【word】 2009年中国CHINET大肠埃希菌和克雷伯菌属细菌耐药性监测

【word】 2009年中国CHINET大肠埃希菌和克雷伯菌属细菌耐药性监测 2009年中国CHINET大肠埃希菌和克雷伯 菌属细菌耐药性监测 430{p???(??{e?b???w??2010??11?h20???d10???d6?(ChinJInfectChemot her?INovtember?e2010?IV01?e10?INo?e6 ???????? 2009??{p??CHINET?R?????I?????_??’U???? ?????t???R???_ ????1?I ?D????5?I ?K??9?I ?x??K7?I ??{F??1?I ??{???5?I ?{{C?{9?I ??{???14?I ?a???(2?I ??????5?I ????-??I ???k??K5 ??????2?I ??’K?16?I ????10?I ‘?{???3?I ???D?’6?I ?K?7?811?I ????3?I ???<??7?I ???f???I ??????4?I ??????7?I ?j??12?I ????4?I ?????L8?I ??????K7?I ???f5?I ??????8?I ?’????K7?I ?????E????{???2009??{p??CHINET?z??14?z?q??{x???6?????R?????I ?????_??’U???????t??????O3???????A?? ?”??????(K-B??)??{x???6???a’????’????O3???????G??CHINET?????t ???R???_??14?z?q???6?????R?????I??7992 ?a?I?????_??’U??4556?a??{????_??’U??377?aO3??{p?P?????1(o??14 ??)???????R?????I?????_??’U?????6?l??21?e3?1 (1700?c7992)??18?e5?1(915?c4933)O3?R?????I?????_??’U????{?ESBLs?a???????6?l{X56?e5?1(33?e3?1??78?e5?1)??41?e 4?1(21?e7?1??70?e8?1)O3?2?q??ESBIO3S?????????A{??????3O3???’?????????j?X?I?R?????I????{???????O4????????????{? ?????+3???????i???????(?K???t?????”?c{?1?1?I???x??????{??o??????????????{?{??m???????t????’{{?6?1O3?????_?? ‘U????3???????i???????(?K?t????{?{?2?e9?1??5?e2?1?I???x?????????o??????????????{?{??m???????t?????6?l{X10?e8?1?? 15?e1?1O3{?ESBIO3S????{n??5?????????t????{?’{{?25?1O350?1{?{n??{?ESBI?IS?a?????R?i?K????{H???(?t??O3?i10?z ?q???6???????????i???????(?K{f?’?(???a?I??{p?????_??’U??132?a?I?R?????I??20?aO383?a?????_??’U????5?a?R?? ???I??{X???t???aO3{q????{p{??f???R???}???{???q??(??73?a)O3?????R?????I?????_??’U???????????i???????(?KO4?x ??????{??o??????????????{?{??m????{?’??4?????’?(?RO3{e2007???????t???R???_?}???????I???????i????{f?’?(???a?6 ????{n?”?e?j?I?S{??????_??’U??{X?EO3 ???Z???E?R?????I???T?_??’U?????T?t???R???_ {p???6?????ER?e378?e21?TR378?e996???Z?C???4?EA?????b???E1009-7708(2010)06-0430KN06 CHINET2009survei??anceofantimicrobialresistanceinE?ecoliandKlebsi ella sppinChina ZHUOChao?ISUDanhong?IN?IYuxing?ISUNJingyong?IYOt?IYunsong?IYANGQing?ISUNZiyong?IJIAN CuiO3WANGFu?IZHUDemei?IHUFupin?IJIANGXiaofei?IWANGChuanqing?IWANGAirnin?IXUYuanKN hongO3SHENJilu?IXUYingchun?ISUNHongli?IZHANGHong?ILIWanhua?ISHANBin?IDUYan?IZHANG ‘??1??’&?E1?e???????W?????N???z???W???????????????????I?????q ?????d{??}???q???I510120l 2?e{n??{??E?R???q?????}???????q???T 3?e?????R???q?????}???d{??q???T 4?e?{{p?????R???I?{?q?????}???I?{?q???T 5?e?f???R???}???{???q???T 6?e?f???R???}???P???q???T 7?e?????q???R???}???d{??q??l 8?e{p???q?????????}???V{??’???q???T 9?e{n??{??E?R???