湖南省细菌耐药监测网2011年度监测报告

Hunan Provincial Bacterial AntimicrobialResistance Surveillance System:2011 surveillance report

摘要:

目的了解湖南地区感染患者细菌标本来源、分布及其对抗菌药物的敏感情况，为临床经验性使用抗菌药物提供参考数据。方法应用WHONET 5. 6 软件对湖南省细菌耐药监测网各网点医院2011年度上报的细菌耐药监测数据进行统计分析。结果共收集24 632株细菌，有标本来源信息的细菌17 413株（70.69%），其中痰标本占48.87%，尿标本和血标本分别占11.95%和8.14%；细菌分布：革兰阳性（G+）菌7 784株（31.60%），革兰阴性（G-）菌16 848株（68.40%），居前3位的细菌分别为大肠埃希菌（17.68%）、肺炎克雷伯菌（12.85%）和金黄色葡萄球菌（11.69%）。肠杆菌科细菌对碳青霉烯类药物最敏感（敏感率90.2%～98.9%）；非发酵菌中最敏感的抗菌药物：铜绿假单胞菌为阿米卡星（敏感率80.0%）、鲍曼不动杆菌为头孢哌酮/舒巴坦（敏感率77.1%）；葡萄球菌属细菌对替考拉宁、奎奴普丁/达福普汀、利奈唑胺和万古霉素的敏感率为90.5%～100.0%,耐甲氧西林金黄色葡萄球菌（MRSA）和耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）的检出占同菌种的37.4%、69.8%；在肠球菌属细菌中，粪肠球菌对替考拉宁最敏感（敏感率98.2%），而屎肠球菌对利奈唑胺最敏感（敏感率96.4%）。结论来源于无菌部位的标本偏少，无菌部位的标本送检率有待提高；细菌分布以G-菌为主，在经验性使用抗菌药物时，应针对可能的病原菌选取不同的抗菌药物。

关键词:

耐药监测;革兰阴性菌;革兰阳性菌;耐甲氧西林金黄色葡萄球菌;耐甲氧西林凝固酶阴性葡萄球菌;抗药性，微生物;抗菌药物

Abstract:

ObjectiveTo investigate the source, distribution and antimicrobial susceptibility of bacteria in patients with bacterial infection in Hunan Province, so as to provide reference for clinical empirical antimicrobial use.MethodsWHONET 5.6 software was used for analyzing bacterial drugresistance surveillance data reported to Hunan Provincial Bacterial AntimicrobialResistance Surveillance System in 2011 by hospitals participating in the system.ResultsA total of 24 632 bacterial isolates were collected, 17 413 (70.69%) isolates had information about the sources of specimens, 48.87%, 11.95% and 8.14% of which were sputum, urine and blood specimens respectively. Distribution of bacteria was as follows: grampositive bacteria 7 784 isolates(31.60%), gramnegative bacteria 16 848 isolates(68.40%), the top three bacteria were Escherichia coli(17.68%), Klebsiella pneumoniae(12.85%), and Staphylococcus aureus(11.69%). Enterobacteriaceaes were most sensitive to carbapenems(sensitive rate were 90.2%-98.9%); among nonfermentative bacteria, the sensitive rate of Pseudomonas aeruginosa to amikacin was 80.0%, Acinetobacter baumannii to cefoperazone/sulbactam was 77.1%; the sensitive rate of Staphylococcus spp. to teicoplanin, quinupristin/dalfopristin, linezolid, and vancomycin were 90.5%-100.0%, and 37.4% of Staphylococcus aureus and 69.8% of coagulase negative Staphylococcus(CNS) were methicillinresistant; Among Enterococcus spp., Enterococcus faecalis had the highest sensitive rate to teicoplanin(98.2%), and Enterococcus faecium had the highest sensitive rate to linezolid(96.4%).ConclusionSpecimens from sterile sites are not common, delivery rate of specimens from sterile sites should be enhanced; the main bacteria are gramnegative bacteria, for the empirical antimicrobial use, antimicrobial agents should be chosen according to probable pathogens.

Key words:

drugresistance surveillance; gramnegative bacteria; grampositive bacteria; methicillinresistant Staphylococcus aureus; coagulase negative Staphylococcus; drugresistance, microbial; antimicrobial agent