CHINET中国细菌耐药性监测课件.ppt

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。,成员单位（致谢）,参加单位,上海华山医院（组长单位）,上海瑞金医院,北京协和医院,卫生部北京医院,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,安徽医科大学一附院,内蒙古医科大学一附,浙江邵逸夫医院,甘肃省人民医院,新疆医大一附院,昆明医大一附院,中国医大一附院,天津医科大学总院,四川大学华西医院,宁波龙赛医院,上海浦东人民医院,湖北秭归县人民医院,福建晋江市医院,四川省人民医院,湖南湘雅医院,陕西省人民医院,河南省人民医院,山东省立医院,山西省儿童医院,江西省儿童医院,吉林中日友谊医院,哈尔滨医科大学一附院,CHINET,在线网站,（,）,材料,细菌,2016.1.1,日,12.31,日临床分离株,剔除同一患者分离的重复菌株（血液、脑脊液和无菌体液除外）,剔除非无菌体液分离的凝固酶阴性葡萄球菌和草绿色链球菌,按统一方案进行抗菌药物敏感试验,培养基,药敏试验用,MH,琼脂，为,oxoid,公司商品。,抗菌药物纸片,抗菌药物纸片为,BBL,公司或,Oxoid,公司商品。,方法,药敏试验,纸片扩散法（,Kirby-bauer,）,自动化仪器检测,MIC,值,质控菌：大肠埃希菌,ATCC 25922,，铜绿假单胞菌,ATCC 27853,，金葡菌,ATCC 25923,，肺炎链球菌,ATCC 49619,和流感嗜血杆菌,ATCC 49247,。,药敏试验结果按,CLSI 2016,年版判断结果,万古霉素对葡萄球菌的药敏试验采用,MIC,法,内酰胺酶检测,头孢硝噻吩纸片法定性检测流感嗜血杆菌和卡他莫拉菌中的,内酰胺酶,方法,青霉素不敏感肺炎链球菌的检测,1mg/,片苯唑西林纸片测定肺炎链球菌的抑菌圈,直径,19mm,者用青霉素,E,试验条进一步测定其,MIC,耐万古霉素肠球菌的检测：,凡万古霉素纸片扩散法结果为非敏感的菌株，用万古霉素,Etest,加以确认，或用,PCR,扩增,vanA,、,vanB,、,vanC,等基因证实。,数据分析,采用,WHONET5.6,软件统计分析数据。,历年革兰阴性菌和阳性菌菌株数,年份,医院数,株数,革兰阴性菌,革兰阳性菌,2005,年,8,22774,15244,7530,2006,年,12,33811,23062,10749,2007,年,12,36001,23637,12364,2008,年,12,36216,25184,11032,2009,年,14,43670,31002,12668,2010,年,14,47850,34282,13568,2011,年,15,59287,42415,16872,2012,年,15,72397,52043,20354,2013,年,16,84572,61709,22863,2014,年,17,78955,57320,21635,2015,年,20,88778,62297,26481,2016,年,30,153084,71.6%,28.4%,所有标本分离菌主要菌种分布,细菌,株数,%,细菌,株数,%,大肠埃希菌,29799,19.47,其他假单胞菌,682,0.45,克雷伯菌属,21141,13.81,气单胞菌属,424,0.28,不动杆菌属,16477,10.76,幽门螺杆菌,408,0.27,金黄色葡萄球菌,13668,8.93,产碱杆菌属,305,0.20,铜绿假单胞菌,13254,8.66,其他嗜血杆菌,269,0.18,肠球菌属,12759,8.33,脑膜败血伊丽莎白金菌,262,0.17,凝固酶阴性葡萄球菌,7351,4.80,金黄杆菌属,258,0.17,肠杆菌属,5737,3.75,拉乌尔菌属,234,0.15,嗜麦芽窄食单胞菌,4775,3.12,弯曲菌属,205,0.13,-,溶血链球菌,4671,3.05,普罗威登菌属,164,0.11,流感嗜血杆菌,4156,2.71,泛菌属,121,0.08,肺炎链球菌,3655,2.39,奈瑟菌属*,104,0.07,变形杆菌属,2715,1.77,罗尔斯顿菌属,100