创伤患者凝固酶阴性葡萄球菌的分布及耐药性分析  

Distribution of coagulase-negative staphylococci from trauma patients and its drug resistance

作　　者：尚玮[1] 杨雅琼[1] 王学民[1] 朱洪涛[1] 

机构地区：[1]天津市天津医院,天津300211

出　　处：《中华医院感染学杂志》2011年第5期1030-1033,共4页Chinese Journal of Nosocomiology

摘　　要：目的探讨凝固酶阴性葡萄球菌(CNS)在创伤患者中的感染现状,并对其耐药性进行分析。方法回顾分析医院2005年1月-2009年12月分离自创伤患者伤口分泌物的葡萄球菌属,进行耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)和甲氧西林敏感凝固酶阴性葡萄球菌(MSCNS)的检测和分析。结果在创伤患者伤口分泌物的1068株葡萄球菌属分离株中,CNS 510株,占47.75%,其中表皮葡萄球菌377株,居首位,其次为溶血葡萄球菌120株,且溶血葡萄球菌的分离率有逐年增高的趋势;MSCNS 283株,MRCNS 227株,亦呈逐年增高的趋势;CNS对多种常用抗菌药物呈高度耐药(>50.00%),尤其对临床常用的三代头孢菌素及碳青霉烯类抗菌药物的耐药性呈明显增加的趋势,而对新近应用于临床的奈替米星、米诺环素的耐药率则较低,万古霉素对CNS仍保持100.00%的抑菌活性。结论创伤患者的CNS分离率逐年增高且呈多药耐药的趋势,临床应给予足够重视,根据药敏结果筛选适当的抗菌药物。OBJECTIVE To investigate the current status of infection caused by coagulase-negafive staphylococcus （CNS） in trauma patients, and analyze the drug resistance. METHODS Staphylococcus isolated from the wound secretion of trauma patients from Jan 2005 to Dec 2009 were retrospectively analyzed. RESULTS Among 1068 strains of staphylococcus isolated from wound secretion, a total of 510 strains were CNS, accounting for 47.75%, among which, Staphylococcus epidermidis （377 strains） was on the first place, then was the Staphylococcus hae- rnolyticus （120 strains） with an increased trend of the isolating rate year by year. Of the 510 CNS isolates, MSCNS （227 strains） and MRCNS （283 strains） were isolated with an increased trend of the isolating rate year by year. CNS appeared to be highly resistant to many commonly used antibiotics, especially to the commonly used three generations of cephalosporin and imipenem with a significantly. CNS was 100.000% suseeptive to vancomycin and was with low resistance rate to netilmicin and minocycline. CONCLUSION It should pay more attention to the increased isolating rate and the multidrug resistance of CNS. Antibiotics should be used rationally according to the susceptibility test results.

关 键 词：创伤 耐甲氧西林凝固酶阴性葡萄球菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]