}???P?2?q???T 10?e?6?e?q?????}???d{??q???T 11?e?????q???R???}???d{??q???T 12?e?????q???R???}???d{??q??# 13?e?9???4{??m?q???T 14?e???(???V{??q??O3 ‘??1??{??E????(1967{?)O3?????e{?{??????t???X?G?N??O3 ?E’?’??1?E????O3EKNmail?EChaoKNsheep@263?enetO3 Zhaoxia?Ij1Ping?IJlABei?IHUANGWenxiang?I WEILianhua?IWULing?IHL?I?1??ian?IAJ Xiaoman?e(StateKeyLaboratoryofRespiratory Diseases?ITheGuangzhouJnstituteofRespiratory Disease?IGuangzhou510120?IChina) Abstract?EObjectiveToinvestigatetheantimicrobialresistKN anceofE?ecoliandK?epneumoniaestrainsisolatedfrom14 hospitalsinChinaCHINETprogramduring2009?eMethods Discdiffusiontest(Kirby-Bauermethod)wasemployedtO studytheantimicrobialresistance?eWHONET5?e4wasapKN pliedfordataanalysis?eResultsAtotalof12548clinicaliSOKN latescollectedduring2009wereanalyzedlincluding7992 strainsofE?ecoli?Iand4556strainsofK?epneumoniae?eAKN bout21?e3?1(1700?c7992)ofE?ecoliand19?e0?1(865?c4 556)ofK?epneumoniaewerecollectedfrompediatricpa- tients?eThetotalprevalenceofESBLs-producingstrainsin 2010??11?h20???d10???d6?(ChinJInfectChemother?INovember?e2010?IV01?e10?INo?e6431 E?ecoliandKlebsiellaspp?eisolateswas56?e5?1and42?e5?1O3respectively?eTheprevalenceofESBLsKNproducingstrainsvaried withhospital?Irangingfrom33?e30Ato78?e5?1inE?ecoli?Ifrom19?e4?1to72?e4?1inK?epneumoniae?eE?ecolistillshowedthe lowestresistance(<1?1)toimipenem?ImeropenemorertapenemO3followedbycefoperazone-sulbactamandpiperacillin-tazobac- tam?Itheresistanceratetowhichwaslowerthan6?1?eK?epneumoniaealsoshowedthelowestresistancetOthe3carbapenemaKN gents?eTheresistancerates rangedfrom2?e9?1tO5?e2?1?Ifollowedbycefoperazone-sulbactam(10?e8oA)andpiperacillin- tazobactam(15?e10A)?eLessthan25?1ofESBLsKNproducingstrainsofE?ecoliandK?epneumoniaewerefoundresistanttOthe3 carbapenemagents?Icefoperazone-sulbactamor piperacillin-tazobactam?eUpto 50?1ESBLsKNproducingstrainswereresistanttO bothgentamieinandciprofloxacin?eAtotalof132strainsofK?epneumoniaeand20strainsofE?ecoli?Iisolatedfrom10hospiKN tals?IwerenotsusceptibletObothimipenemandmeropenem?eAnd103ofthe132strainsofK?epneumoniaeand8ofthe20 strainsofE?ecoliwereresistanttoalltheantimicrobialagentstested?eSuchpan-resistantstrainsweremainlyfoundinShanghai HuashanHospital?eConclusionsComparedwiththeCHINETdatain2008?I earbapenems?Icefoperazone-sulbactamandpipKN eracillin-tazobactamarestillhighlyactiveagainstEnterobacteriaceae?eItis worthytonotethattheprevalenceofthestrainsnon- susceptibletOcarbapenemisincreasingrapidly?IespeciallyvK?epneumoni ae?e Keywords?EE?ecoli}Klebsiellaspp?e?I surveillanceofantibioticresistance {p??CHINET?????t???R???