Mohnarin 2011年度报告:华北地区细菌耐药监测  

Mohnarin report of 2011:monitoring of bacterial resistance in north China

作　　者：张伟丽[1] 孔海深[1] 杨青[1] 陈晓[1] 魏泽庆[1] 陈云波[1] 沈萍[1] 崔大伟[1] 肖永红[1] 李兰娟[1] 

机构地区：[1]浙江大学医学院附属第一医院传染病诊治国家重点实验室,浙江杭州310003

出　　处：《中华医院感染学杂志》2012年第22期4965-4970,共6页Chinese Journal of Nosocomiology

基　　金：卫生行业科研专项项目(201002021)

摘　　要：目的调查分析2011年度华北地区医院临床分离细菌构成以及对常用抗菌药物的耐药性,为临床抗菌药物应用提供依据。方法北京、天津、内蒙和山西成员单位,按照统一方案分离菌株,进行药物敏感性试验,结果用WHONET 5.6软件进行统计分析。结果 2011年华北地区8所医院共收集菌株19 324株,其中革兰阳性菌5108株占26.4%,革兰阴性菌14 216株,占73.6%,MRSA和MRCNS的检出率分别为58.0%和77.5%,未发现耐万古霉素葡萄球菌;粪肠球菌对万古霉素、替考拉宁不敏感株分别为0.7%和0,屎肠球菌不敏感菌株分别为6.3%和6.7%,大肠埃希菌、肺炎克雷伯菌、产酸克雷伯菌和奇异变形菌产ESBLs率分别为59.9%、32.1%、20.3%和34.9%,肺炎链球菌162株,其中PRSP占8.3%;流感嗜血菌144株,产酶率为10.9%,肠杆菌科细菌仍对亚胺培南和美罗培南保持>90.0%的敏感率;铜绿假单胞菌和鲍氏不动杆菌的耐药率分别达23.6%、19.2%和51.3%、48.4%。结论细菌耐药性仍呈上升趋势,需要关注耐万古霉素肠球菌、耐碳青霉烯类肠杆菌科细菌及多药耐药非发酵菌情况,采取积极措施控制进一步恶化。OBJECTIVE To investigate bacterial distribution and antimicrobial resistance in north China in 2011 so as to furnish basis for clinical use of anfibiotics.METHODS The drug susceptibility testing was carried out in the member hospitals in Beijing,Tianjin,and Shanxi according to an agreed protocol and standard.The results were analyzed by WHONET 5.6.RESULTS A total of 19 324 clinical isolates were collected from Jan to Dec 2011,of which the gram-negative bacteria and the gram-positive bacteria accounted for 73.6%（14 216 strains） and 26.4%（5 108 strains）,respectively.The detection rates of MRSA and MRCNS were 58.0% and 77.5% respectively,and no trains of vancomycin-resistant Staphylococci were found.The detection rates of the vancomycin and teicoplanin-resistant Enterococcus faecalis strains were 0.7% and 0,while the detection rates of the vancomycin and teicoplanin-resistant Enterococcus faecium strains were 6.3%and 6.7%,respectively.The detection rates of the ESBLs-producing Escherichia coli Klebsiella pneumonia,Klebsiella oxytoca,and P.mirabilis were 59.9%,32.1%,20.3%,and 34.9%,respectively.There were 162 strains of Streptococcus pneumoniae,8.3% of which were identified as PRSP.There were 144 strains of Hemophylus influenzae,10.9% of which produced theβ-1actamase.Enterobacteriaceae strains remained 90.0% of the susceptibility rate to imipenem and meropenem.The drug resistance rates of Pseudomonas aeruginosa strains were 23.6% and 19.2%,and the drug resistance rates of Acinetobacter baumannii were 51.3% and 48.4%,respectively.CONCLUSION The bacterial resistance is still on the rise in this area,it is necessary to focus on the vancomycin-resistant Enterococci,carbapenems-resistant Enterobacteriaceae,and the multidrug-resistant non-fermenting bacteria so as to take the prevention measures to prevent further deterioration.

关 键 词：卫生部全国细菌耐药监测网 华北地区 2011年 细菌耐药性 革兰阴性菌 革兰阳性菌 

分 类 号：R978.1[医药卫生—药品]