中国细菌耐药性监测-CHINET监测—房山讲课1.ppt

Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,中国细菌耐药性监测,-,CHINET,监测,（,2010,年,）,参加单位,上海华山医院,上海瑞金医院,北京协和医院,卫生部北京医院,浙医一附院,上海儿科医院,湖北同济医院,广州医学院一附院,上海市儿童医院,重庆医大一附院,甘肃省人民医院,新疆医大一附院,安徽医科大学一附院,昆明医学院一附院,2010,年,CHINET,监测网,临床分离菌在门诊和住院患者中的分布,住院患者,（,85.8,）,（,41060/47850,）,门诊患者,（,14.2,）,（,6790/47850,）,2010,年,CHINET,监测网,临床分离菌在各类标本中的分布,呼吸道标本,（,46.9,）,尿液标本,（,19.9,）,血液标本,（,11.9,）,伤口脓液（,5.2,）,无菌体液（,4.0,）,生殖道分泌物（,1.7,）,粪便标本（,1.2,）,其他（,8.2,）,脑脊液（,1.0,）,CHINET,耐药监测革兰阴性菌菌种分布,细菌,株数,细菌,株数,大肠埃希菌,9225,26.91,摩根菌属,195,0.57,克雷伯菌属,5529,16.13,产碱杆菌,107,0.31,不动杆菌属,5523,16.11,少动鞘氨醇单胞菌,94,0.27,铜绿假单胞菌,5080,14.82,金杆菌属,92,0.27,肠杆菌属,1961,5.72,罗尔斯顿菌属,74,0.22,嗜麦芽窄食单胞菌,1661,4.85,气单胞菌属,76,0.22,变形杆菌属,907,2.65,多源菌属,53,0.15,流感嗜血杆菌,734,2.14,普罗威登菌属,46,0.13,沙雷菌属,437,1.27,志贺菌属,149,0.43,其他假单胞菌,420,1.23,丛毛单胞菌,14,0.04,其他嗜血杆菌,395,1.15,奈瑟菌属,11,0.03,沙门菌属,355,1.04,博特菌属,13,0.04,柠檬酸杆菌属,350,1.02,黄杆菌属,16,0.05,伯克霍尔德菌属,320,0.93,其他,218,0.64,莫拉菌属,227,0.66,合计,34282,100.0,CHINET,耐药监测革兰阳性菌菌种分布,细菌,株数,金葡菌,4452,32.81,肠球菌属,4046,29.82,凝固酶阴性葡萄球菌,3078,22.69,（血液脑脊液等无菌体液）,肺炎链球菌,944,6.96,-,溶血性链球菌,808,5.96,草绿色链球菌（血液及无菌体液）,186,1.37,其他,54,0.40,合计,13568,100.0,MSSA(2177,株,),与,MRSA(2302,株,),的耐药率（,%,）,MRSA,的耐药率,MSSA,约,80%,和,70%,的菌株对,TMP/SMZ,、磷霉素仍敏感,MSSA,对,内酰胺类、,TMP/SMZ,、磷霉素、利福平和左氧氟沙星的耐药率,10%,无万古霉素、利奈唑胺或替考拉宁耐药株,MSCNS(817,株,),和,MRCNS(2302,株,),的耐药率（,%,）,MRCNS,的耐药率,MSCNS,MRCNS,中有,88%,、,77%,和,73%,的菌株对利福平、氨苄西林,/,舒巴坦、磷霉素仍敏感,无万古霉素、利奈唑胺或替考拉宁耐药株,2010,年,14,家医院粪肠球菌,(1829,株,),和屎肠球菌,(1817,株,),的耐药率（,%,）,屎肠球菌的耐药率粪肠球菌，但氯霉素反之,粪肠球菌对呋喃妥因、磷霉素、氨苄西林的耐药率低,少数屎肠球菌、粪肠球菌对万古霉素、利奈唑胺或替考拉宁耐药,2010,年,14,家医院,9225,株大肠埃希菌耐药率（,%,）,2010,年,14,家医院,5529,株克雷伯菌属耐药率（,%,）,2010,年,14,家医院,907,株变形杆菌属耐药率（,%,）,2010,年,14,家医院,1961,株肠杆菌属细菌耐药率（,%,）,2010,年,14,家医院,350,株柠檬酸杆菌属细菌耐药率（,%,）,2010,年,14,家医院,195,株摩根菌属细菌耐药率（,%,）,2010,年,14,家医院,437,株沙雷菌属细菌耐药率（,%,）,2010,年,14,家医院,355,株沙门菌属细菌耐药率（,%,）,抗菌药物,耐药,敏感,氨苄西林,56.2,42.6,氨苄西林,/,舒巴坦,24.8,52.1,阿莫西林,/,克拉维酸,18.3,61.4,头孢哌酮,/,舒巴坦,0.0,89.9,头孢曲松,14.6,81.8,环丙沙星,4.6,76.2,复方磺胺甲噁唑,40.6,57.9,磷霉素,1.7,98.3,氯霉素,35.7,63.5,2010,年,14,家医院福氏志贺菌和宋内志贺菌的敏感性（,%,）,抗菌药物,福氏志贺菌（,54,株）,宋内志贺菌（,86,株）,耐药,敏感,耐药,敏感,氨苄西林,100.0,0.0,92.6,6.0,氨苄西林,/,舒巴坦,60.4,10.4,9.6,67.5,头孢曲松,60.0,40.0,53.8,46.2,环丙沙星,48.2,37.5,2.3,89.5,复方磺胺甲噁唑,65.5,30.9,90.5,8.3,磷霉素,2.6,97.4,1.6,98.4,氯霉素,68.2,25.0,3.2,95.2,2010,年,