,0.07,沙雷菌属,1782,1.16,无色杆菌属,86,0.06,伯克霍尔德菌属,1726,1.13,丛毛单胞菌属,61,0.04,柠檬酸杆菌属,1224,0.80,微球菌属,50,0.03,卡他莫拉菌,1180,0.77,志贺菌属,46,0.03,草绿色链球菌,1179,0.77,产单核细胞李斯特菌,43,0.03,沙门菌属,1026,0.67,其他,291,0.19,摩根菌属,696,0.45,Total,153084,100,*包括淋病奈瑟菌,89,株和脑膜炎奈瑟菌,15,株,主要标本分离菌株变迁,年份,菌株数,2005,年,22774,2006,年,33811,2007,年,36001,2008,年,36216,2009,年,43670,2010,年,47850,2011,年,59287,2012,年,72397,2013,年,84572,2014,年,78955,2015,年,88778,2016,153084,呼吸道,尿液,血液,伤口脓液,历年住院和门诊患者分离的菌株数,年份,医院数,株数,2005,年,8,22774,2006,年,12,33811,2007,年,12,36001,2008,年,12,36216,2009,年,14,43670,2010,年,14,47850,2011,年,15,59287,2012,年,15,72397,2013,年,16,84572,2014,年,17,78955,2015,年,20,88778,2016,年,30,153084,153084,株临床分离菌在各类标本中的分布,呼吸道标本,（,41.6%,）,尿液标本,（,19.1%,）,血液标本,（,13.3%,）,无菌体液（,5.4%,）,生殖道分泌物（,1.3%,）,粪便标本（,1.3%,）,其他（,9.0%,）,脑脊液（,1.6%,）,伤口脓液（,7.3%,）,63671,株呼吸道标本分离菌主要菌种分布（,%,）,29259,株尿道标本分离菌主要菌种分布（,%,）,20366,株血液标本分离菌主要菌种分布（,%,）,11188,株伤口脓液标本分离菌主要菌种分布（,%,）,8331,株其他无菌体液标本分离菌主要菌种分布（,%,）,2383,株脑脊液标本分离菌主要菌种分布（,%,）,主要革兰阴性杆菌分离率变迁,大肠埃希菌（,3949,）,肺炎克雷伯菌（,2136,）,鲍曼不动杆菌,（,2016,）,铜绿假单胞菌,（,2646,）,阴沟肠杆菌,（,641,）,嗜麦芽窄食单胞菌,（,1088,）,各医院金葡菌,MR,菌株检出率,医院,金黄色葡萄球菌,医院,金黄色葡萄球菌,MR,株数,/,总株数,（,%,）,MR,株数,/,总株数,（,%,）,武汉同济医院,973/1292,75.3,哈医大一附院,321/976,32.9,上海华山医院,275/434,63.4,内蒙医大一附院,159/489,32.5,宁波龙赛医院,43/69,62.3,湖南湘雅医院,216/672,32.1,北京医院,104/180,57.8,山东省立医院,159/508,31.3,甘肃省人民医院,222/384,57.8,福建晋江医院,60/199,30.2,广医一附院,167/312,53.5,中国医大一附院,93/324,28.7,安医一附院,194/391,49.6,四川华西医院,174/626,27.8,上海瑞金医院,206/428,48.1,湖北秭归人民医院,44/159,27.7,上海市儿童医院,281/654,43,北京协和医院,204/764,26.7,河南省人民医院,201/468,42.9,天津医大总医院,119/468,25.4,浦东人民医院,57/133,42.9,吉林中日友谊医院,84/333,25.2,江西省儿童医院,80/192,41.7,四川省人民医院,95/421,22.6,浙江邵逸夫医院,142/391,36.3,新疆医大一附院,135/625,21.6,昆明医大一附院,135/384,35.2,陕西省人民医院,50/407,12.3,复旦儿科医院,221/652,33.9,山西儿童医院,31/333,9.3,总计,5245/13668,38.4,各医院凝固酶,(-),葡萄球菌,MR,菌株检出率,医院,