细菌耐药监测报告2013课件

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,（,2013,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,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,浙江邵逸夫医院,甘肃省人民医院,新疆医大一附院,昆明医学院一附院,中国医大一附院,天津医科大学总院,四川大学华西医院,中国细菌耐药性监测-CHINET监测（2013年）参加单位,1,材料,细菌,2013.1.1,日,12.31,日临床分离株,剔除同一患者分离的重复菌株（血液和脑脊液除外）,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。,材料细菌,2,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 2013,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,方法药敏试验,3,XDR,菌株的统计方法,由于不是所有医院均做了黏菌素和替加环素的药敏，故本次只统计广泛耐药株（,XDR,），而未能统计全耐药株（,PDR,）,由于部分医院药敏试验采用,MIC,法，或,MIC,法和纸片法并行，同一菌株所选用的抗菌药物种类有所差别，因此统计时必须仔细查看各医院的抗菌药物种类，再进行设定。,XDR,统计标准：对除黏菌素和替加环素外其他抗菌药物全耐药者,XDR菌株的统计方法由于不是所有医院均做了黏菌素和替加环素的,4,方法,青霉素不敏感肺炎链球菌的检测,1,m,g/,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,MIC,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。,方法青霉素不敏感肺炎链球菌的检测,5,2013,年,CHINET,监测网各医院的菌株数（,84572,株）,医院,革兰阴性菌,革兰阳性菌,医院,革兰阴性菌,革兰阳性菌,华山医院,3247,1122,甘肃省人民医院,2282,703,瑞金医院,3610,1377,新疆医大一附院,4923,1478,协和医院,5147,2089,安徽医科大学一附院,3256,1079,同济医院,6372,3041,昆明医学院一附院,2844,1252,北京医院,1760,623,浙江邵逸夫医院,3342,1363,广医一附院,3157,546,中国医大一附院,2968,1407,儿科医院,3980,2095,天津医科大学总院,7041,1899,儿童医院,1708,1353,四川大学华西医院,6072,1436,合计,61709,（,73.0%,）,22863,（,27.0%,）,2013年CHINET监测网各医院的菌株数（84572株）医,6,2013,年,CHINET,监测网临床分离菌在门急诊和住院患者中的分布,住院患者,（,86.2,）,（,63184/84572,）,门急诊患者,（,13.8,）,（,11634/84572,）,2013年CHINET监测网临床分离菌在门急诊和住院患者中,7,2013,年,CHINET,监测网,84572,株临床分离菌在各类标本中的分布,呼吸道标本,（,43.2,）,尿液标本,（,20.9,）,血液标本,（,13.1,）,伤口脓液（,9.8,）,无菌体液（,4.8,）,生殖道分泌物（,2.1,）,粪便标本（,1.6,）,其他（,3.3,）,脑脊液（,1.3,）,2013年CHINET监测网84572株临床分离菌在各类标,8,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,16794,27.21,其他嗜血杆菌,177,0.29,克雷伯菌属,12121,19.64,拉乌尔菌属,114,0.18,不动杆菌属,10120,16.40,多源菌属,75,0.12,铜绿假单胞菌,8257,13.38,志贺菌属,77,0.12,肠