2005—2014年CHINET志贺菌耐药性监测

发布时间：2019-01-05 01:40

【摘要】：目的了解2005年1月—2014年12月中国不同地区19所医院临床分离志贺菌属的构成、分布及耐药性。方法收集19所教学医院临床分离的志贺菌属,按照统一方案,采用纸片扩散法或自动化仪器法进行药敏试验,按美国临床和实验室标准化协会(CLSI)2014年版标准判读结果,采用WHONET5.6进行数据统计分析。结果共收集到各医院临床分离志贺菌属1 110株。其中宋内志贺菌检出率48.4%,福氏志贺菌检出率46.2%。10年间,志贺菌属所测试药物中对氨苄西林耐药率最高(83.3%~97.6%),其次是甲氧苄啶-磺胺甲唑(55.6%~92.3%%)、头孢曲松(0~58.3%)、氨苄西林-舒巴坦(18.7%~64.4%)、阿莫西林-克拉维酸(6.8%~100%)、氯霉素(0~60%)、环丙沙星(6.8%~46.2%)。成人分离株对环丙沙星、头孢曲松的的耐药率分别为41.1%和25.5%,而儿童分离株对两者耐药率分别为17.2%和54.0%。结论10年间,临床分离的志贺菌属以宋内志贺菌和福氏志贺菌为主,上述分离株对喹诺酮类抗菌药物耐药率相对较低,对氨苄西林和甲氧苄啶-磺胺甲唑耐药率高;成人分离株对环丙沙星的耐药率高于儿童,对头孢曲松、氯霉素和阿莫西林-克拉维酸的耐药率低于儿童分离株。药敏试验结果提示临床上常规使用氨苄西林和甲氧苄啶-磺胺甲唑治疗志贺菌感染可能会导致治疗失败。
[Abstract]:Objective to investigate the composition, distribution and drug resistance of Shigella isolated from 19 hospitals in different regions of China from January 2005 to December 2014. Methods the clinical isolates of Shigella from 19 teaching hospitals were collected. According to the unified scheme, the drug sensitivity tests were performed by disk diffusion or automatic instrument method. The results were interpreted according to the (CLSI) 2014 edition of the American Association for Clinical and Laboratory Standardization. The data were analyzed by WHONET5.6. Results A total of 110 strains of Shigella were collected. Among them, the detection rate of Shigella sonnei and Shigella flexneri were 48.4 and 46.2.10 years respectively, the resistance rate of Shigella to ampicillin was the highest (83.3%). Trimethoprim sulfamethazol (55.6%), ceftriaxone (58.3%), ampicillin sulbactam (18.7%), amoxicillin clavulanic acid (6.8%), ampicillin (64.4%), amoxicillin (64.4%), ceftriaxone (58.3%), amoxicillin (64.4%), amoxicillin (64.4%), Chloramphenicol (0%), ciprofloxacin (6. 8%). The drug resistance rates of adult isolates to ciprofloxacin and ceftriaxone were 41. 1% and 25. 5%, respectively, while those of children were 17. 2% and 54. 0%, respectively. Conclusion during the past 10 years, Shigella sonnei and Shigella flexneri were mainly isolated. The resistance rate of these isolates to quinolones was relatively low, and the resistance to ampicillin and trimethoprim was high. The resistance rate of adult isolates to ciprofloxacin was higher than that of children, and to ceftriaxone, chloramphenicol and amoxicillin-clavulanic acid was lower than that of children. The results of drug sensitivity test suggested that routine use of ampicillin and trimethoprim-sulfamethazol in the treatment of Shigella infection may lead to failure of treatment.
【作者单位】：昆明医科大学第一附属医院;复旦大学附属儿科医院;上海交通大学附属儿童医院;北京协和医院;华中科技大学同济医学院附属同济医院;复旦大学附属华山医院;浙江大学附属第一医院;上海交通大学医学院附属瑞金医院;天津医科大学总医院;广州医科大学第一附属医院;新疆医科大学第一附属医院;浙江大学医学院附属邵逸夫医院;甘肃省人民医院;安徽医科大学第一附属医院;北京医院;中国医科大学附属第一医院;四川大学华西医院;内蒙古医科大学附属医院;重庆医科大学附属第一医院;
【分类号】：R446.5

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