2008年中国15所教学医院医院感染患者分离的肠杆菌科细菌耐药性分析

目的监测2008年我国不同地区15所教学医院医院感染患者中分离的肠杆菌科细菌的耐药性。方法按设计方案收集非重复的1 357株医院感染患者中分离的肠杆菌科细菌。菌株经中心实验室复核后,采用琼脂稀释法测定15种抗菌药物的最低抑菌浓度(MIC),数据输入WHONET5.6软件进行统计分析。结果大肠埃希菌、肺炎克雷伯菌和奇异变形杆菌敏感率较高的药物有美罗培南(97.6%～100%)、帕尼培南(79.8%～98.4%)、亚胺培南(64.9%～98.1%)、厄他培南(91.3%～97.4%)、哌拉西林-他唑巴坦(87.2%～97.4%)、头孢美唑(82.1%～97.0%)和阿米卡星(89.9%～93.8%)。肠杆菌属细菌敏感率较高的抗菌药物有美罗培南(98.7%)、帕尼培南(96.4%)、亚胺培南(95.4%)和阿米卡星(85.7%)。弗劳地枸橼酸杆菌和黏质沙雷菌敏感率较高的药物有碳青霉烯类抗生素(92.0%～100%)、哌拉西林-他唑巴坦(93.1%～99.1%)、阿米卡星(89.0%～94.3%)和头孢吡肟(86.2%～93.1%)。结论碳青霉烯类抗生素、哌拉西林-他唑巴坦和阿米卡星对医院分离的肠杆菌科细菌保持了较高的抗菌活性,头孢美唑对大肠埃希菌、肺炎克雷伯菌和奇异变形杆菌表现出良好的抗菌活性。

Antimicrobial resistance surveillance study in 2008 on the nosocomial Enterobacteriaceae strains isolated from 15 teaching hospitals in China

Objective To investigate the antimicrobial resistance in nosocomial Enterobacteriaceae isolates collected from 15 teaching hospitals located at different regions of China in 2008.Methods According to the study protocol,a total of 1 357 nonduplicate nosocomial strains of Enterobacteriaceae were collected and sent to the central lab for re-identification and susceptibility testing.The minimum inhibitory concentrations(MICs) of 15 antimicrobial agents were determined by agar dilution method.WHONET 5.6 software was used to analyze the data.Results The antimicrobial agents exhibiting high in vitro activity against Escherichia coli,Klebsiella pneumoniae and Proteus mirabilis included meropenem(to which 97.6%-100% of the strains were susceptible),panipenem(79.8%-98.4%),imipenem(64.9%-98.1%),ertapenem(91.3%-97.4%),piperacillin-tazobactam(87.2%-97.4%),cefmetazole(82.1%-97.0%) and amikacin(89.9%-93.8%).Meropenem(to which 98.7% of the strains were susceptible),panipenem(96.4%),imipenem(95.4%) and amikacin(85.7%) were highly active against Enterobacter spp.Carbapenems(92.0%-100%),piperacillin-tazobactam(93.1%-99.1%),amikacin(89.0%-94.3%) and cefepime(86.2%-93.1%) displayed high activity against Citrobacter freundii and Serratia marcescens.Conclusions Carbapenem,piperacillin-tazobactam and amikacin remain highly active against nosocomial strains of Enterobacteriaceae,while cefmetazole exhibited high activity against Escherichia coli,Klebsiella pneumoniae and Proteus mirabilis isolates.