2010年CMSS对革兰阴性杆菌耐药性监测报告
2010년CMSS대혁란음성간균내약성감측보고
Report from Chinese Meropenem Susceptibility Surveillance in 2010 : antimicrobial resistance among nosocomial gram-negative bacilli
  • 万方数据
    中华检验医学杂志 중화검험의학잡지
    CHINESE JOURNAL OF LABORATORY MEDICINE
    2011年 10期 897-904 ,共8页

    王辉%赵春江%王占伟%倪语星%陈民钧%徐英春%俞云松%张莉滟%梅亚宁%褚云卓%胡志东%廖康%张晓兵%孙自镛%徐修礼%黄心宏%张菲菲%张冀霞%王启

    왕휘%조춘강%왕점위%예어성%진민균%서영춘%유운송%장리염%매아저%저운탁%호지동%료강%장효병%손자용%서수례%황심굉%장비비%장기하%왕계

    革兰氏阴性菌%抗药性,细菌%微生物敏感性试验 革蘭氏陰性菌%抗藥性,細菌%微生物敏感性試驗
    혁란씨음성균%항약성,세균%미생물민감성시험
    Gram-negative bacteria%Drug resistance,bacterial%Microbial sensitivity tests
    目的 监测2010年中国革兰阴性杆菌的耐药性.方法 收集2010年9-12月全国13家教学医院的1 259株非重复的革兰阴性杆菌.菌株经中心实验室复核后,采用琼脂稀释法测定美罗培南等广谱抗菌药物的MIC.药敏结果判断采用CLSI 2011年M100-S21标准.结果 14种抗菌药物对845株肠杆菌科细菌的抗菌活性,敏感性依次为美罗培南829株(98.1％)、阿米卡星794株(94.0％)、亚胺培南761株(90.0％)、哌拉西林/他唑巴坦739株(87.5％)、头孢吡肟701株(83.0％)、厄他培南696株(82.4％)、头孢哌酮/舒巴坦678株(80.3％)、黏菌素637株(75.4％)、头孢他啶591株(70.0％)、环丙沙星499株(59.1％)、头孢西丁463株(54.8％)、头孢曲松452株(53.5％)、头孢噻肟442株(52.3％)、米诺环素435株(51.5％).大肠埃希菌中ESBL的发生率为61.3％ (106/173),高于肺炎克雷伯菌[41.2％ (70/170)].大肠埃希菌对美罗培南、亚胺培南、阿米卡星、哌拉西林/他唑巴坦保持较好的敏感性,而对环丙沙星、头孢曲松和头孢噻肟的耐药率较高.肺炎克雷伯菌对美罗培南、亚胺培南、阿米卡星和黏菌素的敏感率均保持在90％以上,而对头孢曲松和头孢噻肟的耐药率较高.阴沟肠杆菌、产气肠杆菌、弗劳地柠檬酸菌,对美罗培南、阿米卡星、头孢吡肟、头孢哌酮/舒巴坦、亚胺培南、哌拉西林/他唑巴坦、厄他培南的敏感率都保持在80.0％以上.对于铜绿假单胞菌敏感性较高的药物为黏菌素(98.4％,182株)、阿米卡星(85.9％,159株)、哌拉西林/他唑巴坦(80.0％,148株)、头孢他啶(79.5％,147株)、美罗培南(74.1％,137株)、环丙沙星(74.1％,137株)、头孢吡肟(73.5％,136株)、亚胺培南(71.9％,132株)和头孢哌酮/舒巴坦(70.8％,131株).鲍曼不动杆菌对碳青霉烯类的敏感率小于37.0％,对米诺环素敏感率为47.8％.97.8％(176株)的鲍曼不动杆菌对黏菌素敏感,泛耐药鲍曼不动杆菌和铜绿假单胞菌发生率分别为60.1％(108株)和18.9％(35株).结论 碳青霉烯类对肠杆菌科仍保持高活性,但鲍曼不动杆菌和铜绿假单胞菌的耐药性增加,鲍曼不动杆菌对碳青霉烯类的耐药性显著增加.
    목적 감측2010년중국혁란음성간균적내약성.방법 수집2010년9-12월전국13가교학의원적1 259주비중복적혁란음성간균.균주경중심실험실복핵후,채용경지희석법측정미라배남등엄보항균약물적MIC.약민결과판단채용CLSI 2011년M100-S21표준.결과 14충항균약물대845주장간균과세균적항균활성,민감성의차위미라배남829주(98.1％)、아미잡성794주(94.0％)、아알배남761주(90.0％)、고랍서림/타서파탄739주(87.5％)、두포필우701주(83.0％)、액타배남696주(82.4％)、두포고동/서파탄678주(80.3％)、점균소637주(75.4％)、두포타정591주(70.0％)、배병사성499주(59.1％)、두포서정463주(54.8％)、두포곡송452주(53.5％)、두포새우442주(52.3％)、미낙배소435주(51.5％).대장애희균중ESBL적발생솔위61.3％ (106/173),고우폐염극뢰백균[41.2％ (70/170)].대장애희균대미라배남、아알배남、아미잡성、고랍서림/타서파탄보지교호적민감성,이대배병사성、두포곡송화두포새우적내약솔교고.폐염극뢰백균대미라배남、아알배남、아미잡성화점균소적민감솔균보지재90％이상,이대두포곡송화두포새우적내약솔교고.음구장간균、산기장간균、불로지저몽산균,대미라배남、아미잡성、두포필우、두포고동/서파탄、아알배남、고랍서림/타서파탄、액타배남적민감솔도보지재80.0％이상.대우동록가단포균민감성교고적약물위점균소(98.4％,182주)、아미잡성(85.9％,159주)、고랍서림/타서파탄(80.0％,148주)、두포타정(79.5％,147주)、미라배남(74.1％,137주)、배병사성(74.1％,137주)、두포필우(73.5％,136주)、아알배남(71.9％,132주)화두포고동/서파탄(70.8％,131주).포만불동간균대탄청매희류적민감솔소우37.0％,대미낙배소민감솔위47.8％.97.8％(176주)적포만불동간균대점균소민감,범내약포만불동간균화동록가단포균발생솔분별위60.1％(108주)화18.9％(35주).결론 탄청매희류대장간균과잉보지고활성,단포만불동간균화동록가단포균적내약성증가,포만불동간균대탄청매희류적내약성현저증가.