杆菌属,3816,6.18,产碱杆菌,52,0.08,嗜麦芽窄食单胞菌,2444,3.96,奈瑟菌属,30,0.05,变形杆菌属,1835,2.97,罗尔斯顿菌属,28,0.05,沙雷菌属,1059,1.71,丛毛单胞菌,25,0.04,流感嗜血杆菌,968,1.57,普罗威登菌属,21,0.03,沙门菌属,877,1.42,气单胞菌属,21,0.03,柠檬酸杆菌属,789,1.28,黄杆菌属,15,0.02,伯克霍尔德菌属,770,1.25,金杆菌属,15,0.02,其他假单胞菌,523,0.85,博特菌属,6,0.01,摩根菌属,298,0.48,其他,91,0.15,莫拉菌属,291,0.47,合计,61709,100.0,CHINET耐药监测革兰阴性菌菌种分布 细菌株数 细菌,9,CHINET,耐药监测革兰阳性菌菌种分布,细菌,株数,金葡菌,8127,35.55,肠球菌属,7058,30.87,凝固酶阴性葡萄球菌,4354,19.04,（血液脑脊液等无菌体液）,肺炎链球菌,1429,6.25,-,溶血性链球菌,1289,5.64,草绿色链球菌（血液及无菌体液）,515,2.25,其他,91,0.40,合计,22863,100.0,CHINET耐药监测革兰阳性菌菌种分布 细菌株数 金葡,10,2013,年,CHINET,监测网各医院金葡菌,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,（,%,）,华山医院,304/503,60.4,甘肃省人民医院,134/326,41.1,瑞金医院,230/410,56.1,新疆医大一附院,186/569,32.7,协和医院,244/700,34.9,安徽医大一附院,176/359,49.0,同济医院,1047/1492,70.2,昆明医大一附院,100/280,35.7,广州一附院,82/196,41.8,浙江邵逸夫医院,170/406,41.9,北京医院,167/232,72.0,中国医大一附院,167/438,38.1,上海儿科医院,123/517,23.8,天津医大总院,200/640,31.3,上海儿童医院,163/434,37.6,四川大学华西医院,179/625,28.6,总计,3672/8127,45.2,2013年CHINET监测网各医院金葡菌MR菌株检出率医院金,11,2013,年,CHINET,监测网各医院凝固酶,(-),葡萄球菌,MR,菌株检出率,医院,凝固酶阴性葡萄球菌,医院,凝固酶阴性葡萄球菌,MR,株数,/,总株数,（,%,）,MR,株数,/,总株数,（,%,）,华山医院,77/141,54.6,甘肃省人民医院,88/108,81.5,瑞金医院,42/108,38.9,新疆医大一附院,260/309,84.1,协和医院,123/179,68.7,安徽医大一附院,195/262,74.4,同济医院,345/418,82.5,昆明医大一附院,285/401,71.1,广州一附院,42/60,70.0,浙江邵逸夫医院,281/331,84.9,北京医院,28/78,35.9,中国医大一附院,340/396,85.9,上海儿科医院,443/613,72.3,天津医大总院,211/276,76.4,上海儿童医院,189/382,49.5,四川大学华西医院,251/292,86.0,总计,3200/4354,73.5,2013年CHINET监测网各医院凝固酶(-)葡萄球菌MR菌,12,MSSA(4620,株,),与,MRSA(3672,株,),的耐药率（,%,）,MSSA(4620株)与MRSA(3672株)的耐药率（%）,13,MSCNS(1762,株,),和,MRCNS(3200,株,),的耐药率（,%,）,MSCNS(1762株)和MRCNS(3200株)的耐药率（,14,2013,年,16,家医院粪肠球菌,(3283,株,),和屎肠球菌,(3062,株,),的耐药率（,%,）,2013年16家医院粪肠球菌(3283株)和屎肠球菌(306,15,2013,年,16,家医院株,溶血性链球菌的耐药率（,%,）,抗菌药物,A,（,193,）,B,（,823,）,C,（,104,