2005年至2007年中国CHINET脑脊液的分离菌及其耐药性

目的 了解2005年至2007年中国CHINET监测网脑脊液分离菌的分布及其耐药性.方法 对CHINET监测网2005年1月至2007年12月所有脑脊液标本按常规方法进行分离、培养、鉴定.按统一方案用Kirby-Bauer纸片扩散法进行抗菌药物敏感试验.结果 2005年至2007年脑脊液标本获分离菌941株,其中革兰阳性菌588株.占62.5%;革兰阴性菌349株,占37.1%;真菌4株,占0.4%.革兰阳性菌所占比例由2005年的59.9%增至2007年的64.6%,革兰阴性菌所占比例由2005年的39.6%降至2007年的35.4%.最常见的分离菌依次分别为凝固酶阴性葡萄球菌、不动杆菌属、肠球菌属、铜绿假单胞菌、金黄色葡萄球菌、大肠埃希菌、克雷伯菌属、肠杆菌属、肺炎链球菌、链球菌属和其他假单胞菌.葡萄球菌属和肠球菌属中未发现万古霉素耐药株,肺炎链球菌对青霉素的耐药率为42.9%.肠杆菌科细菌对碳青霉烯类高度敏感,不动杆菌属和铜绿假单胞菌对碳青霉烯类耐药率为24.1%～29.3%.结论 2005年至2007年脑脊液分离菌中革兰阳性菌多于革兰阴性菌,脑脊液分离株对常用抗菌药物耐药明显.

Antimicrobial susceptibility in isolates from cerebrospinal fluid specimens in CHINET of China from 2005 to 2007

Objective To investigate the distribution and drug resistance of antimicrobial susceptibility in cerebrospinal fluid culture isolates in CHINET of China from 2005 to 2007.Methods The cerebrospinal fluid specimens in CHINET from Jan.2005 to Dee.2007 were routinely isolated,cultured and identified.The susceptibilities were determined by Kirby-Bauer methods.Results A total of 941 strains were isolated from the cerebrospinal fluid specimens from 2005 to 2007,Gram positive bacteria and Gram negative bacteria accounted for 62.5%(588/941)and 37.1%(349/941),respectively.Fungus accounted for 0.4%(4/941).The Gram positive bacteria increased from 59.9% in 2005 to 64.6% in 2007 and Gram negative bacteria decreased from 39.6% to 35.4% in the meantime.The most frequent isolates were coagulase negative Staphylococci,Acinetobacter spp,Enterococci spp,Pseudomonas aeruginosa,Staphylococcus aureus,Escherichia coli and Klebsiella spp,Enterobacter spp,Streptococcus pneumoniae,Streptococcus spp and Pseudomonas spp.No strains resistant to vancomycin were found in Staphylococci and Enterococci.Penicicillin-resistant Streptococcus peurnoniae was found in 42.9% of strains.Enterobacteriaeeae were highly susceptible to earbapenem,while carbapenem resistant Acinetobacter and Pseudornonas aeruginosa were found in 24.1%-29.3% of strains.Conclusions Gram positive bacteria are more prevalent than Gram negative bacteria in isolates from cerebrospinal fluid specimens and resistance to the first line antibiotics is common among all cerebrospinal fluids isolates.