【word】 2009年中国CHINET肠球菌属细菌耐药性监测

【word】 2009年中国CHINET肠球菌属细菌耐药性监测 2009年中国CHINET肠球菌属细菌耐药性 监测 2010??11?n20???P10???P6?(ChinJInfectChemother?eNovember?t2010? eV01?t10?eNo?t6421 2009???D??CHINET ???? ?g???? ?????? ?????? ??????1?e ??????5?e ?}??9?e ????14?e ?u???(2?e ??????5?e ?)?7?810?e ????14 ??????2?e ???)?C6?e ???c10?e ???????? ???1?????????o???R???[ ?????A3?e??????3?e??????4?e????4?e???c5?e ???g??6?e????7?e???F??7?e??????8?e???$??8?e ?)?????e???i??11?e??????)7?e?U??12?e???M??)7?e ?????T?????????????c?e?Q?p?U???h?????1???????????6?????????????o???RQ0?????????c?e?Q?p14?z?????q??(12 ?z???n?R?q???e2?z?{???q??)?J???????$Q2???-??????????Q2????(K)bB??)???S???i??(CLSI2009???$)???]???1?????????? ?o???R???[Q0???????h???Q3769?u?????c???1??Q0???W???????p?????1??1764?u(46?t8?C)Q2?????1??1605?u (42?t6?C)Q2???K???1??60?u(1?t60A)Q2?(???1??51?u(1?t4?C)Q0???1???????????s?$?r??Q2?i???J?)Q2???1???????????((?o?? ??<4?C)?e????3?u?s?$?r???o?????1???e?????1?????????1?????i???J?)?o?????h?a?p0?t3?C??3?t5?CQ0?????1?????[?? ????Q2???J?)Q2?-???????o?????????e?h?a?p4?t3?CQ211?t3?CQ215?t6?C?e???????????R?J?)?o?????p40?t1?C?5?????1???o???R?t?} ?????????1???e???-???????o????????90?C?e???????????R?J?)?o????????70?C?e?=???G?J?)?o???????p5?t4?CQ0?c?e?q?? ?h???????1???????????????o?????J???????0Q0?????i???J?B?o?????1?????(???J????????Q0???a?G???????u?a?s?$?r ???o???????1?????u?t???V???U??????????????????Q0 ???Y???T???1???5?????o???R???[?e???????? ?D???h?????TR378?t2???Y?i???2?TA?????4???T1009-7708f2010)06-0421)b05 CHINET2009survei??anceofantibioticresistanceinE??fP?eDcDcc)3sinChina YANGQing?eyQo?eYunsong?eNJYuxing?eSUNJingyong?eXUYingchun?eSUNHongli?eSUNZiyong?e JIANCui?eWANGFu?eZHUDemei?eHUFupin?eJIANGXiaofei?eWANGChuanqing?eWANGAimin?e ZHUOChao?eSUDanhong?eHU?????????w???9???????q???5 4?t???D?????R???e???q?????w???e???q???5 5?t?c???R???w???????q???5 6?t?c???R???w???{???q???5 7?t?????q?????w???P???q???5 8?t???(???9???q???5 9?t?????q???R???w???P???q???e 10?t?????q???R???w???P???q???e 11?t?I?????T?R???w???{???q???5 12?t?H???2???r?q???5 13?t?????q???R???w???P???q???5 14?t?h?t?q?????w???P???q??Q0 ???C?????T????(1972??)?e?ZQ0???q?????n?e?q???????e?q???????? ???(???R???????????