）,G,（,72,）,草链,（,515,）,青霉素,2.9,1.2,20.7,0.0,7.3,红霉素,87.2,62.5,73.4,58.8,61.5,克林霉素,80.9,55.0,65.8,57.6,58.8,头孢呋辛,0.0,0.8,6.2,2.3,8.5,头孢噻肟,5.0,9.5,12.5,7.9,15.2,头孢曲松,2.4,6.2,2.3,9.8,14.3,万古霉素,0.0,0.0,0.0,0.0,0.0,利奈唑胺,0.0,0.0,0.0,0.0,0.0,左氧氟沙星,0.6,41.4,7.6,7,16.4,2013年16家医院株溶血性链球菌的耐药率（%）抗菌药物A,16,2013,年,CHINET,监测网各医院产,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,（,%,）,华山医院,408/664,61.4,168/720,23.3,40/83,48.2,瑞金医院,/,/,/,/,/,/,协和医院,696/1410,49.4,217/924,23.5,30/133,22.6,同济医院,1069/1497,71.4,529/1081,48.9,18/76,23.7,北京医院,/,/,/,/,/,/,广州一附院,334/726,46.0,112/393,28.5,0/86,0.0,上海儿科医院,723/1441,50.2,308/572,53.8,3/67,4.5,上海儿童医院,303/559,54.2,209/309,67.6,5/48,10.4,甘肃省人民医院,413/859,48.1,86/524,16.4,9/56,16.1,新疆医大一附院,601/1350,44.5,327/1169,28.0,27/140,19.3,安徽医大一附院,578/1021,56.6,200/565,35.4,0/62,0.0,云南医大一附院,626/1097,57.1,211/633,33.3,1/34,2.9,浙医邵逸夫医院,530/1068,49.6,117/591,19.8,26/161,16.1,中国医大一附院,378/707,53.5,183/578,31.7,30/91,33.0,天津医大总院,584/1170,49.9,392/1595,24.6,32/178,18.0,四川大学华西医院,971/1636,59.4,466/1420,32.8,0/121,0.0,合计,8214/15205,54.0,3525/11074,31.8,221/1336,16.5,2013年CHINET监测网各医院产ESBL菌株检出率医院大,17,2013,年,16,家医院,16794,株大肠埃希菌耐药率（,%,）,2013年16家医院16794株大肠埃希菌耐药率（%）,18,2013,年,14,家医院产与非产,ESBLs,大肠埃希菌的耐药率（,%,）,抗菌药物,耐药率,抗菌药物,耐药率,产,ESBL,(8214,株,),非产,ESBL,(6991,株,),产,ESBL,(8214,株,),非产,ESBL,(6991,株,),阿米卡星,5.7,1.8,头孢哌酮,/,舒巴坦,8.3,3.4,庆大霉素,56.5,36.6,头孢西丁,19.7,11.7,哌拉西林,96.8,46.9,亚胺培南,0.8,1.0,哌拉西林,/,他唑巴坦,4.6,2.9,美罗培南,3.5,2.8,头孢唑林,99.4,37.9,厄他培南,1.3,1.4,头孢呋辛,98.6,27.0,环丙沙星,71.4,40.9,头孢噻肟,98.8,21.2,复方磺胺甲噁唑,66.0,47.2,头孢他啶,45.1,10.2,磷霉素,10.1,3.1,头孢吡肟,34.6,6.4,呋喃妥因,6.0,4.5,2013年14家医院产与非产ESBLs大肠埃希菌的耐药率（%,19,2013,年,16,家医院,12121,株克雷伯菌属耐药率（,%,）,2013年16家医院12121株克雷伯菌属耐药率（%）,20,2013,年,14,家医院产与非产,ESBLs,克雷伯菌属的耐药率（,%,）,抗菌药物,耐药率,抗菌药物,耐药率,产,ESBL,(3525,株,),非产,ESBL,(7549,株,),产,ESBL,(3525