凝固酶,(-),葡萄球菌,医院,凝固酶,(-),葡萄球菌,MR,株数,/,总株数,（,%,）,MR,株数,/,总株数,（,%,）,福建晋江医院,35/37,94.6,天津医大总医院,213/272,78.3,上海瑞金医院,49/54,90.7,内蒙医大一附院,111/142,78.2,四川华西医院,187/211,88.6,哈医大一附院,634/815,77.8,昆明医大一附院,166/190,87.4,湖南湘雅医院,446/581,76.8,新疆医大一附院,106/125,84.8,山东省立医院,28/37,75.7,武汉同济医院,442/524,84.4,复旦儿科医院,285/379,75.2,北京医院,174/209,83.3,上海华山医院,162/217,74.7,吉林中日友谊医院,192/233,82.4,河南省人民医院,230/319,72.1,甘肃省人民医院,43/53,81.1,山西儿童医院,173/246,70.3,中国医大一附院,145/179,81,宁波龙赛医院,40/59,67.8,安医一附院,343/425,80.7,北京协和医院,215/318,67.6,广医一附院,118/147,80.3,江西省儿童医院,37/62,59.7,上海市儿童医院,448/560,80,浦东人民医院,23/47,48.9,四川省人民医院,322/403,79.9,陕西省人民医院,71/165,43,浙江邵逸夫医院,260/331,78.5,湖北秭归人民医院,3/11,27.3,总计,5701/7351,77.6,MRSA,和,MRCNS,的检出率变迁,MSSA,（,7967,株）与,MRSA,（,5245,株）对抗菌药的耐药率（,%,）,MRSA,对抗菌药的耐药率高于,MSSA,，但除外复方磺胺甲噁唑,(7.4%Vs 17.3%),未发现万古霉素、利奈唑胺和替考拉宁耐药的菌株。,MSCNS(1471,株,),和,MRCNS(5701,株,),对抗菌药的耐药率（,%,）,MRCNS,对抗菌药的耐药率高于,MSCNS,发现极少数利奈唑胺耐药菌株，但对万古霉素和替考拉宁敏感,MRCNS,对大多抗菌药的耐药率低于,MRSA,，但复方磺胺甲噁唑反之（,54.7%VS 17.3%,）,MRCNS,对利福平的耐药率较低，为,12.7%,；对其他均,30%,以上,粪肠球菌,(5402,株,),和屎肠球菌,(6473,株,),对抗菌药的耐药率（,%,）,屎肠球菌对抗菌药的耐药率高于粪肠球菌，但氯霉素反之（,23.4%Vs 5.8%,）。,144,株,VRE,中，粪肠球菌,21,株、屎肠球菌,123,株,溶血性链球菌对抗菌药的耐药率（,%,）,抗菌药物,A,组,B,组,C,组,F,组,G,组,未分型,草链,(n=2076),(n=2345),(n=156),(n=12),(n=34),(n=47),(n=1179),青霉素,0,0,0,0,0,0,7.4,红霉素,94.5,69.5,68.6,72.7,53.8,75,64.7,克林霉素,92.2,58.8,57.7,72.7,48.1,80,56,头孢噻肟,0,0,0,0,0,0,13,头孢曲松,0,0,0,NA,0,0,10.5,万古霉素,0,0,0,0,0,0,0,利奈唑胺,0,0,0,0,0,0,0,左氧氟沙星,0.5,55,4.3,0,3.4,5.9,11.6,成人和儿童医院中非脑膜炎肺炎链球菌的分布,菌株,儿童分离株,成人分离株,2015,年,2016,年,2015,年,2016,年,株数,%,株数,%,株数,%,株数,%,PSSP,900,86.5,2263,89.6,426,91.8,788,95.4,PISP,66,6.3,186,7.4,26,5.6,28,3.4,PRSP,75,7.2,78,3.1,12,2.6,10,1.2,合计,1041,100,2527,100.0,464,100,826,100.0,儿童患者分离非脑膜炎肺炎链球菌对抗菌药的敏感性,(%),肺炎链球菌对红霉素、克林霉素和复方磺胺甲噁唑的耐药率高,抗菌药物,PSSP,（,2263,株）,PISP,（,186,株）,PRSP,（,78,株）,耐药,敏感,耐药,敏感,耐药,敏感,青