[???o???p?l?b??Q0 ?T?????C?T???????eE-mailzyvysll9@163?tcomQ0 Yan?t(DepartmentofInfectiousDiseases?eFirst AffiliatedHospital?eCollegeofMedicine?eZhejiang University?eHangzhou310003?eChina) Abstract?T0bjectiveToinvestigatetheantimicrobialresist)b anceinEnterococcusspeciesisolatedfromhospitalsinseveral regionsofChinaduring2009?tMethodsTwelvegeneralhos)b pitalsand2children)EShospitalswereinvolvedinthispro)b gram?tAntimicrobialsusceptibilitytestingwascarriedOutby meansofKirby-Bauer(KB)accordingtoaunifiedprotoc01?t ThedatawereanalyzedbyWHONET5?t4softwareaccord)b ingtoCLSI2009breakpoint?tResultsAtotalof3769non- duplicateEnterococcusisolateswerecollected?tincludingE?t faecalis(rl=1764?e46?t8?C)Q0E?tfaecium(n=1605?e 42?t6?C)?eEgallinarum(?4=60Q01?t60A)andE?tavium(?? =51?e1?t4+A)?tStrainsofEnterococcuswerestillhighlySUS)b 422?D???(???t?4???d??2010??11?n20???P10???P6?(ChinJInfectChemother?eNovtember?t2010?eV01?t10?eNo?t6 ceptibletolinezolid?evancomycinandteicoplanin?tTheoverallresistantrat eswere<4?C?tOnly3strainswerefoundresistantto linezolid?tThepercentageofE?t??ecalisandE?tfaeciumstrainsresistanttov ancomycinwere0?t3oAand3?t5?C?tAbout4?t3?C?e 11?t3?Cand15?t6?CofE?t??ecaliswereresistanttonitrofurantoin?efosfomycinandampicillin?tFortypercent(40?C)ofE?tfae)b calisisolateswereresistantto gentamicin(highlevel)?tE?tfaeciumstrainsweremoreresistanttomostoftheantibioticstested thanE?t?e??ecalis?tMorethan90?CE?tfaeciumstrainswereresistanttoampicillimandnearly70?Cresistanttogentamicin (highlevel)?ebutonly5?t4?Cresistanttochloramphenic01?tTheantibioticresistanceofEnterococcu$variedwidelywithregionor hospital?tConclusionsTheincreasingprevalenceofVREinsomehospitals?eespeciallytheemergenceoflinezolidresistant strains?eshouldbepaidseriousattentiontoinclinicalandlaboratorypractice?t Keywords?5Enterococcus?5antibioticresistancesurvellance?5antimicrobialagent ???1?????????G?q???(?????W?????????????e ?P??????????2009???D??CHINET?????o???R?? ?[??14?z?q?????U???h?????1???????????o???R ???[????Q0 ?????t???? ??Q2???u???? ?l??2009??1?n1????2000??12?n31?D?? CHINET?????o???R???[???D14?z?q???U???i?P ?h???????1?????e???????c???uQ0 ??Q2???????? ???-CLSI?????????+??????(Kirby)bBauer?e K)bB)Q0????????ATCC25923?p?-?????e???????? ?????JCLSI2009???$?i???S???????yQ0?i???J ?)Q2?s?$?r?????+?[?????????p?o???u?e?E???d?6?D ???-?i???J?)Q2???1????Q2?s?$?r??E???????[?? MIC????Q0?z?J???????-WHONET5?t4?????? ???h??Q0 ???? ??Q2???1?????????h?1 2009??14?z?q?????h?????1????3769?u?e?W ?????????K?p?????1??1764?u(46?t8?C)Q2?????1?? 1605?u(42?t6?C)Q2???K???1??60?u(1?t6?C)Q2?(???1 ??51?u(1?t4?C)?e????1Q0?q???h?????{??(1902 ?u)Q2?z??(383?u)Q2???@???????U?>????????(374 ?u)?e?{???i?P?D?????1?????????1???h?????????e?h ?a?p46?t1?C(877?m1902)Q244?t3?C(842?m1902)?e?=?