,株,),非产,ESBL,(7549,株,),阿米卡星,11.8,9.0,头孢哌酮,/,舒巴坦,23.5,12.6,庆大霉素,54.0,16.1,头孢西丁,25.0,11.2,哌拉西林,96.6,26.9,亚胺培南,8.4,10.5,哌拉西林,/,他唑巴坦,18.0,11.7,美罗培南,14.7,13.3,头孢唑林,98.5,36.5,厄他培南,13.2,14.1,头孢呋辛,97.2,25.1,环丙沙星,36.9,14.5,头孢噻肟,97.6,23.4,复方磺胺甲噁唑,62.8,14.6,头孢他啶,58.4,17.7,磷霉素,16.3,21.9,头孢吡肟,39.9,11.3,呋喃妥因,48.1,31.8,2013年14家医院产与非产ESBLs克雷伯菌属的耐药率（%,21,2013,年,16,家医院,1835,株变形杆菌属耐药率（,%,）,2013年16家医院1835株变形杆菌属耐药率（%）,22,2013,年,14,家医院产与非产,ESBLs,奇异变形杆菌的耐药率（,%,）,抗菌药物,耐药率,抗菌药物,耐药率,产,ESBL,(221,株,),非产,ESBL,(1115,株,),产,ESBL,(221,株,),非产,ESBL,(1115,株,),阿米卡星,13.9,1.5,头孢哌酮,/,舒巴坦,1.6,0.5,庆大霉素,58.6,21.3,头孢西丁,10.3,2.3,哌拉西林,67.1,11.1,亚胺培南,9.2,8.7,哌拉西林,/,他唑巴坦,0.9,0.4,美罗培南,0.6,2.5,头孢唑林,97.5,49.1,厄他培南,0.0,0.6,头孢呋辛,94.7,23.0,环丙沙星,76.3,34.2,头孢噻肟,96.3,16.7,复方磺胺甲噁唑,92.2,49.3,头孢他啶,9.5,3.4,磷霉素,71.6,25.2,头孢吡肟,15.8,2.3,呋喃妥因,97.5,97.5,2013年14家医院产与非产ESBLs奇异变形杆菌的耐药率（,23,2013,年,16,家医院,298,株摩根菌属细菌耐药率（,%,）,2013年16家医院298株摩根菌属细菌耐药率（%）,24,2013,年,16,家医院,3816,株肠杆菌属细菌耐药率（,%,）,2013年16家医院3816株肠杆菌属细菌耐药率（%）,25,2013,年,16,家医院,789,株柠檬酸杆菌属细菌耐药率（,%,）,2013年16家医院789株柠檬酸杆菌属细菌耐药率（%）,26,2013,年,16,家医院,1059,株沙雷菌属细菌耐药率（,%,）,2013年16家医院1059株沙雷菌属细菌耐药率（%）,27,2013,年,16,家医院株沙门菌属细菌耐药率（,%,）,抗菌药物,伤寒沙门菌,（,21,株）,副伤寒沙门菌,（,85,株）,耐药,敏感,耐药,敏感,氨苄西林,7.1,85.7,8.3,86.9,氨苄西林,/,舒巴坦,27.3,72.7,2.8,97.2,阿莫西林,/,克拉维酸,0.0,90.9,9.1,81.8,头孢哌酮,/,舒巴坦,0.0,91.7,0.0,100.0,头孢曲松,0.0,100.0,1.2,98.8,环丙沙星,5.0,95.0,2.4,90.6,复方磺胺甲噁唑,0.0,100.0,2.6,96.1,氯霉素,12.5,87.5,1.4,97.2,2013年16家医院株沙门菌属细菌耐药率（%）抗菌药物伤寒沙,28,2013,年,16,家医院,639,株沙门菌属细菌耐药率（,%,）,抗菌药物,肠炎沙门菌,（,214,株）,鼠伤寒沙门菌,（,260,株）,耐药,敏感,耐药,敏感,氨苄西林,70.0,28.6,71.9,27.3,氨苄西林,/,舒巴坦,20.6,46.9,23.8,50.4,阿莫西林,/,克拉维酸,2.7,83.3,5.4,68.8,头孢哌酮,/,舒巴坦,0.0,94.3,0.0,93.0,头孢曲松,31.9,66.7,13.5,85.7,环丙沙星,1.4,98.6,3.1,75.3,磷霉素,13.1,85.1,0.5,99.5,复方磺胺甲噁唑,9.7,87.4,38.4,60.4,氯霉素,13.2,83.7,43.3,53.5,2013年16家医院639株沙门菌属细菌耐药率（%）抗菌药物,29,2013,年,16