2010年度卫生部全国细菌耐药监测网报告:伤口感染病原菌分布及耐药监测  

Mohnarin annual report 2010:distribution of pathogens causing wound infections and surveillance of drug resistance

作　　者：胡志东[1] 王凤霞[1] 李金[1] 李静[1] 徐海茹[1] 田彬[1] 

机构地区：[1]天津医科大学总医院检验科,天津300052

出　　处：《中华医院感染学杂志》2012年第1期23-27,共5页Chinese Journal of Nosocomiology

摘　　要：目的了解2010年我国114所三级甲等医院临床患者伤口感染的细菌分布及耐药性。方法采用纸片法、MIC法或E-test法进行药敏试验,采用WHONET 5.5软件进行统计分析。结果共分离病原菌14 424株,其中革兰阴性菌8428株占58.4%,革兰阳性菌5877株占40.8%;分离率最高的前5位病原菌依次为:大肠埃希菌占20.7%、金黄色葡萄球菌占16.3%、铜绿假单胞菌占9.6%、肺炎克雷伯菌占7.6%、表皮葡萄球菌占5.1%;未检出对万古霉素和利奈唑胺中介或耐药的葡萄球菌属,金黄色葡萄球菌、表皮葡萄球菌和溶血葡萄球菌对替考拉宁的中介率分别为0.1%、1.8%、0,耐药率分别为0.2%、0.9%、3.4%;未发现对利奈唑胺中介或耐药的肠球菌属,粪肠球菌和屎肠球菌对万古霉素的中介率分别为3.4%、1.4%,耐药率分别为1.3%、1.4%,粪肠球菌对替考拉宁的耐药率为0.8%,屎肠球菌对替考拉宁的中介率为0.6%,未发现耐替考拉宁屎肠球菌;肺炎克雷伯菌和大肠埃希菌对美罗培南的耐药率分别为3.1%、1.1%,鲍氏不动杆菌对多数抗菌药物的敏感性<33.0%,铜绿假单胞菌和鲍氏不动杆菌对美罗培南的耐药率分别为15.4%、49.9%。结论我国临床患者伤口感染主要致病菌分别为大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌和肺炎克雷伯菌,细菌耐药现象严重。OBJECTIVE To investigate the distribution and antibiotic resistance of bacteria causing wound infections in 114 tertiary hospitals in China in 2010. METHODS Disc diffusion test, MIC test and E-test were used to detect the drug susceptibility. WHONET 5. 5 was applied for statistically analysis of the data. RESULTS A total of 14424 strainswere isolated from wound infections, including 8428 strains of gram-negative bacteria, accounting for 58.4%, and 5877 strains of gram-positive bacteria, accounting for 40.8%. The top five pathogens were Escherichia coli （20.7 % ）, Staphylococcus aureus （ 16.3 %）, Pseudomonas aeruginosa （9.6% ）, K lebsiella pneumoniae （7. 6%） and Staphylococcus epidermidis （5. 1 %）. No Staphylococcus spp. intermediate or resistant to vancomycin and linezolid was detected. The intermediate and resistant rates of S. aureus, S. epidermidis and S. haemolyticus to teicoplanim were 0.1%, 1.8%, 0 and 0.2%, 0.9%, 3.4%, respectively. No Enterococcus spp. was intermediate or resistant to linezolid. The intermediate and resistant rates of Enterococcus faecalis and E. faecium to vaneomycin （VRE） were 3.4% ,1.4% and 1.3% ,1.4%, respectively. The resistance rate of E. faecalls to teicoplanin was 0.8%, and the intermediate rate of E. faecium to teicoplanin was 0. 6%. No teitoplaninresistant E. faeciurn isolate were found. The resistance rates of K. pneumonia and E. coli to meropenem were 3.1% and 1. 1%, respectively. The susceptibility to most antibiotics of Acinetobacter baumannii was less than 33.0%. The resistance rates of P. aeruginosa and A. baumannii to meropenem were 15. 4% and 49. 9%, respectively. CONCLUSION E. coli, S. aureus, P. aeruginosa and K. pneumoniae are the predominant pathogens causing wound infections in China, and the bacterial resistance is serious.

关 键 词：耐药性 细菌 伤口感染 大肠埃希菌 

分 类 号：R378[医药卫生—病原生物学]