_??????2005?? ???I???????E{a?O?X{x???6?????i??{????k???,???? ???_?I???&???i10{a?4?314?z?q?????????t???R?? ?_????O3???62009??CHINET???_???R?????I?? ???_??’U????(??????{????_??’U??)?????_?????q ????{JO3 ????{e???? {?O4???? ({?)????2009??1?h{?2009??12?h CHINET?z????14?z?q???????G?????????f{x?? ?6?????aO3 ({?)???????????????????”???’?????AMH ?#?3O4???????????”{XBBL?bOXOID????{???O3 {?O4???? ({?)???’?????iCLSI?????????”??????( Kirby-Bauer)???,O3?A?????a{X?R?????I?? ATCC25922???????_??’U??ATCC700603O3?? ?’?????iCHINET??{??G???????k???,O3??’??? ???????????#{p?z?VO3 ({?)ESBLs?????_???ACLSI??????ESBLs ???”???i?????????G?w???X???????????_???R???? ?I?????_??’U????{p{?ESBLs?aO3 ({i)???’?????????S?????????6???2?6?i CLSI2009???k?C???S?????’????????[1]?I?????? ?????6?????AWHONET5?e4??{?O3 ???? {?O4?????????6?0 14?z?q??2009??1KN12?h?(?????G??12925 ?????f?a?I?R?????I??7992?a?I?????_??’U??4556 ?a??{????_??’U??377?aO3???z?q???????a?6?l ???q????2?e5?1??11?e8?1O3??{p2?z?P???q???6???? ?R?????I?????????_??’U???6?l??18?e6?1(1489?c 7992)??12?e6?1(620?c4933)O3?R?????I??{q?????? {??P??(49?e5?1)O4???W??(20?e2?1)O4?z??(7?e2?1)O4?? ?M???????x(5?e5?1)O4’S?????r?R?6?????C?d(5?e 1?1)O3?????_??’U??{q??????{????W??(64?e8?1)O4?P ??(14?e9?1)???z???C?d(5?e7?1)O3{????_??’U??{q?? ????{????W??(55?e7?1)O4?P??(17?eO?1)O4???M?????? ?x(5?e6?1)???z???C?d(4?e8?1)O3 {?O4???’???????? ({?)ESBLs????????14?z?q???R?????I?? ???_??’U??ESBLs???q???????6?l{X56?e5?1?? 41?e7?1O3{f?I?O?X?q???6????{pESBLs???????? ?A???3O3?????q???R???}???d{??q??O4?9???4{??m ?q?????????R???q?????}???d{??q?????R?????I?? ESBLs???????”??{????”?x???I???+?I?{?q??O4{n?? ?{???q??O4{n??{??E?R???}???P???q??O4?f???R???} ???P???q??O4???+?I?{?q??O4?????q???R???}???d{? ?q?????????q???R???}???d{??q?????_??’U????{p ESBLs??????????{????”?x??O3?z?i14?z?q???R?? ???I????ESBLs???????”??{??_??’U?????I????1O3 ({?)?R?????I?????_??’U?????????’???????? ?R?????I?????_??’U???????????????????’???? ????????2O3 KH({i){?ESBLs??????{?ESBLs???????’???? ?????q?????’?????????j?X?I?R?????I??{? ESBLs?a?t????<30?1??????’??-?U?E{??????? (0?e1o?c6)O4????????(O?e3?1)O4??{?????(0?e5?1)O4???? ????{?{??m????(5?e1?1)O4?x??????{??o????(7?e4?1)O4 ?P?????((10?e1?1)???x????{4(13?e2?1)O3?????_?? ‘U??{?ESBLs?a?t????<30?1??????’??-?U?E{??? ????(2?e3?1)O4????????(2?e60?c6)O4??{?????(3?e7?1)O4 432{p???(??{e?b???w??2010??11?h20???d10???d6?(ChinJInfectChemotherO3Novtember?e2010?IV01?e10?INo?e6 ?x??????{??o????(17?e1?1)O4?x????{4(22?e8?1)O4?? ??????{?{??m????(22?e9?1)???P?????((24?e7?1)O3 {????_??’U??{?ESBLs?a?t????<30?1??????’? ?-?U?E{???????