Mohnarin 2008年度ICU细菌耐药性监测

目的了解我国来源于重症监护病房(ICU)患者病原菌的分布及对抗菌药物的耐药性。方法采用纸片法、MIC法或E-test法测定细菌药物敏感性,使用WHONET5.4软件进行分析,对卫生部全国细菌耐药性监测网(Mohnarin)所属89所三级甲等医院2008年1月1日-12月31日上报数据中明确标明ICU来源的菌株进行分析。结果共分离病原菌6115株,其中革兰阴性菌4378株(71.6%),革兰阳性菌1737株(28.4%),前5位分别为鲍氏不动杆菌933株(15.3%)、铜绿假单胞菌850株(13.9%)、金黄色葡萄球菌765株(12.5%)、肺炎克雷伯属669株(10.9%)和大肠埃希菌559株(9.1%);耐头孢西丁金黄色葡萄球菌、表皮葡萄球菌和溶血葡萄球菌的检出率分别为84.8%、93.0%和95.0%,未发现对万古霉素和利奈唑胺耐药的葡萄球菌属;粪肠球菌和屎肠球菌中分别有1.5%和6.7%对万古霉素耐药,3.6%和1.2%对替考拉宁耐药;大肠埃希菌对三代头孢菌素(包括头孢他啶)、头孢吡肟、氨曲南的耐药率70.0%,对喹诺酮类的耐药率70.0%;大肠埃希菌和肺炎克雷伯菌产ESBLs比率分别为74.4%和73.1%,高于同期整体监测水平;铜绿假单胞菌、鲍氏不动杆菌对碳青酶烯类耐药率进一步上升,鲍氏不动杆菌耐药率为60.0%,超过铜绿假单胞菌耐药率。结论我国ICU来源细菌仍然以非发酵菌、葡萄球菌属、肺炎克雷伯菌、大肠埃希菌为主;细菌的耐药进一步恶化,必须加以注意。

Mohnarin Annual Report of 2008:Monitoring of Bacterial Drug Resistance in Intensive Care Unit

OBJECTIVE To determine the bacterial distribution and drug resistance in ICU infections in China.METHODS Disc diffusion test,MIC test and E-test were used to detect the antimicrobial sensitivity of bacterial isolates from ICU patients.WHONET 5.4 was applied for analyzing the bacterial sensitive data from 89 tertiary Mohnarin member hospitals in China from Jan 1,2008 to Dec 31,2008.RESULTS A total of 6115 strains of pathogens were isolated in the survey period,which included 4378(71.6%) Gram-negative strains...