,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（,38,株）,宋内志贺菌（,34,株）,耐药,敏感,耐药,敏感,氨苄西林,93.8,6.2,80.8,11.5,氨苄西林,/,舒巴坦,59.3,7.4,17.9,71.4,头孢曲松,55.6,37.0,30.8,65.4,环丙沙星,45.9,35.1,3.0,93.9,复方磺胺甲噁唑,70.6,29.4,81.8,18.2,磷霉素,4.3,91.3,0.0,100.0,氯霉素,71.4,19.0,0.0,94.7,2013年16家医院福氏志贺菌和宋内志贺菌的敏感性（%）抗菌,30,2013,年,16,家医院,37897,株肠杆菌科细菌耐药率（,%,）,抗菌药物,耐药,敏感,亚胺培南,5.1,92.6,美罗培南,6.7,92.7,厄他培南,6.5,91.5,阿米卡星,5.9,92.7,磷霉素,13.2,82.4,哌拉西林,/,他唑巴坦,7.7,86.0,头孢哌酮,/,舒巴坦,9.2,77.0,头孢他啶,27.6,68.0,头孢吡肟,18.3,76.7,庆大霉素,34.7,63.9,2013年16家医院37897株肠杆菌科细菌耐药率（%）抗菌,31,2013,年,16,家医院,8257,株铜绿假单胞菌耐药率（,%,）,2013年16家医院8257株铜绿假单胞菌耐药率（%）,32,2013,年,16,家医院,10120,株不动杆菌属,(,鲍曼不动,89.2%),细菌的耐药率（,%,）,2013年16家医院10120株不动杆菌属(鲍曼不动89.2,33,2013,年,16,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（,2444,株）,抗菌药物,伯克霍尔德菌属（,770,株）,耐药,敏感,耐药,敏感,头孢哌酮,/,舒巴坦,27.3,43.9,替卡西林,/,克拉维酸,91.2,5.3,左氧氟沙星,7.8,89.0,头孢他啶,9.1,86.5,复方磺胺甲噁唑,6.2,92.5,美罗培南,10.0,87.9,米诺环素,2.2,92.9,复方磺胺甲噁唑,10.8,87.7,氯霉素,31.9,25.5,米诺环素,6.9,77.8,头孢他啶,44.9,46.6,氯霉素,27.8,33.3,替卡西林,/,克拉维酸,43.2,31.7,左氧氟沙星,19.9,69.4,2013年16家医院嗜麦芽窄食单胞菌和伯克霍尔德菌属的耐药率,34,CHINET,各医院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,美罗培南,耐药,敏感,耐药,敏感,上海儿童医院,123,15.4,83.7,13.1,85.2,广州医大一附院,586,22.6,68.7,18.4,77.2,上海儿科医院,277,25.8,72.7,25.0,73.1,卫生部北京医院,382,39.5,58.1,34.0,61.8,上海华山医院,620,42.2,55.8,41.2,54.7,北京协和医院,819,19.4,77.5,15.6,81.3,甘肃省人民医院,215,10.2,88.4,5.2,92.0,上海瑞金医院,381,37.5,58.8,29.9,65.4,湖北同济医院,958,30.9,67.1,28.2,68.2,新疆医大一附院,711,25.3,69.8,20.3,75.1,安徽医大一附院,401,27.3,60.4,27.1,68.7,昆明医大一附院,238,28.4,63.5,29.2,65.8,浙江邵逸夫医院,417,23.3,70.9,22.0,73.8,中国医大一附院,412,38.7,55.7,30.0,60.3,天津医大总院,975,20.2,72.9,16.9,66.1,四川大学华西医院,742,24.3,68.3,62.0,34.2,CHINET各医院铜绿假单胞菌对亚胺培南和美罗培南的耐药率医,35,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,243,68.2,31.8,68.3,31.3,广州医大一附院,546,65.2,33.6,66