(1?e0?1)O4????????(1?e0?1)O4??{??? ??(3?e7?1)O4?P?????((12?e8?1)O4?x??????{??o???? (25?e8?1)???x????{4(25?e9?1)O3???????i???????( ?K?b?I{?ESBLs??????’????????t???R????{???{? ESBLs???I????3O3 {iO4?2?q??{?ESBLs??????{?ESBLs?????? ?’???????????? ?2?q??{?ESBLs?a???’?????????????j?X?I14 ?z?q???R?????I??{?ESBLs?a??{???????O4?????? ??O4?x??????{??o????O4????????{?{??m????O4?x???-??O4 ?P?????(????{H???(???t???0???6?l{X?E0??1?e5?1O4 0??4?e8?1O40??22?e1?1O40?e8?1??12?e5?1O416?e0?1?? 95?e5?1O43?e0?1??16?e0?1??32?e2?1”-94?e6?1O314?z?q ???_??’U??{?ESBLs?a??{n??7?????????t???0?? ‘??-?6?l{X?E0??8?e2?1O40??10?e7?1O41?e9?1??42?e1?1O4 5?e8?1??47?e3?1O418?e8?1??90?e7?1O40”--43?e3?1??7?e2?1 ??63?e6?1O3?????I???I?????U?R?????I?????U?_??’U ??{?ESBLs?a?t{??q??ESBLs?6???a??????????{? {??m????O4?x??????{??o????O4??{H???(O4?P?????(?? ?t???R?e?j??{??P???aO3?A?t{??q??{p?I?????q???R ???}???q????{?{n???????????t?????e?j{X???I???? ???#????{????????I????4O4??5O3 ??1?2?q???R?????I?????_??’U??{?ESBLs?????? Table1?ePrevalenceofESBLsKNpositivestrains in???E?,??Pr06??ffPrinfPd?? RJH?EShanghaiRuijinHospital?TPUH?EPekingUnionHospiKN tallHSH?EShanghaiHuashanHospitallTJH?EWuhanTongjiHosKN pital?TBJH?EBeijingHospital?TSCH?EShanghaiChildrenKHSHospital?T PED?e?eShanghaiPediatricHospital?TZJH?ETheFirstAffiliatedHosKN pitalofZhejiangUniversityMedicalCollege?TKMH?ETheFirstAffilKN iatedHospitalofKunmingMedicalCollege?TGSH?EThePeopleKHSHosKN pitalofGansuProvince?T-?H?ETheFirstAffiliatedHospitalofXinjiang MedicalUniversitytAHH?ETheFirstAffiliatedHospitalofAnhuiMediKN calUniversity?TGZH?ETheFirstAffiliatedHospitalofGuangzhouMediK N calCollege?TCQH?ETheFirstAffiliatedHospitalofChongqingMedical University?e ??2?R?????I?????_??’U???????2?????????????t???????’?(??(?1) Table2?eSusceptibilityofE?ecoli?eK?epneumoniaeandK?eoxytocatoanti microbialagents(?1) Antimicrobialagent E?ecoli(7992)K?epneumoniae(4556)K?eoxytoca(377) RSRSRS Imipenem0?e499?e62?e996?e7 Meropenem0?e499?e63?e096?e5 Ertapenem0?e898?e85?e293?e7 Cefepime23?e165?e3j 26?e068?e5 Ceftazidime20?e072?e326?e068?e5 Cefotaxime54?e036?e841?e049?e5 Cefoperazone-sulbactam5?e377?e610?e872?e0 Cefuroxime63?e934?e250?e846?e9 Cefac]or62?e636?e360?e638?e4 Cefazolin66?e431?e853?e045?e9 Cefoxitin10?e982?e413?e084?e3 PiperacillinKNtazobactam4?e786?e115?e168?e5 Piperacillin76?e716?e655?e731?e8 AmpicillinKNsulbactam45?e333?e019?e771?e0 Ampicillin88?e69?e498?e00?e9 Amikacin7?e688?e814?e483?e6 Gentamicin52?e246?e033?e565?e3 Ciprofloxaein58?e737?e727?e861?e3 Levofloxacin65?e932?e020?e375?e2 0?e8 0?e6 2?e1 16?e0 17?e3 27?e8 10?e9 39?e3 45?e3 45?e9 11?e7 12?e8 46?e2 33?e3 97?e5 7?e1 26?e6 20?e2 20?e2 99?e4 99?e4 96?e9 79?e5 76?e5 62?e9 83?e1 58?e2 53?e1 45?e9 85?e8 78?e9 41?e3 51?e0 0?e7 87?e7 76?e6 62?e9 74?e6 Sulfamethoxazole-trimethoprim66?e231?e245?e450?e035?e158?e4 2010??11?h20???d10???d6?