卫生部全国细菌耐药监测网(Mohnarin)2011-2012年革兰阳性菌耐药监测报告  

Antimicrobial susceptibility surveillance of gram-positive bacterial from Ministry of Health National Antimicrobial Resistant Investigation Net(Mohnarin) 2011-20112

作　　者：李耘[1] 吕媛[1] 薛峰[1] 张秀珍[2] 胡云建[2] 于庭[3] 胡志东[4] 赵建宏[5] 潘世扬[6] 胡必杰[7] 俞云松[8] 邓秋连[9] 李艳[10] 刘文恩[11] 周玲[12] 费樱[13] 府伟灵[14] 徐修礼[15] 裴凤艳[16] 孟灵[17] 季萍[18] 汤进[19] 郑波[1] 刘健[1] 杨维维[1] 张佳[1] 

机构地区：[1]北京大学第一医院临床药理研究所,北京100034 [2]北京医院,北京100730 [3]吉林大学第二医院,长春130041 [4]天津医科大学总医院,天津300052 [5]河北医科大学第二医院,石家庄050000 [6]南京医科大学第一附属医院,南京210029 [7]复旦大学中山医院,上海200023 [8]浙江大学邵逸夫医院,杭州310003 [9]广州市妇女儿童医疗中心,广州510623 [10]武汉大学人民医院,武汉430060 [11]中南大学湘雅医院,长沙410008 [12]昆明市第一人民医院,昆明650011 [13]贵阳医学院附属医院,贵阳550001 [14]第三军医大学西南医院,重庆400038 [15]第四军医大学西京医院,西安710032 [16]济南市中心医院,济南250013 [17]兰州大学第二医院,兰州730030 [18]新疆医科大学第一医院,乌鲁木齐830054 [19]汉中市中心医院,陕西汉中723000

出　　处：《中国临床药理学杂志》2014年第3期251-259,共9页The Chinese Journal of Clinical Pharmacology

摘　　要：目的监测我国主要城市三级甲等医院住院患者的细菌耐药状况。方法定点收集全国医院临床分离细菌,由中心实验室按美国临床实验室标准协会(CLSI)指南,统一用琼脂二倍稀释法测定抗菌药物最低抑菌浓度(MIC)。结果对2011-07至2012-06来自18家医院的2087株临床分离革兰阳性菌进行了MIC测定。甲氧西林耐药金黄色葡萄球菌(MRSA)和甲氧西林耐药表皮葡萄球菌(MRSE)检出率分别为45.0%和81.4%。未发现对万古霉素、利奈唑胺不敏感葡萄球菌,凝固酶阴性葡萄球菌对替考拉宁有7.5%的中介率和4.7%的耐药率。粪肠球菌对氨苄西林的耐药率为7.2%,屎肠球菌则高达87.6%。万古霉素耐药肠球菌(VRE)检出率1.0%,保持平稳;利奈唑胺不敏感率为1.7%。青霉素耐药肺炎链球菌(PRSP)和青霉素中介肺炎链球菌(PISP)的检出率按非脑膜炎给药折点计算,分别为1.4%和7.9%,按脑膜炎折点计算,耐药率为73.7%,有上升趋势。不同病房、不同年龄以及不同标本来源菌株耐药率比较显示,重症监护病房(ICU)菌株耐药率高于非ICU。来自儿童的金黄色葡萄球菌耐药率明显低于成人和老年人。不同标本来源菌株耐药率总体差异不大。结论 MRSA检出率自2008年后呈下降趋势,VRE检出率稳定。与国外监测报告比较,革兰阳性菌对大环内酯类耐药严重。Objective To investigate the antibacterial resistance in nationwide and understand the distribution of bacterial and trend of antimicrobial resistance. Methods All the clinical isolates were collected from hospitals and the susceptibility tests were performed using agar dilution method recommended by Clinical and Laboratory Standards Institute（CLSI） in central laboratory. The susceptibilities of isolates to antimicrobial agents were determined by using CLSI（2013） guideline. Results A total of 2087 gram-positive isolates from 18 tertiary hospitals over the period from July 2011 to June 2012 were studied. Based on the MIC results, the prevalence of methicillin resistance Staphylococcus aureus（MRSA） and methicillin resistance Staphylococcus epidermidis（MRSE） reached 45.0% and 81.4% respectively. Staphylococci showing intermediate or resistance to vancomycin or linezolid were not observed. Coagulase negative Staphylococci（CoNS） showed intermediate and full resistance to teicoplanin at 7.5% and 4.7%, respectively. Antibiotic resistance rate of E. faecalis to ampicillin was 7.2%, while the resistance rate of E. faecium to ampicillin reached up to 87.6%. Vancomycin resistant Enterococci（VRE） rate was 1.0% and continue to be low. Nonsusceptible to linezolid for Enterococcus spp. was at 1.7%. Penicillin resistance Streptococcus pneumoniae（PRSP） and penicillin intermider Streptococcus pneumoniae（PISP） rates were 1.4% and 7.9% respectively based on non-meningitis criterion; while the resistance rate was 73.7% for cases of meningitis according to the CLSI（2013）. Resistance rates of strains isolated from intensive care unit（ICU） were higher than those from non-ICU. Staphylococcus aures isolated from children（≤14 years） were more susceptible than those from other patients. Strains isolated from different specimens groups showed similar resistance rates. Conclusion Compared with surveillance results in the past, the prevalence of MRSA showed decrease trend from 2008 and VRE rate was

关 键 词：细菌耐药监测 最低抑菌浓度 敏感率 耐药率 

分 类 号：R978.1[医药卫生—药品] R969.3[医药卫生—药学]