中文摘要：

目的监测2013—2014年中国云南省28家三级医院血流感染病原菌构成及耐药状况，为菌血症病原菌分布及其耐药积累数据资料。方法2013—2014年全国细菌耐药监测网云南省28家三级医院成员单位，按统一的方案进行血培养分离、鉴定和药敏试验。收集阳性菌株数据用Whonet5．6软件按CLSIM100．s24判断标准进行统计分析。结果14519株血培养阳性菌株中革兰阴性杆菌7490株，占51．59％；革兰阳性球菌6196株，占42．68％；真菌421株，占2．90％；其他菌株412株，占2．84％。本研究检出金黄色葡萄球菌786株，其中MRSA190株，占24．17％；凝固酶阴性葡萄球菌4395株，MRCNS3177株，占72．29％。葡萄球菌对万古霉素、利奈唑胺、替考拉宁100％敏感，MRSA和RCNS对红霉素、四环素、克林霉素、阿奇霉素、喹诺酮类耐药率均大于40％。粪肠球菌对青霉素及氨苄西林耐药率分别为4．2％及3．4％，而屎肠球菌对青霉素耐药率为89．5％，对氨苄西林耐药率为84％，对万古霉素耐药率为0．8％。肺炎链球菌对青霉素耐药率为3．7％，草绿色链球菌对青霉素耐药率为9．1％。大肠埃希菌共检出3785株，其中产超广谱B内酰胺酶大肠埃希菌为1984株，占比52．42％。肺炎克雷伯菌共检出1010株，其中产超广谱B内酰胺酶肺炎克雷伯菌364株，占LL36．04％。大肠埃希菌（ESBLs’）菌株对亚胺培南耐药率为0．9％，对美罗培南耐药率为0．2％；肺炎克雷伯菌（ESBLs’）菌株对美罗培南耐药率为22．6％，对亚胺培南耐药率为28％。沙门菌检出845株，对常规检测药物多为敏感。铜绿假单胞菌共检出264株，其中泛耐药菌株为21株，占7．95％。鲍曼不动杆菌共检出275株，其中泛耐药菌株36株，占13．09％。嗜麦芽寡养单胞菌检出158株，对常规检测药物耐药率显示：头孢他啶41．9％，左氧氟沙星3％，复方磺胺甲?

英文摘要：

Objective To investigate the distribution of positive blood culture pathogen detection and drug resistance analysis of 28 general hospitals in Yunnan provincal surveillance of China （2013--2014）, to accumulate the data of bacteremia pathogenic bacteria distribution and drug resistance. Methods The positive blood culture pathogens were collected from 28 general hospitals in Yunnan surveillance of China. All hospitals were carried with the unified solution for bacteria culture, isolation, identification and antibiotic sensitivity tests. The datas were analyzed by WHONET 5.6 software according to CLSI M100-$24. Results In the 14,519 strains, the gram negative bacilli 7,490 strains, accounting for 51.59%; the gram positive coccus 6196 strains, accounting for 42.68%; fungus 421 strains, accounting for 2.90%; the rest 412 strains, accounting for 2.84%. 786 strains of Staphylococcus aureus were obtained, MRSA 190 strains, accounting for 24.17%; MRCNS 3177 strains, accounting for 72.29%; the resistant rates of Staphylococcus to vancomycin, linezolid were 0; but the resistant rates of MRSA and MRCNS to erythromycin, tetracycline, clindamycin, azithromycin, quinolone were greater than 40%. The resistant rates of Enterococcus faecalis to penicillin and ampicillin were 4.2% and 3.4% respectively, and the resistance rate of Enterococcus faecium to penicillin was 89.5%, to ampicillin was 84%, to vancomycin was 0.8%. The resistant rate of Streptococcuspneumoniae to penicillin was 3.7%, the resistant rate of the Streptococcus viridans to penicillin was 9.1%. 3,785 strains of E. coli were detected. The producing extended-spectrum beta-actamases E. coli were 1984 strains, accounting for 52.42%. 1,010 strains of Klebsiella pneumoniae were detected, the producing extended-spectrum beta- actamases Klebsiella pneumonia were 364 strains, accounting for 36.04%. The resistant rates of E. coli （ESBLs＋） strains to imipenem and meropenem were 0.9% and 0.2% respectively, the resistant rate of Klebsiella pneumoniae （ESBLs＋） st