    Objective To investigate antimicrobial resistance among gram-negative bacilli in China in 2010.Methods A total of 1 259 consecutive and non-repetitive gram-negative bacilli were isolated from 13 teaching hospitals from September to December in 2010 in China.All of these isolates were sent to the central laboratory for re-identification and susceptibility testing.The MIC of meropenem and other antibacterial agents were determined by agar dilution method.Interpretive results was determined by CLSI M100-S21.Results The activity of 14 antibacterial agents against 845 Enterobacteriaceae isolates was as follows in order:meropenem ( 98.1％,829 ),amikacin ( 94.0％,794 ),imipeuem ( 90.0％,761 ),piperacillin/tazobactam ( 87.5％,739 ),cefepime ( 83.0％,701 ),ertapenem ( 82.4％,696 ),cefoperazone/sulbactam ( 80.3％,678 ),colistin (75.4％,637),ceftazidime (70.0％,591 ),ciprofloxacin (59.1％,499 ),cefoxitin ( 54.8％,463 ),ceftriaxone ( 53.5％,452 ),cefotaxime ( 52.3％,442 ) and minocycline(51.5％,435).The prevalence of ESBL was 61.3％ (106/173) in Escherichia coli,which was much higher than 41.2％ (70/170) in Klebsiella pneumoniae.The susceptibility rate of Klebsiella pneumoniae against meropenem,imipenem,amikacin and colistin were more than 90％,but were highly resistant to ceftriaxone and cefotaxime.Over 80％ of Enterobacter cloacae,Enterobacter aerogenes,Citrobacter freundii,were susceptible to meropenem,amikacin,cefepine,cefoperazone/sulbactam,imipenem,piperacillin/ tazobactam,and ertapenem.The most active antibiotics against Pseudomonas aeruginosa were Colistin (98.4％,182),Amikacin ( 85.9％,159 ),Piperacillin/Tazobactam ( 80％,148 ),Ceftazidime ( 79.5％,147),Meropenem (74.1％,137),Ciprofloxacin (74.1％,137),Cefepime (73.5％,136),Imipenem (71.9％,132) and Cefoperazone/Sulbactam (70.8％,131 ).Less than 37％ of Acinetobacter baumannii isolates were resistant to carbapenems.The susceptible rate to Minocycline was 47.8％.Colistin kept good activity against Acinetobacter baumannii (susceptible rate,97.8％,n =176),The prevalence of Pan-drug resistant P.aeruginosa and A.baumannii was 18.9％ (n =35),and 61.8％ (n =108),respectively.Conclusions Carbapenems remained very high activity against Enterobacteriaceae.Increasing resistance to the antimicrobials agents test among A.baumanni and P.aeruginosa,especially carbapenems among A.baumanni brought great concern.
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