霉素,0,100,0,0,100,0,万古霉素,0,100,0,100,0,100,利奈唑胺,0,100,0,100,0,100,红霉素,96.9,2.1,97.3,2.2,98.7,0,克林霉素,95.5,4,97.2,2.8,97.4,2.6,复方磺胺甲噁唑,74.6,18.4,91.1,3,100,0,左氧氟沙星,0.7,99,0,100,0,94.7,莫西沙星,0.3,99.6,0,100,0,100,氯霉素,7.9,92.1,0,100,11.1,88.9,成人患者分离非脑膜炎肺炎链球菌对抗菌药的敏感性,(%),抗菌药物,PSSP,（,788,株）,PISP,（,28,株）,PRSP,（,10,株）,耐药,敏感,耐药,敏感,耐药,敏感,青霉素,0,100,0,0,100,0,万古霉素,0,100,0,100,0,100,利奈唑胺,0,100,0,100,0,100,红霉素,92.7,6.5,100,0,100,0,克林霉素,89.1,9.2,95.7,4.3,100,0,复方磺胺甲噁唑,59.5,27,95.7,0,83.3,16.7,左氧氟沙星,3.3,95.5,7.1,92.9,0,90,莫西沙星,1.8,97.6,4.5,95.5,0,100,氯霉素,11.7,88.3,6.2,93.8,20,80,各医院产,ESBL,菌株检出率,医院,大肠埃希菌,肺克和产酸,奇异变形杆菌,产,ESBLs,株数,/,总株数,（,%,）,产,ESBLs,株数,/,总株数,（,%,）,产,ESBLs,株数,/,总株数,（,%,）,安医一附院,844/1444,58.4,247/871,28.4,35/99,35.4,北京医院,216/413,52.3,41/321,12.8,8/54,14.8,甘肃省人民医院,382/738,51.8,91/324,28.1,2/26,7.7,广医一附院,447/1264,35.4,138/730,18.9,2/174,1.1,河南省人民医院,781/1374,56.8,313/1010,31,16/76,21.1,上海华山医院,195/799,24.4,51/751,6.8,8/80,10,四川华西医院,733/1323,55.4,256/963,26.6,5/100,5,哈医大一附院,642/1279,50.2,484/1249,38.8,21/143,14.7,福建晋江医院,163/331,49.2,43/161,26.7,4/15,26.7,吉林中日友谊医院,386/774,49.9,185/914,20.2,13/50,26,昆明医大一附院,703/1260,55.8,391/832,47,11/36,30.6,宁波龙赛医院,106/235,45.1,51/119,42.9,3/20,15,内蒙医大一附院,850/1568,54.2,167/775,21.5,17/60,28.3,浦东人民医院,201/341,58.9,48/242,19.8,19/35,54.3,复旦儿科医院,508/1046,48.6,217/590,36.8,0/58,0,北京协和医院,796/1768,45.0,210/1209,17.4,46/162,28.4,上海瑞金医院,553/1099,50.3,370/953,38.8,24/88,27.3,上海市儿童医院,317/742,42.7,169/494,34.2,0/61,0,四川省人民医院,595/1033,57.6,283/845,33.5,0/78,0,山东省立医院,293/1213,24.2,71/488,14.5,7/51,13.7,山西儿童医院,8/691,1.2,0/311,0,0/19,0,陕西省人民医院,29/1109,2.6,7/602,1.2,0/71,0,浙江邵逸夫医院,558/1026,54.4,118/653,18.1,44/136,32.4,中国医大一附院,379/810,46.8,161/609,26.4,53/125,42.4,武汉同济医院,882/1458,60.5,220/952,23.1,22/72,30.6,天津医大总医院,533/1002,53.2,344/1459,23.6,0/145,0,新疆