1296株革兰阳性球菌的分布和耐药性分析  

Analysis of the clinical distribution and drug resistance of 1 296 strains of Gram-positive cocci

作　　者：黎村艳[1] 曹友德[1] 蔡瑞云[1] 李浩[1] 

机构地区：[1]湖南省人民医院检验科,湖南长沙410007

出　　处：《中国病原生物学杂志》2013年第1期76-79,共4页Journal of Pathogen Biology

基　　金：湖南省人民医院仁术发展基金项目(No.201058)

摘　　要：目的了解革兰阳性球菌在医院的临床分布及耐药情况,为临床合理使用抗菌药物提供依据。方法常规方法培养细菌,HZS新阳光全自动细菌鉴定分析系统对病原菌分型,采用K-B纸片扩散法进行药敏试验。结果 2010年5月～2012年3月医院共分离出革兰阳性球菌1 296株,菌株数较多的球菌为金黄葡萄球菌、粪肠球菌、表皮葡萄球菌,分别占19.06%、18.67%和13.81%。各种临床标本中以尿液标本分离菌株数最多(占30.02%)。金黄葡萄球菌和凝固酶阴性葡萄球菌对复方新诺明和青霉素耐药率均高于80.00%,对利奈唑胺、替考拉宁和呋喃妥因耐药率均低于10.00%,未检出万古霉素耐药株。肠球菌对利奈唑胺、替考拉宁和万古霉素耐药率分别为4.58%、3.77%和3.14%,对其他抗菌药物耐药率较高。MRSA的分离率为40.48%,MRS的分离率为72.72%;MRSA的耐药率显著高于MSSA。结论金黄葡萄球菌、粪肠球菌、表皮葡萄球菌为医院感染的主要革兰阳性球菌,对抗菌药物的耐药性广泛;临床医疗过程中应重视病原菌检测及药敏试验,以减少耐药菌株产生。Objective To investigate the clinical distribution and drug resistance of Gram-positive cocci in order to guide the clinical use of antibiotics. Methods Conventional methods were used for bacterial culture. A fully automated bacte- ria identification system from Sunshine Bio was used to identify the bacteria and conduct antibiotic susceptibility testing. Results A total of 1 296 strains of Gram-positive cocci were obtained from a variety of specimens from May 2010 to Mar 2012. The top three isolates of Gram-positive cocci were Staphylococcus aureus （19. 06%）, followed by Enterococcus faecalis （18.67%） and Staphylococcus epidermidis （13.81 %）. S. aureus and eoagulase negative Staphylococcus spp. had resistance to a sulfamethoxazole compound and penicillin of more than 80.00% and a resistance to linezolid, teieopla- nin, and nitrofurantoin of no more than 10%. Vancomycin-resistant （VRE） strains were not found. Enterococcus resist ance to linezolid, teicoplanin, and vancomycin was 4.58%, 3.77%, and 3.14%, respectively. Of the isolates, 40.48% were MRSA and 72.72% were MRS. MRSA was more resistant to antibiotics than MSSA P〈0.05）. Conclusion S. aureus, E. faecalis and S. epidermidis were the main Gram-positive cocci causing hospital infections. The detection and monitoring of drug resistance among clinical pathogens should be enhanced because of the variance in their drug resist ance. Drugs should be used rationally in accordance with the results of drug susceptibility testing.

关 键 词：革兰阳性球菌 葡萄球菌 肠球菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]