14,家医院,19289,株肠杆菌科细菌耐药率（,%,）,抗菌药物,耐药,敏感,亚胺培南,4.6,87.6,美罗培南,4.2,91.8,厄他培南,5.9,83.9,头孢哌酮,/,舒巴坦,阿米卡星,9.1,10.0,75.3,87.0,哌拉西林,/,他唑巴坦,10.4,79.3,头孢他啶,31.0,61.6,头孢吡肟,22.0,69.6,庆大霉素,41.1,56.9,2010,年,14,家医院,5080,株铜绿假单胞菌耐药率（,%,）,2010,年,14,家医院,5523,株不动杆菌属,(,鲍曼不动,89.6%),细菌的耐药率（,%,）,除头孢哌酮,/,舒巴坦、米诺环素外，其余抗菌药的耐药率均,50%,亚胺培南和美罗培南的耐药率接近,60%,2010,年,14,家医院嗜麦芽窄食单胞菌和伯克霍尔德菌属的耐药率（,%,）,抗菌药物,嗜麦芽窄食单胞菌（,1661,株）,抗菌药物,伯克霍尔德菌属（,320,株）,耐药,敏感,耐药,敏感,头孢哌酮,/,舒巴坦,13.8,65.2,哌拉西林,/,他唑巴坦,22.1,70.4,左氧氟沙星,10.7,86.1,头孢他啶,21.8,72.8,复方磺胺甲噁唑,11.2,86.7,美罗培南,19.7,70.3,米诺环素,3.4,82.1,复方磺胺甲噁唑,27.6,64.0,米诺环素,17.6,68.1,CHINET,各医院,不动杆菌属,对亚胺培南和美罗培南的耐药率,医院,株数,亚胺培南,美罗培南,耐药,敏感,耐药,敏感,上海儿童医院,100,50.0,48.0,48.0,52.0,广州医大一附院,243,33.3,62.9,39.5,58.9,重庆医大一附院,377,63.1,35.8,63.3,35.5,上海儿科医院,186,47.0,43.8,58.9,37.8,卫生部北京医院,247,61.9,38.1,61.5,37.7,上海华山医院,532,62.7,36.7,63.8,36.0,北京协和医院,706,67.5,32.1,68.0,31.7,甘肃省人民医院,244,12.3,87.7,13.2,86.4,上海瑞金医院,503,46.8,53.0,46.1,53.3,湖北同济医院,595,54.8,43.4,57.6,42.1,浙医一附院,782,74.6,24.6,75.7,23.8,新疆医大一附院,294,35.8,61.8,32.2,65.3,安徽医大一附院,422,54.0,43.6,58.4,40.4,昆明医大一附院,292,72.4,24.0,70.4,29.6,2010,年,14,家医院流感嗜血杆菌的耐药率,(%),抗菌药物,总体（,734,株）,儿童株（,432,株）,成人株（,302,株）,耐药,敏感,耐药,敏感,耐药,敏感,氨苄西林,31.7,59.0,34.9,52.6,27.0,68.8,氨苄西林,/,舒巴坦,14.5,85.5,16.0,84.0,12.1,87.9,头孢呋辛,7.2,88.4,8.7,86.4,4.8,91.6,头孢噻肟,8.9,91.1,9.0,91.0,8.9,91.1,头孢曲松,14.1,85.9,16.1,83.9,6.5,93.5,氯霉素,12.5,78.3,12.7,76.6,12.2,81.2,阿奇霉素,4.2,95.8,2.1,97.9,8.0,92.0,环丙沙星,14.2,85.8,3.7,96.3,17.3,82.7,复方磺胺甲噁唑,64.5,34.0,71.8,27.7,53.5,43.4,儿童株产酶率：,31.6%,，成人株产酶率：,23.3%,（总产酶率：,28.1%,）,（,2009,年，,27.5%,）,2010,年儿童患者,674,株肺炎链球菌的耐药率,(%)*,抗菌药物,PSSP,（,474,株）,PISP,（,107,株）,PRSP,（,93,株）,耐药,敏感,耐药,敏感,耐药,敏感,青霉素,0.0,100.0,0.0,0.0,100.0,0,头孢丙烯,4.9,88.0,55.4,29.3,77.9,11.8,万古霉素,0.0,100.0,0.0,100.0,0,100.0,红霉素,97.4,1.5,98.1,1.0,81.8,15.9,克林霉素,96.6,3.4,97.2,2.8,81.3,18.7,莫西沙星,0.0,99.8,0.0,100.0,0.0,100.0,左氧氟沙星,0.9,98.7,0.0,100.0,1.1,94.6,利奈唑胺,0.0,100.0,0.0,100.0,0.0,100.0,儿童,PSSP,、,PISP,和,PRSP,株对红霉素、克林霉素的耐药率均高于成人,儿童分离株对氟喹诺酮类的耐药率低于成人株,2010,年成人患者,270,株肺炎链球菌的耐药率,(%)*,抗菌药物,PSSP(249,株,),PISP(9,株,),PRSP(12,株,),耐药,敏感,耐药,敏感,耐药,敏感,青霉素,0.0,100.0,0,0,100.0,0,万古霉素,0.0,100.0,0,9,0,100.0,红霉素,79.0,16.5,9,0,75.0,25.0,克林霉素,76.6,20.8,8,1,66.7,33.7,莫西沙星,3.7,94.7,0,9,0.0,100.0,左氧氟沙星,7.4,90.5,0,9,0.0,100.0,THANK YOU,！,CHINET,监测,