2005—2014年CHINET变形杆菌属、沙雷菌属、枸橼酸杆菌属、摩根菌属及普罗威登菌属细菌耐药性监测

Changing resistance profile of Proteus,Serratia,Citrobacter,Morganella and Providencia isolates in hospitals across China:data from CHINET Antimicrobial Resistance Surveillance Program 2005-2014

目的了解国内主要地区临床分离变形杆菌属、沙雷菌属、枸橼酸杆菌属、摩根菌属及普罗威登菌属细菌对常用抗菌药物的敏感性和耐药性。方法对CHINET细菌耐药性监测网临床分离菌,采用纸片扩散法或自动化仪器法按统一方案进行药物敏感性试验。结果 2005—2014年分离出变形杆菌属、沙雷菌属、枸橼酸杆菌属、摩根菌属、普罗威登菌属共计21 663株。10年间,变形杆菌属细菌的检出率呈上升趋势:2005年为1.41%,2014年为2.09%;沙雷菌属细菌的检出率呈上升趋势:2005年为0.99%,2014年为1.28%;枸橼酸杆菌属、摩根菌属和普罗威登菌属细菌的检出率基本无变化。变形杆菌属对头孢哌酮-舒巴坦、哌拉西林-他唑巴坦、头孢他啶、头孢西丁、阿米卡星、替加环素耐药率低于10%。沙雷菌属对头孢哌酮-舒巴坦、哌拉西林-他唑巴坦、阿米卡星、替加环素耐药率低于10%。枸橼酸杆菌属对头孢哌酮-舒巴坦、哌拉西林-他唑巴坦、头孢吡肟、阿米卡星、替加环素耐药率低于20%。摩根菌属对头孢哌酮-舒巴坦、哌拉西林-他唑巴坦、头孢吡肟、阿米卡星、替加环素耐药率低于10%。普罗威登菌属对头孢哌酮-舒巴坦、哌拉西林-他唑巴坦、头孢吡肟、头孢西丁、替加环素耐药率低于20%。结论 10年中细菌耐药性仍呈增长趋势,严格采取有效的感控措施及合理用药是减缓耐药性增长的有效方法。

Objective To understand the changing resistance profile of Proteus, Serratia, Citrobacter, MorganelIa and Providencia in hospitals across China according to the data from CHINET Antimicrobial Resistance Surveillance Program 2005-2014. Methods Antimicrobial susceptibility was tested by using Kirby-Bauer method or automatic minimum inhibitory concentration determination according to a unified protocol. Results A total of 21 663 clinical isolates were collected from January 2005 to December 2014. The proportion of Proteus and Serratia isolates increased with time from 1.41% in 2005 to 2.09% in 2014, and from 0.99% in 2005 to 1.28% in 2014 among all the isolates. No change was found for the proportion of Citrobacter, Morganella, or Providencia. Less than 10% of the Proteus isolates were resistant to cefoperazone-sulbactam, piperacillin-tazobactam, ceftazidime, cefoxitin, amikacin and tigecycline. Less than 10% of the Serratia isolates were resistant to cefoperazone-sulbaetam, piperacillin-tazobactam, amikacin and tigecycline. Less than 20% of the Citrobacter isolates were resistant to cefoperazone-sulbactam, piperacillin-tazobactam, cefepime, amikacin and tigeeycline. Less than 10% of the Morganella isolates were resistant to cefoperazone-sulbactam, piperaeillin- tazobactam, eefepime, amikacin and tigecycline. Less than 20% of the Providencia isolates were resistant to cefoperazone- sulbactam, piperacillin-tazobactam, cefepime, cefoxitin and tigecycline. Conclusions The antibiotic resistance of Proteus, Serratia, Citrobacter, Morganella and Providencia isolates in hospitals across China is growing during the period from 2005 to 2014. Strengthening infection control and rational antibiotic use are effective to slow the growth of drug resistance.