2012年中国CHINET不动杆菌属细菌耐药性监测

摘要

目的：了解2012年我国不同地区15所医院临床分离不动杆菌属细菌的构成、分布及其耐药性。方法共收集15所教学医院临床分离的8739株不动杆菌属，其中鲍曼不动杆菌7827株（89．6％）。按照统一方案，采用纸片扩散法或自动化仪器法进行药敏试验，结果按CLSI 2013年版标准判读，采用WHONET5．6软件进行数据分析。结果8739株不动杆菌属细菌主要分离自住院患者，占85．4％，门急诊患者占14．6％。26．4％不动杆菌属分离自IC U ，其次为内科病房（22．0％）。鲍曼不动杆菌对替加环素、米诺环素和头孢哌酮-舒巴坦的耐药率最低，分别为10．9％、35．2％和35．7％，其次为阿米卡星（43．4％）；对亚胺培南和美罗培南的耐药率分别为63．5％和68．2％。不同医院不动杆菌属细菌对抗菌药物的耐药率也有不同，不同科室分离株的耐药率也有不同，其中以IC U 分离株耐药率最高。出现较多多重耐药（45．0％，3521/7827）和泛耐药（20．0％，1567/7827）株。结论鲍曼不动杆菌是不动杆菌属中最常见的菌种，检出率呈逐年增长的趋势。该菌对于除米诺环素、阿米卡星和头孢哌酮-舒巴坦外的大多数抗菌药物的耐药率在60．0％以上，且耐药率有逐年增高的趋势。不同地区医院鲍曼不动杆菌的耐药率相差较大，不同科室菌株的耐药率也有很大差异。%Objective To investigate the antimicrobial resistance in the A cinetobacter baumannii strains in different parts of China during 2012 .Methods A total of 8 739 clinical isolates of Acinetobacter were collected from 13 general hospitals and two children’s hospitals ,of which most were A . baumannii (89 .6% , 7 827/8 739 ) . Antimicrobial susceptibility testing was carried out by means of Kirby-Bauer method according to the unified protocol . The susceptibility testing data were analyzed by WHONET 5 .6 software according to CLSI 2013 breakpoints .Results Majority (85 .4% ) of the Acinetobacter strains were isolated from inpatients .The remaining 14 .6% were from outpatients and emergency room patients .Of the 7 827 strains of A .baumannii , 10 .9% ,35 .2% ,35 .7% and 43 .4% were resistant to tigecycline ,minocycline ,cefoperazone-sulbactam and amikacin , respectively .The percentage of A .baumannii resistant to imipenem and meropenem was 63 .5% and 68 .2% ,respectively . The antimicrobial resistant pattern varied in different hospitals . The resistance of A . baumannii varied between different clinical departments .A number of pandrug resistant (PDR) (20 .0% ,1 567/7 827) and multidrug-resistant (MDR) (45 .0% , 3 521/7 827 ) A . baumannii were identified . Conclusions A . baumannii is the most popular pathogenic bacteria among Acinetobacter .The antibiotic resistance of A .baumannii is still increasing .Cefoperazone-sulbactam and minocycline has good in vitro antibacterial activity against A .baumannii .The antibiotic resistance of A .baumannii varies greatly with hospital and department .