医大一附院,613/1710,35.8,280/1250,22.4,11/131,8.4,湖南湘雅医院,574/1030,55.7,293/946,31,0/85,0,湖北秭归人民医院,197/440,44.8,54/340,15.9,7/35,20,合计,13484/29799,45.2,5303/21062,25.2,378/2285,16.5,产,ESBLs,菌株的检出率变迁,29799,株大肠埃希菌对抗菌药的耐药率（,%,）,21141,株克雷伯菌属对抗菌药的耐药率（,%,）,肺炎克雷伯菌对碳青霉烯类的耐药率变迁,11473,株克雷伯菌属对抗菌药的耐药率（,%,）,呼吸道标本,2654,株克雷伯菌属对抗菌药的耐药率（,%,）,血液标本,108,株克雷伯菌属对抗菌药的耐药率（,%,）,脑脊液标本,2715,株变形杆菌属对抗菌药的耐药率（,%,）,5737,株肠杆菌属细菌对抗菌药的耐药率（,%,）,1782,株沙雷菌属细菌对抗菌药的耐药率（,%,）,1224,株柠檬酸杆菌属细菌对抗菌药的耐药率（,%,）,696,株摩根菌属细菌对抗菌药的耐药率（,%,）,临床分离沙门菌属细菌对抗菌药的敏感性（,%,）,抗菌药物,鼠伤寒沙门菌,（,n=354,）,肠炎沙门菌,（,n=235,）,伤寒沙门菌,（,n=33,）,耐药,敏感,耐药,敏感,耐药,敏感,氨苄西林,86.5,13.2,79.1,20.5,34.4,65.6,氨苄西林,/,舒巴坦,17.9,49.2,23.2,34.5,32.1,64.3,阿莫西林,/,克拉维酸,2.7,82.4,2.4,81,0,83.3,头孢哌酮,/,舒巴坦,0,89.4,0,96.1,0,100,头孢曲松,27.7,71.8,19.3,80.3,3.6,96.4,环丙沙星,11.3,50.6,4.4,40.3,7.7,19.2,复方磺胺甲噁唑,32.8,66.7,5.6,94.4,9.1,90.9,氯霉素,47.9,51.4,8.7,91.3,0,100,64734,株肠杆菌科细菌对抗菌药的耐药率（,%,）,抗菌药,株数,耐药,敏感,替加环素,33067,3.3,81.2,阿米卡星,61282,5.4,93.6,厄他培南,36578,5.5,94,亚胺培南,61643,7,91.3,美罗培南,48449,7.2,92.3,哌拉西林,/,他唑巴坦,60823,9.4,85.8,头孢哌酮,/,舒巴坦,50328,10.9,78,头孢吡肟,61650,23.4,67.9,头孢他啶,56183,26.4,69.3,庆大霉毒,62548,32,66.6,环丙沙星,60565,38.5,57.7,13254,株铜绿假单胞菌对抗菌药的耐药率（,%,）,16477,株不动杆菌属,(,鲍曼不动,90.6%),对抗菌药的耐药率（,%,）,嗜麦芽窄食单胞菌和伯克霍尔德菌属对抗菌药的耐药率（,%,）,抗菌药物,嗜麦芽窄食单胞菌（,n=4775,）,抗菌药物,洋葱伯克霍尔德菌（,n=1668,）,耐药,敏感,耐药,敏感,头孢哌酮,/,舒巴坦,19.6,55,替卡西林,/,克拉维酸,84.2,5.3,左氧氟沙星,10.4,86.5,头孢他啶,10.1,84.6,复方磺胺甲噁唑,7.4,92,美罗培南,20.5,70.6,米诺环素,2.1,94,复方磺胺甲噁唑,4.8,93.8,氯霉素,12.4,59.2,米诺环素,3.8,80,头孢他啶,31.6,59.4,左氧氟沙星,14,70.6,替卡西林,/,克拉维酸,37,22.2,39266,株不发酵糖菌对抗菌药的耐药率（,%,）,抗菌药,耐药,敏感,头孢哌酮,/,舒巴坦,29.8,52.1,阿米卡星,32.3,65.3,哌拉西林,/,他唑巴坦,38.5,52.2,头孢他啶,42.4,52.6,环丙沙星,43.6,52.3,头孢吡肟,47.4,42.7,美罗培南,47.8,49.2,亚胺培南,52.7,43.9,流感嗜血杆菌对抗菌药的耐药率,(%),抗菌药物,儿童株（,n=2629,）,成人株（,n=1527,）,耐药,敏感,耐药,敏感,氨苄西林,56.9,33.9,47.2,46.2,阿莫西林,/,克拉维酸,16,84,18.4,81.6,氨苄西林,/,舒巴坦,19