2010年度卫生部全国细菌耐药监测报告:0～14岁儿童细菌耐药监测分析

目的了解我国2010年度0～14岁细菌感染患儿病原菌构成及耐药性。方法收集2010年1-12月129所成员单位医院的儿科及成都市妇女儿童中心医院、山东大学齐鲁儿童医院0～14岁住院患儿细菌感染的临床分离菌株,依据2010年CLSI标准的常规鉴定和纸片扩散法(K-B),测定菌株对抗菌药物的敏感性,采用WHO-NET软件对收集到的细菌监测资料进行统计分析。结果共收集细菌25 110株,其中革兰阴性菌14 910株占59.4%,革兰阳性菌10 200株占40.6%;分离细菌在前5位的依次为大肠埃希菌占15.1%、凝固酶阴性葡萄球菌占14.4%、金黄色葡萄球菌占11.9%、肺炎克雷伯菌占11.3%、铜绿假单胞菌占7.6%;耐甲氧西林金黄色葡萄球菌(MRSA)、耐甲氧西林凝固酶阴性葡萄球菌(MRSCN)检出率分别为21.9%、83.1%,未发现对万古霉素、利奈唑胺耐药和中介的金黄色葡萄球菌及凝固酶阴性葡萄球菌;链球菌属未发现对利奈唑胺、万古霉素、替考拉宁中介和耐药株;产ESBLs大肠埃希菌占27.6%、肺炎克雷伯菌占36.0%、阴沟肠杆菌占33.4%;肠杆菌科均出现耐碳青霉烯类抗菌药物,奇异变形菌对亚胺培南的耐药率达25.3%。结论 4年儿童细菌耐药监测结果提示了细菌耐药趋势,对儿童细菌感染性疾病合理使用抗菌药物有重要指导意义。

Mohnarin annual report 2010:surveillance for bacterial resistance among children 0-14 years of age

OBJECTIVE To investigate the bacterial distribution and resistance in patients form 0 to 14 years of age.METHODS Under the unified program of Mohnarin,the clinical isolates were collected from the children at 0 to 14 years of age from department of pediatrics of 129 Mohnarin member hospitals and Chengdu Woman and Children Central Hospital;the drug susceptibility testing was carried out according to K-B recommended by CLSI 2010,and the statistical analysis of the data of surveillance for the collected bacteria was performed with use of WHONET 5.5.RESULTS There were totally 25 110 strains of bacteria collected which included 14910(59.4%) strains of gram-negative bacteria and 10 200(40.6%) strains of gram-positive bacteria;the isolated bacteria ranking for the top 5 were as the following:Escherichia coli(15.1%),coagulase-negative Staphylococus(14.4%),S.aureus(11.9%),Klebsiellia pneumonia(11.3%),and Pseudomonas aeruginosa(7.6%);the detection rates of methicillin-resistant S.aureus(MRSA) and coagulase-negative Staphylococcus(MRSE)were 21.9% and 83.1%,respectively.No S.aureus or MRSE isolates resistant or intermediate to vancomycin and linezolid were found.No Streptococcus isolates were found resistant or intermediate to linezolid,vancomycin,or teicoplanin;ESBLs-producing E.coli accounted for 27.6%,ESBLs-producing K.pneumoniae 36.0%,Enterobacter cloacae 33.4%;Enterobacteriaceae were resistant to carbopenems,the drug resistance rate of Proteus mirabilis to imipenem was 25.3%.CONCLUSION The result of the surveillance for bacterial resistance in 4 years shows the trend of bacterial resistance,which has important guiding significance in rational use of antibiotics in treatment of bacterial infectious diseases in children.