.9,31.8,上海儿科医院,326,65.3,33.4,65.4,33.3,卫生部北京医院,270,54.4,45.6,54.1,45.9,上海华山医院,537,65.3,33.8,67.1,32.6,北京协和医院,795,65.0,33.6,65.8,33.9,甘肃省人民医院,236,56.4,42.7,55.5,43.2,上海瑞金医院,536,58.5,40.4,60.0,39.8,湖北同济医院,1491,71.1,26.9,69.8,29.8,新疆医大一附院,751,52.2,46.7,49.3,49.3,安徽医大一附院,441,67.3,31.5,66.2,32.7,昆明医大一附院,371,66.8,31.3,63.1,35.2,浙江邵逸夫医院,516,72.6,27.2,70.4,29.2,中国医大一附院,633,83.2,16.8,82.9,15.2,天津医大总院,1370,23.0,76.6,15.6,84.4,四川大学华西医院,1058,59.6,39.2,11.8,0.6,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,36,2013,年,16,家医院,22583,株非发酵菌耐药率（,%,）,抗菌药物,耐药,敏感,头孢哌酮,/,舒巴坦,26.1,54.1,阿米卡星,28.8,68.6,头孢他啶,47.2,45.2,头孢吡肟,40.7,53.6,哌拉西林,/,他唑巴坦,38.4,58.7,美罗培南,43.5,51.9,亚胺培南,46.3,50.5,环丙沙星,40.3,55.8,2013年16家医院22583株非发酵菌耐药率（%）抗菌药物,37,2013,年,16,家医院流感嗜血杆菌的耐药率,(%),抗菌药物,总数（,968,株）,儿童株（,559,株）,成人株（,399,株）,耐药,敏感,耐药,敏感,耐药,敏感,氨苄西林,39.3,49.5,40.7,46.6,36.4,54.6,氨苄西林,/,舒巴坦,24.6,75.4,27.5,72.5,17.6,82.4,阿莫西林,/,克拉维酸,17.1,82.9,19.2,80.8,15.1,84.9,头孢呋辛,15.4,79.7,17.5,77.3,11.2,84.3,头孢噻肟,12.0,87.9,14.4,85.6,7.7,91.9,头孢曲松,8.9,91.1,10.0,90.0,5.6,94.4,氯霉素,10.3,75.1,7.1,74.5,14.5,76.7,阿奇霉素,7.2,92.8,7.3,92.7,7.1,92.9,环丙沙星,6.3,93.6,5.1,94.9,8.1,91.6,复方磺胺甲噁唑,61.3,36.8,64.9,33.5,52.9,44.6,儿童株产酶率：,34.6%,， 成人株产酶率：,32.6%,（总产酶率：,33.9%,）,2013年16家医院流感嗜血杆菌的耐药率(%)抗菌药物总数（,38,成人和儿童医院中肺炎链球菌的分布,菌株,儿童分离株,成人分离株,2012,年,2013,年,2012,年,2013,年,株数,%,株数,%,株数,%,株数,%,PSSP,720,77.1,608,67.1,384,93.9,475,90.8,PISP,119,12.7,105,11.6,22,5.4,27,5.2,PRSP,95,10.2,193,21.3,3,0.7,21,4.0,合计,934,100.0,906,100.0,409,100.0,523,100.0,成人和儿童医院中肺炎链球菌的分布菌株儿童分离株成人分离株20,39,2013,年儿童患者分离肺炎链球菌的耐药率,(%)*,抗菌药物,PSSP,（,608,株）,PISP,（,105,株）,PRSP,（,193,株）,耐药,敏感,耐药,敏感,耐药,敏感,青霉素,0.0,100.0,0.0,0.0,100.0,0.0,阿莫西林,/,克拉维酸,0.6,99.4,0.0,97.6,19.6,60.3,万古霉素,0.0,100.0,0.0,100.0,0.0,100.0,红霉素,96.4,1.7,99.0,0.0,98.4,0.0,克林霉素,95.1,4.4,100.0,0.0,97.4,2.1,莫西沙星