สถานการณ์ชº้อด้อยาต้านจ»ลชช พ ป...
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6M 2019 79H
สถานการณ์เชือ้ดือ้ยาต้านจุลชช พป 2000-2019
ศูนย์เฝ้าระวังเชือ้ดือ้ยาต้านจุลชช พแห่งชาต ิ(NARST)
สถาบนัวิจัยวิทยาศาสตร์สาธารณสุข กรมวิทยาศาสตร์การแพทย์
http://narst.dmsc.moph.go.th
6M 2019 79H NARST data
40.5
37.2
53
42.737.5
42.846.1
49.3 52.5
51
51.2
52.9
35
46.2
47.950
47.8 47.6
44.7
39.7
39.6
39.7
39.6
1.7 1.8 0.6 1.2 0.2 0.5 0.4 1.7 2.2 3.63.1 2.8 3.3
0 1 0.6 0.2 0 0 0.4 1.24.6 4.8 5 6.4
58.4
68.171
67.764.2
67.563
65.9 64.4 63.6 65.6 63.9
79.783.6
86 87.181.8
84.8 8487.2 86.5
90
0
10
20
30
40
50
60
70
80
90
100
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
Antimicrobial Resistance rates of Enterococcus spp. by year
(NARST - 79 hospitals, 6M 2019)
%R
Tetracycline (UTI)
Erythromycin
Gentamicin (120µg)
Penicillin G
VancomycinTeicoplanin
6M 2019 79H NARST data
Rate of vancomycin resistant enterococci
8.1
2
1.4
1.50.8
0.10.31.3
0.40.70.4 0.3
7.1
1.10.5
1.9
0.4
1.60.7
3.2
4.3
4.5
9.9
8.3 8.1
9.3
0
2
4
6
8
10
12
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
E.faecalis E.faecium
% R
6M 2019 79H NARST data
Percent resistance of E. faecium, E. faecalis to vancomycin
0 0
3.42.5
0 0
5.6
0 0 0 2.8
12.2
3.6
7.5
9 10.6
0
10.2
4.3
8.7
8.69.8 11.2
0 0 0 0
3
0 0 0 0 0 0
6.7
22.2
7.58.7
10.8
0
5
10
15
20
25
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
OPD IPD ICU
Vancomycin
E. faecium
% R
0 0 0 0 0
1.50.8
0
0.4
0.30
1.91.2
00.5
0.2
0.41.7
0.70.30 0 0
4.8
0
2.7 1.5
0
0.5
0
0.6
0.20
5
10
15
20
25
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
OPD IPD ICU% R
E. faecalis
Vancomycin
6M 2019 79H NARST data
35.6
41.2
36.438.2
36.8 33.9
30.830.3 32.5
28
33.6 34.433
37.5
31
34.4 34.333.8
13.3
17.5
22.424
29.8 30.7 32.5
28.128.6 28
30.6
23.625.4
18.2
29.1 29.1
27.1
21.2 2220.4
0 0 0 0 0 0.3 0.1 0.6 0.4
0
5
10
15
20
25
30
35
40
45
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
%R
Antimicrobial Resistance rates of Staphylococcus spp. by year
(NARST - 79 hospitals, 6M 2019)
Oxacillin(Cefoxitin)
Ciprofloxacin
Clindamycin
Vancomycin by MIC
Erythromycin
6M 2019 79H NARST data
Percent isolates of Methicillin Resistance S. aureus (MRSA) and
Methicillin Resistance Staphylococcus coagulase negative (MRSCN)
0 0 0 0
28
20 21
19
22 2218 14.2
9.6
8.1
9.1
0
10
20
30
40
50
60
70
80
90
100
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
3026 29
4953
55
54.5