-?z ???i?P?D?????1???h?????????????1???e?h?a?p 49?t6?C(190?m383)Q238?t9?C(149?m383)?e????2Q0 ??114?z?q???h???????1???????h?1(?u??) Table1?tSpeciesdistributionofEnterococcusisolatesbyhospital(numberof isolates) SpeciesAHHBJHCQHGSHGZHHSHKMHPEDPUHRJHSCHTJHXJHZJHTotal?C E?tfaecalis8030484274193421272793812916358218176446?t8 E?tCaecium10535524060232831771591892698103246160542?t6 Egallinarum64129151310601?t6 E?tavium5152182126511?t4 E?tralf{nosu$2141263371?t0 Ecasseliflavus E?tdurans Ehirae 0therEnterococci 2 1 73 72 3 20 3 176 1 Total2106811287139429125361505572554531624913769100 AHH?TTheFirstAffiliatedHospitalofAnhuiMedicalUniversity?5BJH?TBeijingHospital?5CQH?TTheFirstAffiliatedHospitalof ChongqingMedicalUniversity}GSH?TThePeople)EsHospitalofGansuProvince?5GZH?TTheFirstAffiliatedHospitalofGuangzhouMedicaI College?5HSH?TShanghaiHuashanHospital?5KMH?TTheFirstAffiliatedHospitalofKunmingMedicalCollege?tPED?TShanghaiPediatricHos?t pital?5PUH?TPekingUnionHospitalRJH?TShanghaiRuijingHospital?5SCH?TShanghaiChildren)EsHospital?5TJH?TWahanTongjiHospital?5 XJH?TTheFirstAffiliatedHospitalofXinjiangMedicalUniversity?5ZJH?TTheFirstAffiliatedHospitalofZhejiangUniversityMedicineCol?? 1ege?t O 3 1 3 A? A? A? A? 1 O O 5 6 3 5 8 3 1 9l 9 2 lm 2 2010??11?n20???P10???P6?(ChinJInfectChemother?eNovember?t2010 Q0V01?t10?eNo?t6423 ??Q2???1???????6???????????????(?R ?????1?????i???J?)Q2???1????Q2?s?$?r???o?? ???+<1?C?e???K???[??????Q2???J?)Q2?-???????o?? ???????e?h?a?p4?t3?CQ211?t3?CQ215?t6?C?e???????????R ?J?)?o?????p40?t1?C?e?????E???(Q2???R?(???(Q2?G?J ?)?o?????-30oA??40?C?e?????J?)Q2?s?????o?????? ??50?CQ0?????1???o???R?t?}?????????1???e???i ???J?)Q2???1????Q2?s?$?r???o????-C4oA?e???-???? ???o?????p90?t9?C?e???[??????Q2???J?)?o?????h?a ?p?p40?t7?CQ232?t1?C?e???????????R?J?)?o?????p 69?t4?C?e?????E???(Q2???R?(???(Q2???J?)Q2?s?????o ?????+>80?C?e?=???G?J?)?o????(5?t4?C)?t?}???? ?????1??(31?t9?C)Q0???K???1?????i???J?)???(?? ????????(88?t3?C)?e?=?????1????Q2?s?$?r???????? ?(?e???G?J?)Q2???J?)?o????<30?C?5?u?????(???1?? ???i???J?)Q2???1????Q2?s?$?r???J?o???u?e???G?J ?????1???D???+??????????5?u?i???J?)?o?? ?u(vancomycin-resistantEnterococcus?eVRE)?e?9?? ?????q???h????1?u??E?????????e???????1?? ???o???e???[?????p?<?JVanA?????e????4?u?D3 ?u?pVanA???o???e1?u?pVanB???o??Q0???s?$ ?r???+???(Q0?????1???D????56?uVRE?e?h?a?? ???????R???q?????w??????(17?u)Q2???>?e???q?? (15?u)Q2?9???????q??(10?u)Q2?9???q??(6?u)Q2?I ???????q??(5?u)Q2?h?t?q?????w??????(3?u)?e?q ???h?????{??(18?u)Q2?z??(15?u)Q2????????(15 ?u)?e???s?$?r?????(???p97?t8?C?e???G?J?)???(?? ?p92?t30AQ0?????1?????o?????p58?t?C?e?D???? 22?t6?C?e?F???o?????????[52?u?pVanA???o???e4 ?u?pVanB???o??Q0???????????s?