(ChinJInfectChemother?INovember?e2010?IV01?e10?INo?e6433 ??3{?ESBLs??????{?ESBLs?????t???R????(?1) Table3?eResistanceratesofESBLs(+)andESBLs({?)strainsofE?ecoli?IK?epneumoniae andK?eoxytocatoantimicrobialagents(?1) EcoliK?epneumoniaeK?eoxytoca AntimicrobialagentESBLs(+)ESBLs({?)ESBLs(+)ESBLs({?)ESBLs(+)ESBIO3s({?) H=4515n=3477n=19367?c=2620K7=105t?c=272 Imipenem1?e0O000?e40000?e61?e50000?e5 Meropenem4?e80000?e200?e601?e21?e5OOO0 Ertapenem3?e800?e90?e3NDNDND01?e23?e700ND0 Cefepime54?e825?e430?e125?e235?e347?e031?e532?e791?e395?e525?e416?e042?e545?e4 Ceftazidime35?e619?e327?e621?e924?e531?e115?e222?eO88?e896?e336?e220?e834?e838?e3 Cefotaxime80?e876?e584?e679?e086?e496?e480?e384?e091?e310091?e182?e2ND84?e5 Celoperazone-sulbactam22?ei5?e210?e45?e715?e24?e56?e53?e708?e67?e13?e0ND10?e1 Cefuroximesodium97?e198?e899?e798?e197?e410095?e998?e097?e510097?e998?e7ND92?e8 Cefazolin97?e198?e410098?e698?e110097?e698?e799?e410098?e298?e910093?e2 CefoxitinND11?e4NDND18?e612?e512?e315?e313?e9NDND5?e0NDND PiperacillinKNtazobactam12?e53?e45?e63?e47?e06?e42?e51?e11?e27?e54?e90?e90?e810?e1 Piperacillin10098?e599?e198?e097?e599?e797?e310096?e210097?e196?e810095?e3 Ampicillin-sulbaetam77?e948?e666?e452?e079?e382?e840?e872?e083?e254?e560?e032?e793?e571?e8 Ampicillin100ND10098?e999?e410098?e510010010098?e699?e410097?e5 Amikacin5?e812?e511?e612?e214?e27?e911?e412?e06?e211?e23?e93?e011?e216?eO Gentamicin69?e267?e270?e665?e066?e565?e764?e675?e370?e866?e955?e433?e259?e162?e7 Ciprofloxacin85?e682?eO80?e179?e884?e370?e884?eO82?e783?e294?e637?e932?e282?e176?eO Sulfamethoxazole-trimethoprim69?e278?eO77?e269?e776?e171?e167? e182?e7ND81?e568?e166?e483?e583?e3 ND?Enotdone?ESeetable1fortheabbreviatiousofhospital?e ??O4{?????????????????{f?’?(???R?????I?? ???_??’U???? ?d?-???_???????????i???????(?K{f?’?(?a (??{???????????????????{f?’?()154?a?I??{p?? 434{p???(??{e?b???w??2010??11?h20???d10???d6?(ChinJInfectChem other?INovtember?e2010?IV01?e10?INo?e6 ???_??’U??132?a?I?R?????I??20?a?I{????_??’U ??2?aO3???’?????????j?X?I?R?????I???????i?? ?????(?K{f?’?(?a?????P?????(???x??????{??o?? ?????t?????6?l?A65?1??45?1?b?I??’??????t???? ???A73?e7?1{?{nO3?????_??’U???????i???????( ?K{f?’?(?a?????P?????(???t????{X80?e5?1?b?I?? ??’???????{{?????t??O383?a?????_??’U????5 ?a?R?????I??{X???t???a?I{q????{p{?{n???{???q ??O4?????R???q?????