2014年中国云南地区细菌耐药监测

发布时间：2018-04-18 03:23

本文选题：耐药性 + 监测　；参考：《中国抗生素杂志》2016年09期

【摘要】：目的了解云南省临床分离菌对常用抗菌药的敏感性和耐药性。方法采用纸片扩散法或自动化仪器法按统一方案进行细菌药敏试验。按CLSI 2014年版标准判断药物敏感性。结果 2014年l月至12月各医院临床分离菌82548株,其中革兰阴性细菌58969株,占71.4%,革兰阳性细菌23579株,占28.6%。甲氧西林耐药金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率分别为27.2%和78.2%,未发现万古霉素、替考拉宁和利奈唑胺耐药菌株。肠球菌属细菌中屎肠球菌对所测试的抗菌药(氯霉素和利奈唑胺除外)的耐药率均显著高于粪肠球菌,两者中均有少数万古霉素和替考拉宁耐药株,耐药率1%。儿童株中对青霉素敏感(PSSP)、中介(PISP)和耐药(PRSP)的检出率分别为75.3%、17.3%和7.4%,成人株中分别为70.5%、27.9%和1.6%。大肠埃希菌、克雷伯菌属细菌和奇异变形菌中产超广谱β-内酰胺酶(ESBLs)株分别为55.4%、29.3%和26%。肠杆菌科细菌对碳青霉烯类抗生素仍高度敏感,绝大多数菌株的耐药率低于10%。大肠埃希菌和肺炎克雷伯菌对亚胺培南和美罗培南的耐药率分别为0.4%和0.3%,6.2%及5.2%,同比2013年有所增长。铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别27.0%和23.3%,鲍曼不动杆菌对亚胺培南和美罗培南的耐药率分别49.1%和51.5%。结论细菌耐药性仍呈增长趋势,对碳青霉烯酶耐药的肠肝菌科细菌及鲍曼不动杆菌因引起高度重视,避免其流行播散,对临床构成严重威胁。进行流行病学调查并采取有效的控制措施,刻不容缓。
[Abstract]:Objective to investigate the susceptibility and drug resistance of clinical isolates to common antimicrobial agents in Yunnan Province.Methods the method of disk diffusion or automatic instrument was used to test bacterial susceptibility according to the unified scheme.Drug sensitivity was assessed according to CLSI 2014 standard.Results from January to December 2014, there were 82548 clinical isolates of Gram-negative bacteria, among which 58969 were Gram-negative bacteria, accounting for 71.4, and 23579 Gram-positive bacteria, accounting for 28.6B.The positive rates of MRSAs and MRCNSs were 27.2% and 78.2%, respectively. Vancomycin, teicoplanin and linazolamide resistant strains were not found in MRSAs and MRCNSs of methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase-negative staphylococci, respectively.The resistance rate of Enterococcus faecium to the tested antibiotics (except chloramphenicol and linazolamide) was significantly higher than that of Enterococcus faecalis. There were a few vancomycin and teicoplanin resistant strains in both strains, and the resistance rate was 1.The positive rates of PSSPN, PISP) and PRSPR in children were 75.3% and 7.4% respectively, and 70.50.29% and 1.6% in adult strains, respectively.Extended-spectrum 尾 -lactamases (ESBLs) strains of Escherichia coli, Klebsiella and Proteus mirabilis were 55.4% and 26.3%, respectively.Enterobacteriaceae bacteria are still highly sensitive to carbapenem antibiotics, and the resistance rate of most strains is lower than 10.The drug resistance rates of Escherichia coli and Klebsiella pneumoniae to imipenem and meropenem were 0.4% and 0.32% and 5.2% respectively, increasing from 2013.The resistance rates of Pseudomonas aeruginosa to imipenem and meropenem were 27.0% and 23.3respectively, and those of Acinetobacter baumannii to imipenem and meropenem were 49.1% and 51.5%, respectively.Conclusion the drug resistance of bacteria is still on the rise, and it is a serious threat to the clinical practice because of the high attention paid to the enterobacteriaceae and Acinetobacter baumannii, which are resistant to carbapenem.It is urgent to carry out epidemiological investigation and take effective control measures.
【作者单位】：昆明医科大学第一附属医院;
【基金】：2014年国家自然科学基金(No.81460322) 2014年云南应用基础研究联合专项(No.2014FB043)
【分类号】：R446.5

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