$?r???o?????1 ??3?u?e???D?????1??1?u?h?????????q???R???w ????Q0?????1??1?u?h?????h?t?q?????w?????e???? ?)Q2?[???????o?????h?a?p9?t5?CQ210?t9?C?e????3Q0???1????????1?u?h???????>?e???q??Q0 ??3?q?????1?????????6?????????????o?????????(??(?C) Table3?tResultsofantimicrobialsusceptibilityofmainEnterococcusspecie s(?C) 424?D???(???t?4???d??2010??11?n20???P10???P6?(ChinJInfectChemother?eNovtember?t2010?eV01?t10?eNo?t6 ??4?i???J?)?o???????1?????????????????(?R(?C) Table4?tResultsofantimierobialsusceptibilityof vancomycinresistantE?t??ecium(?C) ?6?z?q???h?????????1?????????1?????????? ?????o???????-???0?e????5Q2??6Q0???????1???D?e ?T???q???h???????u???-???????o????<20?C?e?= ?????q???R???w???????????u???-???????o?????? ??80?t9?C?e?h?t?q?????w???????????u?????E???( ?o?????????e???p6?t5?CQ0?????1???D?e???>?e???q ?????9???q???????u???i???J?)?o?????p15?CQ0?? ???R???q?????w?????????9???????q???????u?o?? ???p7?C?e?t?}?????????q??Q0?c???R???w???{?? ?q???????u???[???????o???????p8?t0?C?e?t?}?? ?????????n?R?q??Q0 ??5?6?q???h?????????1?????q?????????????o????(?C) Table5?tResistancerateofE?t?e??ecalisisolatestoantimicrobialagentsindi fferenthospitals(?C) 94?t3 14?t3 11?t4 91?t4 85?t4 6?t9 6?t9 83?t2 86?t0 7?t0 7?t0 89?t4 90?t6 0 1?t0 83?t6 88?t9 0 0 84?t6 O O 95?t3 2?t2 0?t4 87?t8 0 O Gentamicin)bHigh80?t068?t466?t764?t7090?t462?t960?t669?t267?t46 8?t656?t073?t371?t8 Nitrofurantoin37?t556?t18?t024?t153?t853?t745?t550?t083?t036?t549 ?t634?t6 Linezolid01?t0001?t21?t90000000 Seetable1fortheabbreviationsofhospitals?t ???? ?P?K???[?????t2008??CHINET?o?????[?w ??????)H1|?e?????1?????????1?????h???????J?t?} ???4?e?=14?z?q???D8?z?q???????1???????????? ?????1??Q0?{???i?P?D?????1?????????????e?t?? ???1???????e?e?z???i?P?D?????1?????????????? ???1??Q0 ?t2008???o?????[?????e?????1???????? ?1???q?o???R???J?t?}???4Q0?????1?????[???? 1 EJ A? 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A? 7 0 0 6 8 9 8 8??{{?? m ?? ?t= ?R ?4 =???? 2010??11?n20???P10???P6?(ChinJInfectChemother?eNovember?t2010 ?eV01?t10?eNo?t6425 ??Q2???J?)?o?????????h?a?p4?t3?CQ211?t3?C?e?S?? ???-???????1???V?????{???(???e???-?????????? ???(?e?o?????p15?t6?C?e???????????R?J?)?o???? 40?t1?CQ0?????1???o???R?t?}?????????1???e???? ?-???????o??????????90?CQ0???????????R?J?)?o ????????70?C?e???p?-???????????R?J?)???n?c?? ?-?????????(???e?=?????1?????G?J?)???o?????? 5?t4?CQ0?????1?????????1?????(?????????????? ??Q2???J?)Q2?s???????(?R?+????Q0?g???6?q???l?? ???????????-?????????c?e?e?z?h???????1?????? ???????????o?????J?????????0Q0???????q???R?? ?w???????h?????????1?????u???