Mohnarin2010年度报告:门急诊患者细菌耐药性监测

目的 了解我国门急诊患者分离菌对抗菌药物的耐药性.方法 采用纸片、MIC或E-test法测定细菌药物敏感性,使用WHONET5.5软件进行数据分析,对卫生部全国细菌耐药性监测网(Mohnarin)所属59所三级甲等医院2010年1月1日-12月31日门急诊来源的细菌药物敏感性进行分析.结果 共分离病原菌6452株,包括革兰阳性菌2279株占35.3％、革兰阴性菌4160株占64.5％,其中大肠埃希菌1501株占23.0％、凝固酶阴性葡萄球菌725株占11.2％、铜绿假单胞菌670株占10.4％、金黄色葡萄球菌564株占8.7％、克雷伯菌属细菌561株占8.7％；耐甲氧西林金黄色葡萄球菌和凝固酶阴性葡萄球菌的检出率分别为34.0％和75.0％,未发现耐万古霉素金黄色葡萄球菌和凝固酶阴性葡萄球菌；5.6％屎肠球菌对万古霉素耐药；链球菌属主要对大环内酯类与克林霉素耐药,β-溶血链球菌和酿脓链球菌对左氧氟沙星耐药率＞30.0％；嗜血菌属对氨苄西林耐药率＞30.0％；大肠埃希菌和肺炎克雷伯菌耐药率低于同期整体监测水平；铜绿假单胞菌对各种抗菌药物的耐药率低于同期整体监测水平.结论 我国门急诊来源病原菌以葡萄球菌属、大肠埃希菌、铜绿假单胞菌多见；细菌耐药率较住院患者低,但主要细菌耐药率较为突出.

Mohnarin report of 2010:surveillance of bacterial resistance of outpatient and emergency patients

OBJECTIVE To explore the bacterial resistance in emergency and outpatient isolates in China. METHODS Disc diffusion test,MIC test and E-test were used to detect the antimicrobial susceptibility of bacteria isolates from outpatients and emergency patients.WHONET 5.5 was applied for analyzing the bacterial susceptibility data from 59 tertiary care Mohnarin member hospitals in China from Jan 1,2010 to Dec 31,2010. RESULTS A total of 6 452 bacterial strains were isolated in the survey period,which included 2 279(35.3%) gram-positive strains and 4 160(64.5%) gram-negative strains.Escherichia coli(1501 strains,23.0%),coagulase-negative Staphylococci(725 strains,11.2%),Pseudomonas aeruginosa(670 strains,10.4%) Staphylococcus aureus(564 strains,8.7%),Klebsiella(561 strains,8.7%) were the most common five isolates.Meticillin-resistant S.aureus and coagulase-negative Staphylococci were 34.0% and 75.0% respectively;no glycopeptides-resistant Staphylococcus were detected.The resistant rates of Enterococcus faecium to vancomycin were 5.6%.Streptococcus were mainly resistant to macrolides and clindamycin and the resistant rates of β-hemolytic Streptococcus and Streptococcus viridans to levofloxacin were over 30.0%;the resistant rates of Hamophilus influenzae to ampicillin were over 30.0%;the resistant rates of E.coli,K.pneumoniae and P.aeruginosa were lower than those of the overall bacterial isolates. CONCLUSION E.coli,Staphylococci,P.aeruginosas,Klebsiella are the predominant pathogens isolated from outpatients and emergency patients in China.The resistant rates of E.coli,K.pneumoniae and P.aeruginosa are lower than the those of the overall bacterial isolates.