.8,80.2,24.9,75.1,头孢呋辛,27.6,64.7,20.6,74.9,头孢曲松,0,96.1,0,94.4,氯霉素,5.3,89.7,10.4,83.3,阿奇霉素,0,71.4,0,85.5,左氧氟沙星,0,99.3,0,94.4,复方磺胺甲噁唑,68.6,28.1,63.5,33.6,儿童株产酶率：,28.3%,，成人株产酶率：,29.9%,（总产酶率：,28.9%,）,克雷伯菌属对亚胺培南和美罗培南的耐药率,医院,株数,亚胺培南,株数,美罗培南,耐药,敏感,耐药,敏感,宁波龙赛医院,118,0.8,99.2,118,0.8,99.2,湖北秭归人民医院,350,0.9,99.1,350,1.1,98.9,内蒙医大一附院,778,1,98.5,751,0.7,98.5,吉林中日友谊医院,912,1.4,98.2,913,1.3,98.7,天津医大总医院,1458,1.8,97.5,NA,NA,NA,四川省人民医院,849,2.1,97.8,838,2.4,97.6,甘肃省人民医院,325,2.2,95.1,325,2.8,96.3,福建晋江医院,161,2.5,97.5,70,2.9,97.1,浦东人民医院,242,2.9,93.8,242,3.3,95.5,新疆医大一附院,1249,4.4,94.7,484,4.3,94.4,四川华西医院,962,4.7,94.5,180,81.1,山东省立医院,480,4.8,94.8,465,4.5,95.3,广医一附院,730,5.2,94.5,718,4.7,94.7,山西儿童医院,309,6.5,93.2,309,7.4,92.2,哈医大一附院,1240,7.8,91.9,351,10,88.9,中国医大一附院,455,7.9,91.4,450,7.8,92,陕西省人民医院,590,13.1,86.3,581,12.9,87.1,北京协和医院,1095,13.3,86.5,1186,12.2,87.5,安医一附院,876,16.2,82.3,515,16.5,82.5,复旦儿科医院,589,20,78.3,589,23.9,72.2,昆明医大一附院,840,20.6,78.6,834,20.3,79.5,湖南湘雅医院,944,21.3,78.3,349,27.8,71.9,上海瑞金医院,952,22.1,75.3,773,22.8,75.4,上海市儿童医院,493,28.4,66.5,493,36.7,58.8,北京医院,322,30.4,69.3,322,31.1,68.6,浙江邵逸夫医院,657,38.8,60,458,31.2,68.6,江西省儿童医院,101,43.6,53.5,101,42.6,57.4,武汉同济医院,951,44.4,54.8,952,44,55.5,上海华山医院,752,44.3,52.9,696,44.4,55,河南省人民医院,881,47.2,51.1,790,46.7,52.7,铜绿假单胞菌对亚胺培南和美罗培南的耐药率,医院,株数,亚胺培南,株数,美罗培南,耐药,敏感,耐药,敏感,湖北秭归人民医院,118,5.1,94.9,118,5.1,94.9,浦东人民医院,139,12.2,81.3,139,10.1,81.3,吉林中日友谊医院,363,14.3,76.6,355,11,85.1,甘肃省人民医院,207,16.4,81.2,211,21.8,73.5,内蒙医大一附院,365,16.7,79.5,346,13,83.8,上海市儿童医院,192,18.8,76.6,191,19.4,77,新疆医大一附院,557,19,72.5,533,16.3,80.9,江西省儿童医院,62,19.4,77.4,63,20.6,79.4,北京协和医院,867,21.5,76.6,857,14.6,82.4,天津医大总医院,767,22.9,65.3,NA,NA,NA,安医一附院,460,23,68.5,314,17.8,77.1,哈医大一附院,530,23.2,63.8,146,17.8,78.8,广医一附院,861,24,69.1,853,20.8,75.3,四川华西医院,721,25.5,59.9,125,28,68,山