2010年全国医院感染横断面调查感染病例病原分布及其耐药性
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文细毛

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R181.3+2

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Distribution of pathogens and antimicrobial resistance: An analysis of China healthcareassociated infection crosssectional survey in 2010
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    摘要:

    目的了解医院感染和社区感染病原体分布及其对抗菌药物的耐药情况。方法对2010年3月1日—12月31日期间卫生部医院感染监测网医院上报的医院感染横断面调查资料中病原体及其耐药性数据进行统计分析。结果740所医院共检出医院感染病原体6 965株,革兰阳性(G+)菌、革兰阴性(G-)菌、真菌各占20.69%、66.03%、10.62%;居病原体首位的为铜绿假单胞菌(17.17%),其次为大肠埃希菌(13.51%)、鲍曼不动杆菌(11.01%)、肺炎克雷伯菌(10.73%)、金黄色葡萄球菌(8.83%),以上菌株占医院感染病原体的61.25%(4 266/6 965)。检出社区感染病原体13 653株,G+菌、G-菌、真菌各占28.68%、46.90%、10.41%;居病原体首位的为大肠埃希菌(12.14%),其次为铜绿假单胞菌(7.75%)、其他链球菌(6.28%)、金黄色葡萄球菌(5.51%)、病毒(5.33%),以上病原体占社区感染病原体的37.01%(5 053/13 653)。耐头孢西丁的金黄色葡萄球菌及表皮葡萄球菌检出率,医院感染分别为75.28%、67.86%,社区感染分别为49.23%、56.09%;大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌对头孢他啶的耐药率为34.24%~62.89%,医院感染与社区感染耐药率相比,高10% 左右,差异具有统计学意义(均P<0.01);社区感染和医院感染鲍曼不动杆菌对头孢哌酮/舒巴坦的耐药率分别为40.00%、59.33%。结论医院感染病原体高度集中,非发酵菌所占比例明显增高;医院感染和社区感染病原体分布及其耐药性均存在一定的差异,在临床经验性使用抗菌药物治疗时应区别对待。

    Abstract:

    ObjectiveTo study the distribution and antimicrobial resistance of pathogens causing healthcareassociated infection (HAI) and communityassociated infection (CAI).MethodsStatistical analysis was conducted based on data about the distribution and antimicrobial resistance of pathogens reported to China healthcareassociated infection crosssectional survey of National Healthcareassociated Infection Surveillance System from March 1 to December 31, 2010.ResultsA total of 6 965 strains of pathogens causing HAI were isolated from 740 hospitals, 20.69% of which were grampositive bacteria, 66. 03% were gramnegative ones, and 10. 62% were fungi; Pseudomonas aeruginosa ranked at the top of the pathogens causing HAI(17.17%), followed by Escherichia coli (13.51%), Acinetobacter baumannii (11.01%), Klebsiella pneumoniae (10.73%), and Staphylococcus aureus (8.38%), the above bacteria constituted 61.25% (4 266/6 965) of pathogens causing HAI. 13 653 strains of pathogens causing CAI were isolated, 28.68% of which were grampositive bacteria, 46.90% were gramnegative ones, and 10.41% were fungi; Escherichia coli ranked at the top of the pathogen causing CAI (12.14%), followed by Pseudomonas aeruginosa (7.75%),other Streptococcus (6.28%), Staphylococcus aureus (5.51%), and virus(5.33%), which in total accounted for 37.01% (5 053/13 653) of pathogens causing CAI. The isolation rate of cefoxitinresistant Staphylococcus aureus and Staphylococcus epidermidis was 75.28% and 67.86% respectively in HAI, and 49.23% and 56.09% respectively in CAI; Resistant rate of Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa to ceftazidime ranged from 34.24% to 62.89%, with a higher rate of around 10% in HAI than that in CAI (all P<0.01). The resistant rate of Acinetobacter baumannii to cefoperazonesulbactam was 40.00% and 59.33% in CAI and HAI respectively.ConclusionThe distribution of pathogens causing HAI is highly concentrated, and the infection caused by nonfermentative bacteria is quite serious; distribution and antimicrobial resistance of pathogens are different in HAI and CAI, therefore, the usage of antimicrobial agents in clinical should be different accordingly.

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文细毛,任南,吴安华.2010年全国医院感染横断面调查感染病例病原分布及其耐药性[J]. 中国感染控制杂志,2012,11(1):1-6.
WEN Ximao, REN Nan, WU Anhua. Distribution of pathogens and antimicrobial resistance: An analysis of China healthcareassociated infection crosssectional survey in 2010[J]. Chin J Infect Control, 2012,11(1):1-6.

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  • 收稿日期:2011-11-15
  • 最后修改日期:2011-12-28
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  • 在线发布日期: 2012-01-30
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