医院金黄杆菌属分布变迁与耐药性研究  

Distribution changes of staphylococcus spp and drug resistance

作　　者：陈晓蓓[1] 

机构地区：[1]宁波市第一医院检验科,浙江宁波315010

出　　处：《中华医院感染学杂志》2011年第4期772-774,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解医院金黄杆菌属感染的菌种在临床的分布状况以及对抗菌药物的耐药趋势,为临床治疗金黄杆菌属感染,合理选择抗菌药物提供正确依据,指导临床用药。方法从医院临床标本中分离获得790株金黄杆菌属,用VITEK-32全自动微生物鉴定药敏分析系统进行菌种的鉴定和药物敏感性试验(部分采用K-B法作药物敏感性试验);用WHONET5统计软件对结果进行统计和分析。结果共分离获得金黄杆菌属790株,其中产吲哚金黄杆菌472株,脑膜脓毒金黄杆菌279株,黏金黄杆菌39株;药敏结果显示,产吲哚金黄杆菌对比阿培南、哌拉西林/他唑巴坦和头孢哌酮/舒巴坦的耐药率分别为11.2%、29.4%和33.5%;对妥布霉素、左氧氟沙星等7种抗菌药物的耐药率均>80.0%;脑膜脓毒金黄杆菌对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦和磺胺甲噁唑/甲氧苄啶的耐药率分别为9.3%、10.0%和27.6%;对妥布霉素、亚胺培南等4种抗菌药物的耐药率均>80.0%;在检出的790株金黄杆菌属中产金属酶脑膜脓毒金黄杆菌167株,产酶率为59.9%,产吲哚金黄杆菌中有307株产金属酶,产酶率为65.0%。结论金黄杆菌属在医院感染有逐年增加趋势,菌种分布发生变迁,多药耐药菌株明显上升;比阿培南、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦对产吲哚金黄杆菌均有很强的抗菌活性,是目前治疗多药耐药产吲哚金黄杆菌感染的最佳选择。OBJECTIVE To study clinical distribution of the species of Staphylococcus spp causing nosocomial infection and the drug resistant trend to antimicrobial agents, to provide bases for clinical treatment of Staphylococcus spp infections and the reasonable application of antimicrobi agents. METHODS A total of 790 strains of Staphylococcus spp were isolated from clinical specimens. The VITEK-32 automated microbial identification system was applied for bacterial susceptibility test of species identification and drug susceptibility testing （part of the KB method was used for drug sensitivity test）. WHONET5 statistical software was used for statistical analysis. RESULTS Staphylococcus spp were isolated from 790, which produced indole Chryseobacterium were 472, meningitis, sepsiS Chryseobacterium 279, 39 strains of Chryseobacterium stick. Susceptibility test results showed that the drug resistant rates of indole-producing Staphylococcus spp to biapenem, piperacillin/tazobactam and cephalosporins/sulbactam were 11. 2%, 29.4% and 33. 5%, respectively. On the proper cloth mold Su, levofloxacin and other antimicrobial resistance rates of seven higher than than 80.0%. Meningococcal sepsis sent Chryseobacterium compound of ketone/sulbactam and piperacillin/tazobactam and cotrimoxazole resistance rates were 9.3%, 10.0% and 27.6% ; of tobramycin, imipenem four imipenem and other antimicrobial resistance rates. greater than 80.0%. CONCLUSION With Staphylococcus spp infections in the hospital,there is a rising trend of drug resistance, changes in species distribution occur, multiple drug-resistant strains increase significantly. Biapenem and piperacillin/tazobactam, Cefoperazone/sulbactam have a strong antibacterial activity to indoleproducing Staphylococcus spp, and which are the primary choice for infection caused by multi-drug resistant indole-producing Staphylococcus app.

关 键 词：金黄杆菌属 变迁 抗菌药物 耐药率 

分 类 号：R978.1[医药卫生—药品]