东省立医院,447,25.7,72.9,444,23.9,73.4,福建晋江医院,154,27.3,59.1,153,20.3,74.5,复旦儿科医院,245,29.8,67.3,244,24.2,73.4,湖南湘雅医院,650,31.2,60.3,259,27,69.5,中国医大一附院,309,31.4,64.4,306,28.8,67.6,四川省人民医院,619,31.5,67,611,26.4,67.3,宁波龙赛医院,112,33,54.5,115,20,70.4,上海华山医院,526,34,64.6,495,30.1,65.7,浙江邵逸夫医院,466,35.4,59.9,367,26.4,69.5,上海瑞金医院,416,38.5,53.8,346,31.8,65,河南省人民医院,513,39,56.9,475,31.6,63.8,武汉同济医院,761,39.6,57.2,763,34.9,60.9,陕西省人民医院,598,39.8,56.5,576,37.7,58.3,昆明医大一附院,228,39.9,55.7,227,37,60.8,北京医院,316,41.1,56.3,316,36.7,57.6,山西儿童医院,263,58.6,41.1,263,58.2,41.4,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,株数,美罗培南,耐药,敏感,耐药,敏感,宁波龙赛医院,28,7.1,92.9,29,6.9,93.1,江西省儿童医院,45,24.4,75.6,45,24.4,75.6,天津医大总医院,1000,26.2,73.7,NA,NA,NA,湖北秭归人民医院,105,27.6,70.5,105,27.6,72.4,山西儿童医院,109,30.3,69.7,93,34.4,63.4,吉林中日友谊医院,307,42.3,56.4,30,36.7,63.3,浦东人民医院,127,45.7,54.3,127,45.7,54.3,北京医院,241,51.5,48.1,241,48.1,49.4,内蒙医大一附院,396,55.6,42.9,359,54.3,44,广医一附院,568,55.6,42.4,553,58.6,40.1,山东省立医院,293,56,44,330,57.3,42.1,上海瑞金医院,595,58.3,40.8,489,54.4,45,新疆医大一附院,865,59.1,40.6,206,56.8,42.2,福建晋江医院,96,59.4,40.6,79,62,38,复旦儿科医院,254,59.8,40.2,253,59.7,39.5,上海市儿童医院,303,65.7,34.3,302,66.2,33.8,北京协和医院,860,70.2,29.4,869,67.8,31.6,四川华西医院,906,70.3,29.2,252,88.5,11.1,上海华山医院,665,72.3,26.8,621,71.7,27.9,浙江邵逸夫医院,586,73.2,25.9,453,70.6,28.5,昆明医大一附院,411,75.4,24.6,173,79.2,19.7,安医一附院,643,75.6,24.1,485,71.3,27.2,湖南湘雅医院,850,75.6,23.3,275,79.6,20,四川省人民医院,598,76.8,22.9,577,75.9,22.9,哈医大一附院,1177,78.9,18.9,302,79.8,19.9,中国医大一附院,701,80.6,19.1,10,50,50,甘肃省人民医院,297,82.2,17.2,297,82.2,16.5,武汉同济医院,1128,85.8,13.4,1129,85,14.3,陕西省人民医院,825,88,11,827,87.1,12.7,河南省人民医院,766,92.4,7.4,716,92.6,7.3,小结,肺炎克雷伯菌对碳青霉烯类的耐药率仍稳步上升,注意,ESBL,检测的假阴性,MRSA,检出率逐年下降,不同标本分离的细菌对抗菌药物的敏感性相差较大,呼吸道标本、血液标本和脑脊液标本等,遏制耐药菌进一步流行播散刻不容缓,联合科研、流行病学调查研究,抗菌药物合理应用、医院感染控制,