-???????o?????? ??80?C?5?e?h?t?q?????w???????????u?????E???( ?o????????Q0???p6?t5?CQ0?????1???D?e???>?e???q ?????9???q???????u???i???J?)?o?????p15?C?e?? ???R???q?????w?????????9???????q???????u?o?? ???p7?C?e?t?}?????????q???e?I???c???R???w???{ ???q???????u???[???????o???????p8?t0?C?e?t?} ???????????n?R?q??Q0 ???1???????i???J?)?????1?????????2?????? ???(?R(?o????<4?C)?e???????h???Q71?uVRE?e ???D?????1??5?u?e?????1??56?uQ0???????1??10 ?u?e???D25?uVRE??E?????????e?????t???+?? ????????Q0?t2007??CHINET???1???o?????[?? ??b3?????e?J7?z?q???h???QVRE?e???a?G???>?e ???q???h?????????1?????i???J?)?o?????t?}???? (2007???u?h???QVRE?e2009???p15?t3?C)?e?9?? ?q???h?????????1?????i???J?)?o???????J?z???? (2007???p9?t8?C?e2009???p14?t3?C)Q0VRE???s ?$?r?????????(?e?????1???????G?J?)???(?e?????? ?????????????o??Q0 ???Y?????s?$?r???-???4???????1?????????1 ???+?J???????????h???Q?s?$?r?? ?o???????1?????????6?1???e???o???p?l?q???t 23SrRNA??????G2576TQ2T2500A??T2504A?? ?????J??[6-9]?e???t?U???I???-?s?$?r???J??Q0?P?? ?w???g???u?????????]???????????s?$?r???? MIC?e?G?<?p?s?$?r???o???u???J??????Q0?????6 ?D??????????T???o???uQ0 ???1???Y?T [1]???c?e?g????Q2???????e?>?t2008???D??CHINET?????o???R ???[[J]?t?D???(???t?4???d???e2009Q09(5)?T321)b329?t [2]ClinicalandLaboratoryStandardsInstitute?tPerformancestandards forantimicrobialsusceptibilitytesting?TFiheenthInformation Supplement[S]?t2009Q0M100??S19?t [3]?????e???????e?u???(?e?>?t2007???D??CHINET???1?????o ???R???[EJ]?t?D???(???t?4???d??Q02009Q09(3)?T175)b179?t [4]?g????Q0?)???M?t?????e?>?t?s?$?r???????4???????-?b??[J]?t ?D???(???t?4???d??Q02008?e8(2)?T?V??88?t [5]BellJMQ0TurnidgeJD?eBellowCH?eeta1?tMulticentreevalua- tionoftheinvitroactivityoflinezolidintheWesternPacific [J]?tJAntimicrobChemother?e2003?e51(2)?T339)b345?t [6]???>?s?t?U?????t???s?(?t?>?t?s?$?r???o???e?i???J?)???(?? ?????1??1??[J]?t?s???q?????????t2009?e39(2)?T140?e143?t [7]SouliM?eSakkaV?tGalaniIQ0eta1?tColonisationwithvaneo)b myein-andlinezolid-resistantEnterococcusfaeciuminauni)b versityhospital?Tmolecularepidemiologyandriskfactorana)b lysis[J1?tIntJAntimicrobAgentsQ02009?e33(2)?T137)b142?t [8]Gomez-GilR?tRomero-GomezMP?eGarcia-AriasA?e??a1?tNoso- comialoutbreakoflinezolid)bresistantEnterococcus faecalis infectioninatertiarycarehospital[J]?tDiagnMicrobiolInfect Dis?e2009?e65(2)?T175)b179?t [9]YoshidaKQ0ShojiH?eHanakiHQ0eta1?tLinezolid-resistantme)b thicillin-resistantSf??pZococfHsaureusisolatedafterlong- termQ0repeateduseoflinezolid[J]?tJInfectChemother?e2009?e 15(6)i417)b419?t ?l?{???(?T2010-07)b15