2012年中国三级医院分离的肠杆菌科细菌耐药监测报告  

Surveillance of antimicrobial resistance in Enterobacteriaceae isolated from first class hospitals in China of 2012

作　　者：吕媛[1] 郑波[1] 崔兰卿[1] 刘玉村[2] 

机构地区：[1]北京大学第一医院临床药理研究所,北京100034 [2]北京大学第一医院普通外科,北京100034

出　　处：《中国临床药理学杂志》2015年第11期976-983,共8页The Chinese Journal of Clinical Pharmacology

基　　金：国家科技支撑计划基金资助项目(2012EP001000)

摘　　要：目的了解2012年度中国三级医院临床分离肠杆菌科细菌对常用抗菌药物的耐药状况。方法中国557家三级医院按照监测方案要求,收集临床肠杆菌科细菌,进行药物敏感性测试;根据美国实验室与标准化研究所(CLSI)2012标准,判断敏感性,用Whonet5.6软件处理数据。结果 2012年度,共收集肠杆菌科细菌372060株,分离量名列前3位的细菌是大肠埃希菌(161211株,43.3%)、肺炎克雷伯菌(112600株,30.3%)和阴沟肠杆菌(31887株,8.6%)。碳青霉烯类对肠杆菌科细菌的耐药率最低,大肠埃希菌对碳青霉烯类耐药率不足2.5%,奇异变形菌对亚胺培南、美罗培南的耐药率不到5%,其余肠杆菌科对碳青霉烯类的耐药率也多在10%以下;哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、阿米卡星对肠杆菌科细菌显示较高的抗菌活性,耐药率多不到10%。比较全国七大地区分离的肠杆菌科细菌对各抗菌药物的耐药率,各地区肠杆菌科耐药率差异不大,华中地区分离的菌株对抗菌药物的耐药率略高于全国整体水平,但是这种差异无统计学意义。结论我国三级医院分离的肠杆菌科细菌对抗菌药物呈现不同程度的耐药,碳青霉烯类抗菌药仍然是活性最高的药物,但已经出现耐药菌株,应引起足够的重视。Objective To investigate the antimicrobial resistance of Enterobacteriaceae isolated from patients of first class hospitals in China in 2012.Methods All the clinical isolates of Enterobacteriaceae were collected and the susceptibility tests of the isolates were performed by 557 first class hospitals around China from 1st Jan.2012 to 31st Dec.2012.The susceptibilities of isolates to antimicrobial agents were determined by using CLSI （2010） guideline and the susceptibility data were processed with Whonet 5.6 software.Results A total of 372052 clinical isolates were collected.Among all the strains Escherichia coli （ 161211starins, 43.3%） outnumbered the other bacteria, followed by Klebsiella pneu-moniae （112600 strains, 30.3%）, Enterobacter clacaer （31887strains, 8.6 %）.The most effective antimicrobials were carbapenems.The re-sistant rates of Escherichia coli to imipenem and meropenem were both be-low 12.5%, and the rates in other Enterobacteriaceae were below 10%.Besides this, piperacillin/tazobactam, cefoperazone/sulbactam and ami-kacin demonstrated good antibacterial activity against Enterobacteriaceae＆amp;nbsp;in vitro.Overall, little difference was observed in the resistant rates of Enterobacteriaceae isolated from first class hospi-tals in different parts of China.Conclusion Enterobacteriaceae from firs class hospital were of different degree resis-tance to various antimicrobial agents.Carbapenems remained very high activity against Enterobacteriaceae,but the car-bapenem resistance strains has appeared and the issue should be attracted attention.

关 键 词：肠杆菌科细菌 耐药监测 最低抑菌浓度 耐药率 敏感率 

分 类 号：R978.1[医药卫生—药品] R969.3[医药卫生—药学]