2007年CHINET大肠埃希菌和克雷伯菌属耐药性监测  

CHINET 2007 surveillance of antimicrobial resistance in E. coli and Klebsiella spp.

作　　者：卓超[1] 苏丹虹[1] 朱德妹[2] 胡付品[2] 汪复[2] 阮斐怡[2] 孙自镛[3] 简翠[3] 徐英春 孙宏莉 倪语星[5] 孙景勇[5] 俞云松[6] 杨青[6] 王传清[7] 薛建昌[7] 张泓 李万华 胡云健[9] 艾效曼[9] 贾蓓[10] 黄文祥[10] 魏莲花[11] 吴玲[11] 张朝霞[12] 季萍[12] 

机构地区：[1]呼吸疾病国家重点实验室(广州医学院)、广州医学院第一附属医院,510120 [2]复旦大学附属华山医院抗生素研究所 [3]华中科技大学同济医学院附属同济医院 [4]中国医学科学院、中国协和医科大学附属协和医院 [5]上海交通大学医学院附属瑞金医院 [6]浙江大学医学院附属第一医院 [7]复旦大学附属儿科医院 [8]上海交通大学附属儿童医院 [9]卫生部北京医院 [10]重庆医科大学附属第一医院 [11]甘肃省人民医院 [12]新疆医科大学附属第一医院

出　　处：《中国感染与化疗杂志》2009年第3期185-191,共7页Chinese Journal of Infection and Chemotherapy

摘　　要：目的了解2007年我国不同地区12所医院临床分离的大肠埃希菌和克雷伯菌属的耐药性。方法采用纸片扩散法(K-B法)对临床分离株作药敏试验。结果共收集CHINET细菌耐药性监测网12所医院分离的大肠埃希菌6527株,肺炎克雷伯菌3051株,催产克雷伯菌206株。其中儿童分离株大肠埃希菌和肺炎克雷伯菌分别占24.0%(1566/6527)和17.8%(542/3051)。大肠埃希菌和克雷伯菌属产ESBLs菌株检出率分别平均为55.0%(12.3%～72.1%)和44.9%(15.4%～70.6%)。各医院ESBLs检出率存在一定差异。药敏结果显示,大肠埃希菌和克雷伯菌属对亚胺培南、美罗培南和头孢哌酮-舒巴坦都保持高度敏感,耐药率均低于10%。产ESBLs株对上述3种药物的耐药率也均低于20%。50%以上的产ESBLs株对庆大霉素和环丙沙星耐药。有5所医院分离出对碳青霉烯类抗生素不敏感菌株,其中肺炎克雷伯菌21株,大肠埃希菌2株,产酸克雷伯菌1株。其中20株肺炎克雷伯菌为泛耐药株,占0.7%(20/3051)。结论大肠埃希菌和克雷伯菌属对碳青霉烯类抗生素和头孢哌酮-舒巴坦仍保持高度敏感性,不同地区的分离株中产ESBLs菌株检出率和药敏试验结果存在差异,儿童分离株中产ESBLs检出率上升值得关注。Objective To investigate the antimicrobial resistance of E. coli and Klebsiella spp. strains isolated from 12 hospitals submitted to China CHINET during 2007. Methods Disc diffusion test （K-B method） was employed to study the antimicrobial resistance. WHONET 5 . 4 was used for data analysis. Results A total of 9 734 clinical isolates were analyzed in 2007, including 6 527 isolates of E. coli, 3 051 of K. pneumoniae and 206 of K. oxytoca. And 24. 0% （1 566/6 527） of E. coli and 17.8% （542/3 051） of K. pneumoniae isolates were collected from two children hospitals. The overall prevalence of ESBLs-producing strains in E. coli and Klebsiella spp. isolates was 55.0% and 44.9%, respectively. The prevalence of ESBLs-producing strains varied with hospital, ranging from 12.3% to 72.1% in E. coli, from 15.4% to 70.6% in Klebsiella spp. Both E. coli and Klebsiella spp. had the lowest resistance （~10%） to imipenem, meropenem and cefoperazone-sulbactam. ESBLs-producing strains of both E. coli and Klebsiella spp. （〈20%） also showed least resistant to imipenem, meropenem and cefoperazone-sulhactam. Up to 50% ESBLs-producing strains were resistant to both gentamiein and ciprofloxaein. It was found that 21 strains of K.pneumoniae, 2 strains of E. coli and 1 strain of K. oxytoca were not susceptible to both imipenem and meropenem. These strains were identified in five hospitals. And 21 of the 24 strains were resistant to all the antimicrobial agents tested. Conclusions Carbapenems and cefoperazone-sulbactam remain most active against straims of E. coli and Klebsiella spp. , the detection rates and result of susceptibility fest of ESBLs-producing strains isolated from different sifies varied.

关 键 词：大肠埃希菌 克雷伯菌属 药敏试验 抗菌药 

分 类 号：R446.5[医药卫生—诊断学]