我国携带NDM-1基因耐药菌流行现况分析  

Epidemiological analysis of NDM-1-positive bacteria in China

作　　者：王盛书[1] 孙金柱[2] 苏文莉[1] 胡智[1] 杨建鹏[1] 王勇[1] 

机构地区：[1]军事医学科学院疾病预防控制所,北京100071 [2]解放军313医院,辽宁葫芦岛125000

出　　处：《军事医学》2015年第11期825-830,共6页Military Medical Sciences

基　　金：国家自然科学基金资助项目(81373077);国家传染病重大专项资助项目(2013ZX10004217-002)

摘　　要：目的：分析我国新德里金属β-内酰胺酶（NDM-1）阳性菌的流行病学特征，探讨携带 NDM-1阳性菌的耐药机制。方法收集2010～2015年报道我国 blaNDM-1流行情况文献，对 NDM-1阳性菌株种类与地区分布、阳性菌株和感染来源、耐药谱和转移机制进行流行病学分析。结果我国共有25个省市发现 blaNDM-1阳性菌株，其中广东地区最高（39．49％，P ＜0．05），阳性菌以肺炎克雷伯菌和阴沟肠杆菌最多（P ＜0．05）；感染阳性菌的患者年龄段主要集中在10岁以下、60～80岁之间（P ＜0．05），痰液标本分离 blaNDM-1阳性菌最多，为40株（41．24％，P ＜0．05）， ICU、儿科和呼吸科分离 blaNDM-1阳性菌显著高于其他科室（P ＜0．05），肺部疾病患者分离出阳性菌最多（P ＜0．05），blaNDM-1阳性菌对阿米卡星、替加环素的耐药率最低，分别为7．69％和2．33％。结论携带 NDM-1基因的耐药菌感染已成为全球性的公共卫生问题，而且在年龄、地区及来源等方面存在显著差异，需进一步开展主动监测，深入研究其发生发展规律。Objective To analyze the epidemiological characteristic of New Delhi metallo-β-lactamase （NDM）-1-positive bacteria in China and explore its mechanism of drug-resistance.Methods The published papers from 2010 to 2015 about domestic blaNDM-1 were collected and analyzed according to the bacteria species,regional distribution,NDM-1-positive bacteria,infectious source,drug-resistance spectra and transfer mechanism.Results NDM-1-positive bacteria were isola-ted from 25 provinces （municipalities）in China,Guangdong Province was predominant and accounted for 39.49%（P 〈0.05）.The number of Klebsiella pneumoniae and Enterobacter cloacae were predominant in the NDM-1-positive bacteria （P 〈0.05）.Number of patients under the age of ten and among 60 -80 years which infected by NDM-1-positive bacteria were predominant of all the reported patients（P 〈0.05）.The most kinds of samples and diseases were sputum sample （P 〈0.05）and pulmonary diseases（P 〈0.05）.NDM-1-positive bacteria which found in China had the lowest resistance to amikacin and tigecycline accounted for 7.69% and 2.33%（P 〈0.05）.Conclusion Antibiotic resistant bacteria with NDM-1 resistant gene have become a global public health problem,and significant difference among age,districts and sources,which need active surveillance and more studies to find how it happens and epidemic in the future.

关 键 词：NDM-1 流行病学特征 耐药谱 转移机制 

分 类 号：R446.5[医药卫生—诊断学]