2005—2014年CHINET克雷伯菌属细菌耐药性监测

发布时间：2017-12-31 02:31

本文关键词：2005—2014年CHINET克雷伯菌属细菌耐药性监测　出处：《中国感染与化疗杂志》2016年03期 　论文类型：期刊论文

【摘要】：目的了解2005—2014年CHINET细菌耐药性监测网所属19所医院临床分离克雷伯菌属细菌的分布及耐药性变迁情况。方法采用纸片扩散法或自动化仪器法对临床分离株作药物敏感性试验,并按CLSI 2014年版标准判断药敏试验结果。结果 2005—2014年共收集19所医院临床分离的肺炎克雷伯菌56 281株、产酸克雷伯菌4 779株、肺炎克雷伯菌臭鼻亚种300株及其他克雷伯菌属细菌46株。其中89.0%菌株(54 664/61 406)分离自住院患者。60.0%菌株(36 835/61 406)分离自呼吸道。成人来源的克雷伯菌属占83.3%(51 158/61 406),儿童(0~17岁)占16.7%(10 248/61 406)。10年间,克雷伯菌属细菌的检出率呈逐年上升趋势:2005年为10.1%,2014年为14.3%。药敏试验结果显示,10年里克雷伯菌属对碳青霉烯类药物耐药率呈上升趋势,对亚胺培南和美罗培南耐药率分别从2.9%上升到10.5%和2.8%上升到13.4%。产ESBL肺炎克雷伯菌和产酸克雷伯菌检出率从39.0%下降到30.1%。细菌对阿米卡星、环丙沙星、头孢他啶、哌拉西林-他唑巴坦和头孢哌酮-舒巴坦耐药率呈下降趋势,对头孢噻肟耐药率波动幅度较小,维持在49.5%左右。共检出碳青霉烯类耐药菌5 796株,其中肺炎克雷伯菌5 492株,产酸克雷伯菌280株。分离出广泛耐药菌共4 740株,其中肺炎克雷伯菌4 520株,产酸克雷伯菌202株。碳青霉烯类耐药株对绝大多数其他测试的抗菌药物耐药率均在60%以上,对替加环素、阿米卡星、甲氧苄啶-磺胺甲唑耐药率分别为16.8%、54.4%、55.1%。结论临床分离克雷伯菌属细菌对碳青霉烯类抗生素的耐药率10年间呈较大幅度增加,对其他常用抗菌药物耐药率较为平稳。
[Abstract]:Objective to investigate the distribution and drug resistance changes of Klebsiella in 19 hospitals under the CHINET bacterial Resistance Surveillance Network (CHINET) from 2005 to 2014. Methods the method of disk diffusion or automatic method was used to investigate the distribution and drug resistance of Klebsiella bacteria. The drug sensitivity of clinical isolates was tested by chemical instrument method. Results 56,281 strains of Klebsiella pneumoniae isolated from 19 hospitals were collected from 2005 to 2014. There were 4 779 strains of Klebsiella acidogenic bacteria. 89.0% strains of Klebsiella pneumoniae and 46 strains of Klebsiella pneumoniae were isolated from hospitalized patients (60.0%). 36 835/61 406) isolated from respiratory tract. Adult Klebsiella accounted for 83.3% 51 158/61 406). The detection rate of Klebsiella bacteria increased year by year: in 2005, it was 10.1%. In 2014, the drug sensitivity test showed that the resistance rate of Klebsiella to carbapenems showed an increasing trend. The rates of resistance to imipenem and meropenem increased from 2.9% to 10.5% and 2.8% to 13.4. the detection rate of Klebsiella pneumoniae and Klebsiella acidogenic bacteria increased from 39.0% to 39.0%, respectively. Down to 30.1. bacteria on amikacin. The resistance rates of ciprofloxacin, ceftazidime, piperacillin-tazobactam and cefoperazone-sulbactam showed a downward trend, and the resistance rate to cefotaxime fluctuated slightly. A total of 5 796 strains of carbapenem resistant bacteria were detected, including 5 492 strains of Klebsiella pneumoniae. 280 strains of Klebsiella pneumoniae were isolated and 4 740 strains were isolated, including 4 520 strains of Klebsiella pneumoniae. 60% strains of Klebsiella acidogenic bacteria. Carbapenem resistant strains were more than 60% to most other tested antimicrobial agents, and were resistant to tegacycline and amikacin. The drug resistance rates of trimethoprim and sulfamethazol were 16.8% and 54.4%, respectively. Conclusion the resistance rate of Klebsiella to carbapenem antibiotics increased significantly in the past 10 years, and the resistance rate to other commonly used antibiotics was relatively stable.
【作者单位】：广州医科大学附属第一医院呼吸疾病国家重点实验室;复旦大学附属华山医院;北京协和医院;华中科技大学同济医学院附属同济医院;上海交通大学医学院附属瑞金医院;天津医科大学总医院;新疆医科大学第一附属医院;复旦大学附属儿科医院;浙江大学附属第一医院;安徽医科大学第一附属医院;昆明医科大学第一附属医院;上海交通大学附属儿童医院;甘肃省人民医院;四川大学华西医院;北京医院;浙江大学医学院附属邵逸夫医院;重庆医科大学附属第一医院;中国医科大学附属第一医院;内蒙古医科大学附属医院;
【分类号】：R446.5
【正文快照】： CHINET细菌耐药性监测网自2005 年起建立,对我国多个地区临床分离菌的耐药情况进行连续监测,目前已有11 个省市、自治区19 所教学医院加入该监测网。现将2005—2014 年CHINET收集的克雷伯菌属细菌对临床常用抗菌药物的耐药性和敏感性结果总结如下。 1 材料与方法 1.1 材材料

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