}???d{??q?????????q???R?? ?}???d{??q??(???t?a?6?l{X73O48??2?a)?I?i1?a ?R?????I?????t?a????{?{n???P???q?????z???6?? ?aO3???t???a?C?d?6?0?j?X?I68?e2?1(60?c88)????{? ???C?d?I9?e1?1(8?c88)????{??z?C?dO3????6O3 ??5?2?q??{?ESBLs?_??’U?????t????(?1) Table5?eResistanceratesofESBIO3s(+)Klebsiellastrainsindifferenthospi tals(?1) Imipenem Meropenem Cefepime Ceftazjdime Cefotaxime Cefoperazone-sulbaetam Cefuroxime Cefazolin PiperacillinKNtazobactam Piperacillin Ampieillin-sulbactam Ampicillin Amikacin Gentamicin 80?e0 95?e0 75?e0 70?e0 95?e0 45?e0 100 100 80?e0 90?e0 80?e0 100 65?e0 85?eO 20?e0 5?e0 10?eO 10?e0 5?e0 15?e0 0 0 15?e0 5?eO 13?e3 0 0 0 0 0 15?e0 20?e0 0 40?e0 0 0 5?e0 5?eO 6?e7 0 35?e0 15?e0 Ciprofloxacin73?e75?e321?e1 90?e3 93?e3 92?e5 94?e8 98?e5 90?e2 100 99?e2 99?e3 100 97?e6 100 80?e5 89?e5 96?e1 9?e7 6?e7 4?e5 4?e5 1?e5 7?e5 0 0 0?e7 0 2?e4 0 0?e8 0 3?e1 Sulfamethoxazole-trimethoprim83?e3016?e796?e103?e9 O 7 3 8 1 8 5 8 o o??m o??o m?No o o???}m 2010??11?h20???d10???d6?(ChinJInfectChemother?eNovember?e2010 O3V01?e10?INo?e6435 ???? ?R?????I?????_??’U????(?????_??’U????{??? ?_??’U??)??{q???t???X?G{_{??U????{?F_,SBLs?I?? ??????8???????????(?K?t??O3{??????(?m??{? ESBLs???0???j?X?I????{??(??ESBLs{q??{XCTX- M-14???????I???A?R?????I?????????_??’U??{? ESBLs?a{p?6?l??63?e4?1(206?c325)??35?e3?1(65?c 184)?c2O3O3?D{?CT_&M?e14??{??x??????{X?x???????I ‘]{f???x???x??{????I’?????????2?????????’?(?? ???????R???3O3’]?????????z???x???x??{????? CTX-M-15?????????I?t?x??{????????]?????????t ?t???E?I???&CTx-M?e15?????t{X???0???W????ES- BLs??O3?A{p?????6?O?XCT)(-M-15??{??t{X{??- {?CTX-M-14?????OO4BLs??L3O34]O3?d?????0??{??j ?X?I?R?????I?????_??’U????{?ESBIO3s?a???x??{??? ???t??????2007???}???k{n?”?????I??{p?R?????I ??{?EsBLs?a???t????{n?”{?10?1(22?e1?1??31?e 1?1)[5]O3????CTX-M-14???UCTX-M-15?????I???D ?A??{????I???W?I???X?s??{??t????????AmpC?? (DHA-1)O4?A???????????b?????????????????t???? ??(??r??aac(67){??e?]fr)?+?I?????????k?E???t ??[2t6]O3?d???}??{p{?ESBLs???????R?i?KO4??{H?? ?(O4???R?(???(?t?????E?A40?1{?{n?I{N?”?j????{? ??{?ESBLs?a?t????O3 {e?????????I???????i???????(?K{f?’?(???R ?????I?????????_??’U???????e?j{n?”?U?d?-???_ ????{?????O32007??CHINET12?z?q?????????i ???????(?K{f?’?(???R?????I?????????_??’U???? ??{X0?e25?1(24?c9781)?I?I2009??????1?e21?1 (152?c12548)O3{S?1??’#???U???a?6???O{?{q???? {p{??{{5?O?X?I’]2009??????{q??????{?1?z?q ???I??64?1(98?c152)???a????{????q??O3?E???N?? ???e?I???]???????????????i???????(?K?t??{e?? ??{?KPC???i??[7]O3KPC???????A{??_??’U?? ??O4?x?????]??O4?R?????I??O4????????O4?V???O???? ???]