,0.2,99.8,0.0,100.0,0.0,100.0,左氧氟沙星,0.3,99.5,1.0,99.0,0.0,100.0,利奈唑胺,0.0,100.0,0.0,100.0,0.0,100.0,2013年儿童患者分离肺炎链球菌的耐药率(%)*抗菌药物PS,40,2013,年成人患者分离肺炎链球菌的耐药率,(%)*,抗菌药物,PSSP(475,株,),PISP(27,株,),PRSP(21,株,),耐药,敏感,耐药,敏感,耐药,敏感,青霉素,0.0,100.0,0.0,0.0,100.0,0.0,阿莫西林,/,克拉维酸,1.7,96.6,万古霉素,0.0,100.0,0.0,100.0,0.0,100.0,红霉素,90.2,9.2,100.0,0.0,100.0,0.0,克林霉素,85.8,13.1,100.0,0.0,100.0,0.0,莫西沙星,1.5,98.2,0.0,100.0,0.0,100.0,左氧氟沙星,2.5,95.9,0.0,100.0,15.0,80.0,利奈唑胺,0,100.0,0.0,100.0,0.0,100.0,2013年成人患者分离肺炎链球菌的耐药率(%)*抗菌药物PS,41,2013,年各医院广泛耐药株数,医院,铜绿假单胞菌,鲍曼不动杆菌,XDR,株数总株数,（）,XDR,株数,总株数,（）,华山医院,25/620,4.0,107/513,20.6,瑞金医院,10/381,2.6,64/516,12.4,协和医院,10/819,1.2,206/714,28.8,同济医院,93/958,9.7,456/922,49.5,广州一附院,3/586,0.5,0/534,0.0,北京医院,15/382,3.9,69/252,27.4,儿科医院,0/277,0.0,5/307,1.6,儿童医院,0/123,0.0,104/235,44.3,甘肃人民医院,0/215,0.0,82/203,40.4,新疆医大一附院,1/711,0.1,0/718,0.0,安徽医大一附院,1/401,0.2,0/425,0.0,昆明医大一附院,1/238,0.4,29/365,7.9,浙江邵逸夫医院,0/417,0.0,0/494,0.0,中国医大一附院,4/412,0.0,83/597,13.9,天津医大总院,0/975,0.0,116/1179,9.8,四川大学华西医院,0/742,0.0,0/1050,0.0,合计,163/8257,2.0,1321/9024,14.6,2012,109/,7271,1.5,1380/7827,17.6,2013年各医院广泛耐药株数医院铜绿假单胞菌鲍曼不动杆菌XD,42,2013,年各医院广泛耐药株数,医院,肺炎克雷伯菌,肠杆菌科细菌*,XDR,株数总株数,（）,XDR,株数总株数,（）,华山医院,60/700,8.6,64/1852,3.5,瑞金医院,24/704,3.4,25/2467,1.0,协和医院,2/830,0.2,4/3143,0.1,同济医院,3/984,0.3,8/3135,0.3,广州一附院,1/380,0.3,2/1424,0.1,北京医院,19/234,8.1,20/870,2.3,儿科医院,5/549,0.9,6/2974,0.2,儿童医院,25/278,9.0,35/1185,3.0,甘肃人民医院,0/428,0.0,1/1752,0.1,新疆医大一附院,0/1023,0.0,0/3151,0.0,安徽医大一附院,11/538,2.0,15/2084,0.7,昆明医大一附院,95/596,15.9,113/2088,5.4,浙江邵逸夫医院,5/584,0.9,8/2134,0.4,中国医大一附院,0/555,0.0,1/1673,0.1,天津医大总院,0/1369,0.0,/4038,0.0,四川大学华西医院,0/1301,0.0,/3927,0.0,合计,250/11053,2.3,302/37897,0.8,2012,373/8772,4.2,395/31277,1.3,2013年各医院广泛耐药株数医院肺炎克雷伯菌肠杆菌科细菌*X,43,THANK YOU,！,CHINET,监测,THANK YOU！CHINET监测,44,