53.2 55.2
58.8
0
10
20
30
40
50
60
70
80
90
100
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
Oxacillin(Cefoxitin)
MRSA MRSCN
Oxacillin(Cefoxitin)
Cefoxitin disk: S ≥22. R ≤21 Cefoxitin disk: S ≥25. R ≤24
(26,584)(25,096)
(33,462) (30,963)
(17,292) (23,364)
%R %R
6M 2019 79H NARST data
45.842.7
48.2
52.3
35.438.5 37.8
35.4
32.4
0 0.3 0.8 0.6 0.5 1 0.8 0.60.8
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15.9 1618.6 19.4
28.531.6 30.1
31.729.3
26.6 27.8 29.1 29.1 30.333.2 32.1
33.734.5
0
10
20
30
40
50
60
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
Penicillin G (Oxacillin %NS) Levofloxacin Vancomycin Clindamycin Erythromycin
Antimicrobial Resistance rates of S. pneumoniae by year
(NARST - 79 hospitals, 6M 2019)
%R
Oxacillin (% non-susceptible)
Erythromycin
Clindamycin
VancomycinLevofloxacin
6M 2019 79H NARST data
Susceptibility of S. pneumoniae by specimen
Penicillin G (Oxacillin) Erythromycin
67 6670
6162.2
52.7
73.369.5
68.9
74
60.9
5056
49
56
47.3
60.6 6161.764.4
75
0
20
40
60
80
100
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
blood sputum
2228
1923
2733 31 31 28
29 29
3328
33 32 30
4138 36 33 35
38
0
20
40
60
80
100
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
blood sputum%R%S
6M 2019 79H NARST data
44.8
48.351.5 49.5
48.5
38.3
31.936.6
33.7
48
64.260.7
70.8
65.363.664.7
58
44.3
52.8
57.460.8
6368.4
67.5
66.1
48.8
37.436.5
47.2
66.2
50.7
35.2
20.3 21.4
29.1
59.4 58.6 59.5
33.8
30.4
5.89.3
30.4
47.5
52.3
58.2
67.4
55.5
42.7
0
10
20
30
40
50
60
70
80
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
Amikacin Cefepime Ciprofloxacin
Piperacillin/Tazobactam Ampicillin/Sulbactam Imipenem%R
Antimicrobial Resistance rates of Acinetobacter spp. by year
(NARST - 79 hospitals, 6M 2019)
6M 2019 79H NARST data
8.6 8.96.9 6.2
9.1 9.6 10.4 10.38.9 9.6
22.2 20.8 21.119.1
20.8 19.3
15.6 16.710.7 11.6
12.4 12.9
19.3 19.519.4 18.1
18.318.7
54.9
40.2
43.9 43.445.5
40.7
37.5
37.8
36.5
23.1
20.917 17.5 18.1
17.9
17.514.7 13.2
14.8
20.316
15.7 15 14 13.8 14.3
8.7 7.98.1
0
10
20
30
40
50
60
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
Piperacillin/Tazobactam Ceftazidime Imipenem
Norfloxacin (UTI) Ciprofloxacin Amikacin%R
Antimicrobial Resistance rates of P. aeruginosa by year(NARST - 79 hospitals, 6M 2019)
Norfloxacin (UTI)
Ceftazidime
Piperacillin/Tazobactam
6M 2019 79H NARST data
Carbapenem Resistance in Acinetobacter spp.