?????????”???????+O3???x?????]??{p?????D ????’?{????b?I??’?????{p???E???A??’K??O3???A GenBank????????KPC?????i11{a{???(KPCIKN 11)(http?E?c?cwww?e1ahey?eorg?cStudies?c)O3?A?m??{q ??{XKPC-2???I?E??{??{{5?O?X[8]O3?D{??t?????? ?E???A??{????I?I{N???6?????????<{?(???????? Tn4401)?????A?I’????t???R?????r’K???I?I???I{e CTXKNM??ESBLs{??Q?I?t???A???W?X?s??{??t?? ??????AAC(6K9)O4OXA{?9?I??’????a????{X?E???t ???E?????t??[91?vO3?d?-???_?z?????????z?q??{f {????????i???????(?K{f?’?(???]???????????? ???I?I{N???t??{???{p{????q???I?i?????????t???X ?G??’K???X?G???,?N???I{????G?t???R?????????(O3 ???b?I?A?d?-???_{p?I??????1’??P???z?????????R ?????I??????{X???t???I???????6?????????t???X ?G{??#????{????N??O3 ???0???Z?E [1]cli??alandLaboratoryStandadsInstitutePerformanceStandards forAntimicrobialSusceptibilityTesting[S]?eSixteenthInforKN mationalSupplementO32009O3M100-S19?e [2]YuYS?ejisJ?IChenYG?Ieta1?eResistanceofstrainsproducing extended-spectrumbeta-lactamasesandgenotypedistribution inChina[J]?eJInfect?I2007O354(1)?E53??57?e [3]LiuW?eChenL?ILiH?Ieta1?eNovelCTXKNM{beta}{?lactamase genotypedistributionandspreadintomultiplespeciesofEn- terobacteriaceaeinChangsha?ISouthernChina[J]?eJAntimiKN crobChemother?e2009?I63(5)?E895KN900?e [4]?????e?{?a???I??{F???I?+?e?????O?XCTX-M-15???????D8 ???????????6?0???????????N??I-J]?e{p?{?????q???w???I 2009?I32(10)?E1114-1119?e [5]?????e??{F???e?D????O3?+?e2007??{p??CHINET?R?????I?? ???_??’U???t???R???_[J3?e{p???(??{e?b???w???I2009?I9 (3)?E185KN191?e [6]YangHO3ChenHO3YangQO3eta1?eHighprevalenceofplas- mid-mediatedquinoloneresistancegenesqnrandaac(6KH){?lb- crinclinicalisolatesofEnterobacteriaceaefromnine teaching hospitalsinChina[J]?eAntimicrobAgentsChemother?I2008O3 52(12)?E4268KN4273?e [7]weizQ?IDuXXO3YuYSO3eta1?ePlasmidKNmediatedKPC-2ina KlebsiellapneumoniaeisolatefromChina[J]?eAntimicrobAKN gentsChemother?I2007O351(2)?E763-765?e [8]CaiJC?IZhouHWO3ZhangR?Ieta1?eEmergenceofSerratia marcescensO3KlebsiellapneumoniaeO3andEscherichiacoliIKN solatespossessing theplasmid-mediatedcarbapenem-hydrolyKN zing{beta}-lactamaseKPC-2inintensivecareunitsofaChi- nesehospital[J]?eAntimicrobAgentsChemother?I2008?I52 (6)?E2014KN2018?e [9]GootzTD?ILescoeMK?IDib-HajjF?Ieta1?eGeneticorganizaKN tionoftransposaseregionssurroundingblaKPCcarbapene- n’lasegenes on plasmidsfromKlebsiellastrainsisolatedina NewYorkCityhospital[J]?eAntimicrobAgentsChemother?I 2009?I53(5)?E1998KN2004?e ElO]NordmannP?ICuzonGO3NaasT?eTherealthreatofKlebsielKN lapneumoniaecarbapenemase-producingbacteria[J]?eLancet InfectDis?I2009?I9(4)?E228-236?e ?G?P???(?E2010-07KN21