2015年广东省东莞市细菌耐药性监测结果

Surveillance of antimicrobial resistance in the bacterial strains isolated from hospitals in Dongguan,Guangdong Province:2015 report

目的了解2015年东莞市细菌耐药性监测情况。方法采用纸片扩散法(Kirby-Bauer法)或自动化仪器法对东莞市22所医院的临床分离菌进行药敏试验,参照2015版CLSI标准判定药敏结果,并用WHONET5.6软件统计分析。结果东莞市各医院全年共检出细菌29 665株,其中革兰阳性菌9 509株,占32.1%,革兰阴性菌20 156株,占67.9%。MRSA和MRCNS分别占金黄色葡萄球菌和凝固酶阴性葡萄球菌(CNS)的23.3%(705/3 024)和43.6%(1 054/2 419),未发现耐万古霉素葡萄球菌;大肠埃希菌和肺炎克雷伯菌产ESBL菌株的检出率分别为36.4%(2 554/7 020)和24.5%(792/3 227),耐碳青霉烯类肠杆菌科细菌(CRE)的检出率为0.2%(30/13 077);耐碳青霉烯类铜绿假单胞菌和鲍曼不动杆菌(CRPA和CRAB)的检出率分别为16.0%(500/3 116)和53.9%(827/1 533)。青霉素耐药肺炎链球菌(PRSP)检出率为10.1%(142/1 404),流感嗜血杆菌产β内酰胺酶率为30.6%(276/902),耐万古霉素的肠球菌(VRE)检出率为0.7%(10/1 441)。结论定期进行细菌耐药性监测有助于了解本地区细菌耐药性变迁,为临床合理规范使用抗菌药物提供依据,指导院感管理防控措施的制定和避免耐药菌株的传播流行。

Objective To survey the resistance profile of clinical isolates to antibiotics across the hospitals in Dongguan, Guangdong Province during 2015. Methods Kirby-Bauer method or automated system was used to test the susceptibility of clinical isolates to selected antimicrobial agents. Results were analyzed according to CLSI 2015 breakpoints. The susceptibility data were analyzed using WHONET 5.6 software. Results A total of 29 665 strains of microorganisms were isolated, of which gram positive cocci accounted for 32. 1% （9 509/29 665） and gram negative bacilli accounted for 67.9% （20 156/29 665）, respectively. The prevalence of methicillin- resistant Staphylococcus was 23.3% （705/3 024） in S. aureus and 43.6% （1 054/2 419） in coagulase-negative Staphylococcus. No vancomycin-resistant staphylococcal strain was found. ESBLs-producing strains accounted for 36.4% （2 554/7 020） in E. coli and 24.5% （792/3 227） in Klebsiella isolates. The prevalence of carbapencm-resistant Enterobacteriaceae was 0.2% （30/13 077）. The prevalence of carbapenem-resistant Pseudomonas aeruginosa （CRPA） and carbapenem-resistant Acinetobacter baumannii （CRAB） was 16.0% （500/3 116） and 53.9% （827/1 533）, respectively. The prevalence of penicillin-resistant S. pneumoniae （PRSP） strains was 10.1% （142/1 404）. Beta-lactamase was produced in 30.6% （276/902） of the H. influenzae strains. The prevalence of vancomycin-resistant Enterococcus （VRE） strains was 0.7% （10/1 441）. Conclusions Periodic surveillance ofantimicrobial resistance is valuable for rationalantimicrobial therapy, formulation of treatment guidelines and infection control and prevention measures, as well as preventing the spread of drug-resistant strains.