and Pseudomonas aeruginosa
44.5
53
61.4
55.1
42.7
45.5
52.2
58.9
52
40.5
0
10
20
30
40
50
60
70
2015 2016 2017 2018 2019
Imipenem Meropenem
% R
18.8 19.3 19.1 18.1 18.7
17.8 18.5 17.8 16.9 16.6
0
10
20
30
40
50
60
70
2015 2016 2017 2018 2019
Imipenem Meropenem
% R
Acinetobacter spp. Pseudomonas aeruginosa
6M 2019 79H NARST data
Rate of Imipenem Resistant Acinetobacter spp.0
.3 0.6
9.6
14
.4
0.4 0.8
10
.7
29
.4
0.3 0.8
11
.5
38
.5
0.3 0.6
50
.4
0.2 0.5
12
.2
0.6 1.8
20
.7
63
.6
1.8 2.7
21
.7
66
.3
3.3
2.9
19
.5
68
.7
8.4
3.7
18
.1
67
.4
10
.2
4
18
.3
55
.5
0
10
20
30
40
50
60
70
80
K. pneumoniae E. cloacae P. aeruginosa Acinetobacter spp.
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019% R
all species
6M 2019 79H
1.2 3
10.7
47
38.341.8
37.8
32
48.1
40.3 41.1
7.6
15.6
27.6
59.3 61.4
7571 70.1 71 72.2
70.3
14.2
25
46.8
68.9
81.285.9
82.4 82.5 81.7 79.8 80.2
0
10
20
30
40
50
60
70
80
90
100
OPD IPD ICU
Percent resistance of A. calcoaceticus-baumannii complex to Imipenem
%R
6M 2019 79H NARST data
0.91.6
2 2 2.4
9.1 8
4.85.2 5
2.8 4 4.3 4 4.6
29.432.2
39.1
46.451 52 50.5 49.7 48
52.2
21.524.7
28.1 28.632
34 32.7 33.9 33 33.3
75.2 76.580.1 82.1
84 86 85.3 85.1 84 83.7
5.6 5.22.7
2 1.4
1.3 1.6 2 1.70
10
20
30
40
50
60
70
80
90
100
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
Ampicillin
Nitrofurantoin (UTI)
Gentamicin
Ciprofloxacin
ImipenemFosfomycin (UTI)
Antimicrobial Resistance rates of E. coli by year
(NARST - 79 hospitals, 6M 2019)
%R
6M 2019 79H NARST data
1 0.9 1.2 0.7 0.4 0.6 1.3 2.66.3 8.4
10.2
10.5
35
45.442.3
47.450
43.4
37
31.7
37.7
36.5
12.6
20.223.1
26.5
26 26 26.1
27.9
28.0
37.9
2225.2 26.5 25.3
23 23 2220 19.3 18.8
17.6 17.5
0
10
20
30
40
50
60
70
80
90
100
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
Nitrofurantoin (UTI)
Gentamicin Ciprofloxacin
Imipenem
Antimicrobial Resistance rates of K. pneumoniae by year
(NARST - 79 hospitals, 6M 2019)
%R
6M 2019 79H NARST data
ESBL producing E. coli
Ceftazidime
Cefotaxime
R≤22
R≤27
20.4
28.7 31.735.9 38.1
42.846.1 48.2 48.6 50
46 48
0
10
20
30
40
50
60
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
ESBL by screen test
13.417.3
2125.7
28.434.2
37.741.2 40.9
38 38 37
0
10
20
30
40
50
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
ESBL by screen test
%R
%R
6M 2019 79H NARST data
ESBL producing K. pneumoniae
%R
%RCeftazidime
Cefotaxime R≤27
25.3 27.432.1 34.7 36.7
40.3
48.844.7 45.3 48 48 49
0
10
20
30
40
50
60
ESBL by screen test
24.4 24.830.8 32.5 34.4 36.5
41.4 39 39.943 41 41
0
10
20
30
40
50
ESBL by screen testR≤22
6M 2019 79H NARST data
Percentage Resistance of E. coli and K. pneumoniae
9 1014
1721 23
2629 29
25 26 25 24 2531 33 34 36 37
35 3437 38 37
912
2026
3034
3844 45 4543 43
25 2732
35 37 39 4138 394141 42
0
10
20
30
40
50
60
70
80
90
100
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019.
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
% R
R ≤17R ≤22
Cefotaxime Ceftazidime
E. coli K. pneumoniae
6M 2019 79H NARST data
Carbapenem Resistance in E. coli and K. pneumoniae
0.6
0.7 0.4 0.51
1.6 2.43.1 3.1
0.8
2.1
0.9
2.5 3.7
3.64.8
6.3
9.5
11.5
13.3
1 1.30.8
0.4 0.5 0.5
1.1
1.6 2 2.4
0.9 0.7 0.6
1.3
1.82.3
3.3
6.3
8.4
10.210.5
0.60.7 0.51.6
2.1
2.6 2.5
1.3
1.6
2
2.4
3.3
6.5
8.6
10.811.5
0
4
8
12
16
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
ERTAPENEM IMIPENEM MEROPENEM
% RE. coli K. pneumoniae
6M 2019 79H NARST data
Percent resistant of Non-typhoidal Salmonella
isolated from Blood, 2000-2019 (6M)
44.7
39.6
50
68.1
61.9
77
58.5
68.3
55.8
65.9 65
56
47 47.4
55
80
18.2
7.5
38.2
21.7
41.7
19
11.8 1211.1 4.2
6.19.8
29.124.6
29.132
13.510.4
11.2
3.5
37.5
0
24.5
15.6 15.1
8.99.9
1.4
4.3
2.6
7.7 7.44.2 3.1 3.1
46.5
53.7
14.7
12.9
1818.9
14.6
10.2
9.9
1.4
31
21.3 17.1
12.4
8.5
0
10
20
30
40
50
60
70
80
90
100Ampicillin Ampicillin/Sulbactam Ceftazidime Ceftriaxone
Ciprofloxacin Co-trimoxazole Cefotaxime
%R
6M 2019 79H NARST data
Percent resistant of Non-typhoidal Salmonella
isolated from Stool & Rectal swab, 2000-2019 (6M)
28.8 27.6
38.1
43.6 52.5
47.5
63.4
56.759.4
54.4
49.1 49.6 49.5
4.50.9
10.4
3
11.1
6.13.6 6.7 13.6 11.1
28.2 29.8
15.312.4
16.5 18 19.5 18.114.8 13.6 12.6
02.4
02.4
1
2.2
2.63.6 4.6 3.4 3.60
10
20
30
40
50
60
70
80
90
100
Ampicillin
Co-trimoxazole
Amoxicillin/clavulanic
Ciprofloxacin
%R