Mohnarin2010年度报告:尿标本细菌耐药监测

目的 了解我国尿路感染常见病原菌的分布及耐药性.方法 59所卫生部全国细菌耐药监测网(Mohnarin)成员单位分离自尿标本的细菌,常规鉴定,采用纸片扩散法(K-B法)或自动化细菌鉴定系统测定细菌的耐药性,按CLSI 2010年版折点判断结果并采用WHONET 5.4软件进行统计分析.结果 共分离到细菌19 621株,其中革兰阳性菌5887株占30.0％,革兰阴性菌13 734株占70.0％,分离率最高的依次为大肠埃希菌8338株占42.5％、粪肠球菌1569株占8.0％、屎肠球菌1521株占7.8％、肺炎克雷伯菌1358株占6.9％；大肠埃希菌和肺炎克雷伯菌ESBLs检出率分别为67.8％、65.6％,对碳青霉烯类抗菌药物最敏感(耐药率＜5.0％),对阿米卡星、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦耐药率＜20.0％；屎肠球菌对各种抗菌药物的耐药率明显高于粪肠球菌,万古霉素(VRE)耐药株检出率分别为4.6％、0.8％,耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)比例分别为54.6％、76.9％,未检测到万古霉素、利奈唑胺耐药株.结论 我国尿路感染致病菌以大肠埃希菌为代表的革兰阴性杆菌为主,但肠球菌属等革兰阳性菌所占比例有所增多,多药耐药菌株增加,细菌耐药性监测对及时了解病原菌及其耐药性非常重要.

Mohnarin report of 2010:Surveillance of resistance of pathogens from urine specimens

OBJECTIVE To investigate the distribution and resistance of clinical isolates in urinary tract infections in China in 2010. METHODS All bacterial isolates from urine samples in 59 Mohnarin member hospitals were collected,antimicrobial susceptibility testing was carried out by Kirby-Bauer(KB) method or automatic microbiological analysis system,and the data were analyzed by WHONET5.4 software according to CLSI 2010 breakpoints. RESULTS A total of 19 621 clinical isolates were collected during 2010,Gram-negative bacilli and Gram-positive cocci accounted for 70.0% and 30.0%,respectively.The most common isolates were Escherichia coli 8338 strains(42.5%),Enterococcus faecalis 1569 strains(8.0%),Enterococcus faecium 1521 strains(7.8%),Klebsiellia pneumoniae 1358 strains(6.9%).The prevalence of extended-spectrum β-lactamases(ESBLs) was 67.8% in E.coli,65.6% in K.pneumoniae.Imipenem and meropenem were the most potent antimicrobial agents against Enterobacteriaceae(resistant rate <5.0%),the resistant rates to amikacin,cefoperazone-sulbactum and piperacillin-tazobactam were also less than 20.0%.E.faecium had higher resistance rates than E.faecalis.0.8% E.faecalis and 4.6% E.faecium were resistant to vancomycin.The detection rate of Methicillin-resistant isolates in S.aureus(MRSA) was 54.6% and 76.9% in coagulase negative Staphylococcus(MRCNS),no vancomycin or Linazolid resistant isolate was found in Staphylococcus. CONCLUSION Gram-negative bacilli such as E.coli are predominant organism causing urinary tract infections in China,but Gram-positive bacteria such as Entercoccus increase obviously in recent years.Multi-resistant pathogens have also increased,and continuous surveillance of trends in resistance patterns of uropathogens is important.