2010年度卫生部全国细菌耐药监测网报告:胆汁培养病原菌的构成及耐药性监测

目的了解我国胆道感染细菌分布及对常用抗菌药物的耐药性。方法按照卫生部全国细菌耐药监测网统一方案,2010年度由114所医院从胆汁分离的细菌进行药敏测定;相关数据采用WHONET 5.5软件进行统计分析。结果共分离4556株细菌,其中革兰阴性杆菌2888株占63.4%,革兰阳性球菌1668株占36.6%;革兰阴性杆菌中位列前3位的是大肠埃希菌占23.2%、肺炎克雷伯菌占8.5%和铜绿假单胞菌占6.8%;最常见的革兰阳性球菌是屎肠球菌占11.6%,粪肠球菌占11.5%;大肠埃希菌和肺炎克雷伯菌对三代头孢菌素的耐药率以头孢噻肟最高,分别为72.9%和60.3%,对头孢吡肟的耐药率分别为30.9%和20.5%,对左氧氟沙星耐药率分别为58.2%和30.2%,对美罗培南的耐药率为2.0%和3.8%;铜绿假单胞菌对美罗培南、头孢哌酮/舒巴坦和哌拉西林/他唑巴坦的耐药率分别为16.1%、20.3%和24.2%;屎肠球菌和粪肠球菌对糖肽类药物的耐药率为0.5%～2.2%;该次检测中首次出现对利奈唑胺的耐药株,耐药率为0.7%和1.7%。结论我国胆道感染病原菌以大肠埃希菌、肠球菌属和肺炎克雷伯菌最常见,肠杆菌科细菌对碳青霉烯类抗菌药物的耐药率呈上升趋势,耐糖肽类肠球菌属分离率有所增加,出现了耐利奈唑胺菌株。

Mohnarin annual report 2010:distribution of bile culture-derived pathogens and surveillance of drug resistance

OBJECTIVE To investigate distribution and antibiotic resistance of bacteria causing biliary tract infection in China.METHODS Bile cultures and antimicrobial susceptibility tests for isolated strains were performed in 114 Mohnarin member hospitals using standard protocols of Mohnarin in 2010.The data were collected and analyzed using WHONET 5.5 software.RESULTS A total of 4556 strains of pathogens were isolated during the study period,including 2888(63.4%) strains of gram-negative bacilli and 1668(36.6%) strains of gram-positive cocci.The top three gram-negative bacilli were Escherichia coli(23.2%),Klebsiella pneumoniae(8.5%) and Pseudomonas aeruginosa(6.8%),whereas the most frequently isolated gram-positive cocci were Enterococcus faecium(11.6%) and E.faecalis(11.5 %).Susceptibility test results showed that E.coli and K.pneumoniae had the highest resistance rates to cefotaxime among the third-generation cephalosporin,i.e.72.9% and 60.3%,respectively.The resistance rates to cefepime were 30.9% and 20.5%,respectively,and the resistance rates to levofloxacin were 58.2% and 30.2%,respectively.Both E.coli and K.pneumoniae were resistant to meropenem,with the resistance rates of 2.0% and 3.8%,respectively.The resistance rates of P.aeruginosa to meropenem,cefoperazone/sulbactam and piperacillin/tazobactam were 16.1%,20.3% and 24.2%,separately.The resistance rates of E.faecium and E.faecalis to glycopeptide varied between 0.5% and 2.2%.linezolid-resistant E.faecium and E.faecalis were firstly reported in our surveillance,with resistance rates of 0.7% and 1.7%,respectively.CONCLUSION The most common pathogens from bile culture are E.coli,Enterococcus and K.pneumonia.The resistance rates of enterobacteriaceae to carbapenem keep increasing and the isolation rates of glycopeptide-resistant Enterococcus increase.Linezolid-resistant isolates have emerged.