2010年中国CHINET肠球菌属细菌耐药性监测

目的了解2010年中国主要地区临床分离肠球菌属细菌对各类抗菌药物的耐药性。方法国内主要地区14所教学医院(12所综合性医院,2所儿童医院)按统一方案、采用统一的材料、方法(K-B法)和判断标准(CLSI 2010年版)进行肠球菌属细菌的耐药性监测。结果共分离到4 046株非重复肠球菌属细菌,最常见菌种为粪肠球菌1 829株(45.2%)、屎肠球菌1 817株(44.9%)、鹑鸡肠球菌78株(1.9%)、鸟肠球菌54株(1.3%)、铅黄肠球菌49株(1.2%)。肠球菌属对利奈唑胺、万古霉素、替考拉宁仍极敏感,耐药率<4%,万古霉素耐药粪肠球菌和屎肠球菌检出率分别为0.6%、3.6%。粪肠球菌对呋喃妥因、磷霉素和氨苄西林耐药率较低,分别为3.2%、5.7%和11.3%,对高浓度庆大霉素耐药率为44.0%;屎肠球菌耐药性明显高于粪肠球菌,对氨苄西林耐药率接近90%,对高浓度庆大霉素耐药率接近70%,对氯霉素耐药率仅为7.3%,儿童屎肠球菌分离株对磷霉素、呋喃妥因耐药率<10%。不同医院分离的肠球菌属细菌对抗菌药物的耐药率有一定差异。结论屎肠球菌的分离率有增加趋势,肠球菌属细菌对利奈唑胺、万古霉素、替考拉宁依然保持极高的敏感性。

CHINET 2010 surveillance of antibiotic resistance in Enterococcus in China

Objective To investigate the antimicrobial resist ance in Enterococcus species isolated from hospitals in several regions of China during 2010. Methods Twelve general hospitals and 2 children hospitals were involved in this program. Antimicrobial susceptibility testing was carried out by means of Kirby-Bauer（K-B） according to the unified protocol. The data were analyzed by WHONET 5.4 software according to CLSI 2010 breakpoints. Results A total of 4 046 nondupli cate Enterococcus isolates were collected. The most common isolates were E. faecalis （1 829, 45. 2%）, E. faeciurn （1 817, 44. 9%）, E. gallinarum （78, 1. 9%）,E. aviurn （54, 1.3%） and E. casseliflavus （49, 1.2%）. The strains of Enterococcus were still highly susceptible to linezolid, vancomycin and teicoplanin. The overall resistance rates were〈4%. The prevalence of vancomycin-resistant E. faecalis and E. faecium was 0. 6% and 3. 6%, respectively. The percentage of E. faecalis resistant to nitrofurantoin, los-fomycin and ampicillin was 3.2% ,5.7% and 11.3%, respectively. About 44.0% of E. faecalis isolates were resistant to genta-micin（high level）. The E. faecium strains were more resistant to most drugs tested than E. faecalis. Nearly 90%%o and 70% E. faecium strains were resistant to ampicillin and gentamicin（high level）, respectively. But only 7.3% of these strains were re sistant to chloramphenicol. Less than 10% of the E. faecium isolated from children were resistant to fosfomycin or nitrofuran toin. The resistance of Enterococcus varied widely with region or hospital. Conclusions The prevalence of E. faecium is increasing progressively. Linezolid, vancomycin and teicoplanin are still active against Enterococcus isolates.