2011年度全国细菌耐药监测报告:65岁以上老年患者细菌耐药监测  

Ministry of Health National Antimicrobial Resistance Investigation Net annual report of 2011: bacterial resistance surveillance among elderly patients

作　　者：褚云卓[1] 田素飞[1] 年华[1] 李富顺[1] 丁丽萍[1] 郭丽洁[1] 王倩[1] 孙国全[1] 尚红[1] 

机构地区：[1]中国医科大学附属第一医院检验科,沈阳110001

出　　处：《中国临床药理学杂志》2014年第2期89-93,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的了解65岁以上老年患者细菌感染种类分布及耐药特点。方法用常规方法分离病原菌,用API或自动化细菌鉴定仪鉴定细菌,用K-B纸片扩散法或自动化仪器微量肉汤稀释法进行药敏试验,用WHONET 5.6软件进行统计分析。结果全国149家医院的65岁以上老年患者共分离112678株细菌,其中革兰阴性菌80688株,革兰阳性菌31990株。45.6%的细菌来源于痰标本。大肠埃希菌、肺炎克雷伯菌、产酸克雷伯和奇异变形菌ESBL的产生率分别为72.6%,58.7%,55.1%和49.3%;对美罗培南和亚胺培南的耐药率均在6%以下。铜绿假单胞菌对美罗培南和亚胺培南的耐药率分别是25.4%和32.0%,对多粘菌素保持95%高度敏感性。鲍曼不动杆菌对美罗培南和亚胺培南的耐药率分别为57.4%和58.1%,对多粘菌素的耐药率也高达56.6%。耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的分离率分别为67.6%和88.2%。未发现对万古霉素和利奈唑胺耐药的葡萄球菌,但对替考拉宁的耐药率是0.7%。肠球菌对万古霉素和替考拉宁的耐药率均在6.5%以下,未发现对利奈唑胺耐药的肠球菌。结论对65岁以上患者细菌耐药性应引起足够重视,加强抗菌药物合理使用以降低耐药性,并采取有效措施控制其传播。Objective To investigate bacterial distribution and antibiotic resistance in clinical isolates among elderly patients. Methods Strains were isolated by routine method and identified by the API or automatic bacteria analysis system. K - B or MIC method was carried out to detect the antirnicrobial susceptibility. The data were analyzed by WHONET 5.4 software. Results A total of 112678 clinical isolates collected a- mong elderly patients more than 65 years in 149 hospitals. 80688 isolates were gram -negative bacilli and 31990 isolates were gram -positive coc- ci. 45.6% of the total isolates were isolate from sputum. The prevalence of extended spectrum {3 lactamases （ESBLs） was 72. 6 % in E. coli, 58.7% in Klebiella pneumoniae, 55.1% in KlebieUa oxytoca and 49.3% in Proteus mirabilis. The resistance rates of Enterobacteriaceae against meropenern and irnipenern were both less than 6%. The resistance rates of P. aeruginosa against meropenern and irnipenern were 25.4% and 32%, respectively. The susceptiblility rate of P. aeruginosa to polyrnyxin was 95 %. The resistance rates of Abaumannii against rneropenem and imipenem were 57.4% and 58. 1%, respectively. The resistance rate of A. baumannii against sistant, and 88.2 % of polymyxin was 56. 6%. About 67.6% of Staphylococcus aureus isdates were methicillin - re- coagulase negative Staphylococcus isolates were methicillin- resistant. No vancomycin or lin- ezolid - resistant isolate was found in Staphylococcu spp.. But the resistance rate of coagulase negative staphylococcus i- solates against teicoplanin was 0. 7%. The resistance rates of Enterococcus spp. to vancomycin and teicoplanin were less than 6.5%. No linezolid - resistant Enterococcus spp isolate was found. Conchmion Special attention should be paid to antibiotic resistance of strains isolated from elderly patients. It is very important to use antimicrobial agents rationally and take effective measures for the control of the spread of resistant isolates.

关 键 词：细菌耐药监测 耐药率 老年患者 

分 类 号：R969.3[医药卫生—药理学] R978.1[医药卫生—药学]