2010年度卫生部全国细菌耐药监测网报告:伤口感染病原菌分布及耐药监测

目的 了解2010年我国114所三级甲等医院临床患者伤口感染的细菌分布及耐药性.方法 采用纸片法、MIC法或E-test法进行药敏试验,采用WHONET 5.5软件进行统计分析.结果 共分离病原菌14424株,其中革兰阴性菌8428株占58.4％,革兰阳性菌5877株占40.8％；分离率最高的前5位病原菌依次为:大肠埃希菌占20.7％、金黄色葡萄球菌占16.3％、铜绿假单胞菌占9.6％、肺炎克雷伯菌占7.6％、表皮葡萄球菌占5.1％；未检出对万古霉素和利奈唑胺中介或耐药的葡萄球菌属,金黄色葡萄球菌、表皮葡萄球菌和溶血葡萄球菌对替考拉宁的中介率分别为0.1％、1.8％、0,耐药率分别为0.2％、0.9％、3.4％；未发现对利奈唑胺中介或耐药的肠球菌属,粪肠球菌和屎肠球菌对万古霉素的中介率分别为3.4％、1.4％,耐药率分别为1.3％、1.4％,粪肠球菌对替考拉宁的耐药率为0.8％,屎肠球菌对替考拉宁的中介率为0.6％,未发现耐替考拉宁屎肠球菌；肺炎克雷伯菌和大肠埃希菌对美罗培南的耐药率分别为3.1％、1.1％,鲍氏不动杆菌对多数抗菌药物的敏感性＜33.0％,铜绿假单胞菌和鲍氏不动杆菌对美罗培南的耐药率分别为15.4％、49.9％.结论 我国临床患者伤口感染主要致病菌分别为大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌和肺炎克雷伯菌,细菌耐药现象严重.

Mohnarin annual report 2010:distribution of pathogens causing wound infections and surveillance of drug resistance

OBJECTIVE To investigate the distribution and antibiotic resistance of bacteria causing wound infections in 114 tertiary hospitals in China in 2010.METHODS Disc diffusion test,MIC test and E-test were used to detect the drug susceptibility.WHONET 5.5 was applied for statistically analysis of the data.RESULTS A total of 14424 strains were isolated from wound infections,including 8428 strains of gram-negative bacteria,accounting for 58.4%,and 5877 strains of gram-positive bacteria,accounting for 40.8%.The top five pathogens were Escherichia coli(20.7%),Staphylococcus aureus(16.3%),Pseudomonas aeruginosa(9.6%),Klebsiella pneumoniae(7.6%) and Staphylococcus epidermidis(5.1%).No Staphylococcus spp.intermediate or resistant to vancomycin and linezolid was detected.The intermediate and resistant rates of S.aureus,S.epidermidis and S.haemolyticus to teicoplanim were 0.1%,1.8%,0 and 0.2%,0.9%,3.4%,respectively.No Enterococcus spp.was intermediate or resistant to linezolid.The intermediate and resistant rates of Enterococcus faecalis and E.faecium to vancomycin(VRE) were 3.4%,1.4% and 1.3%,1.4%,respectively.The resistance rate of E.faecalis to teicoplanin was 0.8%,and the intermediate rate of E.faecium to teicoplanin was 0.6%.No teitoplanin-resistant E.faecium isolate were found.The resistance rates of K.pneumonia and E.coli to meropenem were 3.1% and 1.1%,respectively.The susceptibility to most antibiotics of Acinetobacter baumannii was less than 33.0%.The resistance rates of P.aeruginosa and A.baumannii to meropenem were 15.4% and 49.9%,respectively.CONCLUSION E.coli,S.aureus,P.aeruginosa and K.pneumoniae are the predominant pathogens causing wound infections in China,and the bacterial resistance is serious.