram-positive cocci were collected from 28 general hospitals in Yunnan Surveillance of China.Data from all of hospitals were applied with the same method of bacteria culture,isolation,identification and antibiotic sensitivity tests.CLSI 2012 M100-S22 was used as assessment criteria.Results：10845 clinical isolates of non-repetitive Gram positive cocci were collected from the 28 hospitals.Among these isolates,Staphylococcus,Enterococcus and Streptococcus was accounted for 65.0%,23.8 and 11.2%,respectively.Methicillin resistant strains in S.aureus （MRSA） and coagulase negative Staphylococcus （MRCNS） was accounted for 38.4% and 80.6%,respectively.The resistant rates of β-lactams and other antimicrobial agents in MR strains were much higher than those of MS strains.No staphylococcal strain was resistant to vancomycin or linezolid.The resistance rate of most drugs tested in E.faecalis strains was much lower than those of E.faecium.A few strains were resistant to vancomycin,teicoplanin and linezolid in E.faecium and E.faecalis.Regarding non-meningitis S.pneumoniae strains,the rate of PISP and PRSP were less than 5%.No S.pneumoniae strain was resistant to vancomycin.Conclusion Gram-positive cocci still keep high sensitivity to linezolid,vancomycin and teicoplanin.However,the isolated rate and drug resistance of Gram-positive cocci is still increasing,which becomes a serious threat to the clinics.Therefore,it is urgent to strengthen infection control.