老年患者常见革兰阳性球菌耐药性监测  

Surveillance of drug resistance of common gram-positive cocci from elderly patients

作　　者：苗秀英[1] 许夕海[1] 胡立芬[1] 程君[1] 叶英[1] 李家斌[1] 

机构地区：[1]安徽医科大学第一附属医院感染科,安徽合肥230022

出　　处：《中华医院感染学杂志》2013年第8期1914-1916,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金(81071394)

摘　　要：目的了解安徽省2008-2010年老年患者临床分离革兰阳性球菌的耐药性,以指导临床合理使用抗菌药物。方法收集2008-2010年安徽省细菌耐药监控中心网络医院门诊或住院老年患者临床分离菌,采用琼脂稀释法对分离的革兰阳性球菌进行药敏试验,按CLSI 2010年版判断结果。结果 2008-2010年共收集老年患者革兰阳性球菌311株,金黄色葡萄球菌89株,占28.6%,溶血葡萄球菌53株,占17.0%,表皮葡萄球菌44株,占14.1%;耐甲氧西林金黄色葡萄球菌(MRSA)的检出率51.7%,MRSA耐药严重,除万古霉素、替考拉宁和利奈唑胺外,对各种抗菌药物的耐药率均≥67.4%;甲氧西林敏感金黄色葡萄球菌(MSSA)对大部分抗菌药物耐药率均<30.0%;3年未发现万古霉素、替考拉宁及利奈唑胺耐药株;肠球菌属除对万古霉素、替考拉宁及利奈唑胺较为敏感外,对其他各种抗菌药物耐药率均≥57.1%,未发现耐利奈唑胺肠球菌。结论老年患者革兰阳性球菌耐药严重,加强细菌耐药性监测对指导临床用药十分重要。OBJECTIVE To investigate the drug resistance of the clinical isolates of gram-positive cocci isolated in Anhui province from 2008 to 2010 so as to guide the rational use of antimicrobial drugs.METHODS The clinical isolates were collected from the center for monitoring of bacterial resistance,Anhui province or the elderly hospitalized patients,the antimicrobial susceptibility testing of the gram-positive bacteria was carried out by using agar dilution method,and the results were analyzed according to CLSI 2010.RESULTS A total of 311 strains of gram-positive cocci were isolated,including 89（28.6%） strains of Staphylococcus aureus,53（17.0%） strains of Staphylococcus haemolyticus and 44（14.1%） strains of Staphylococcus epidermidis.The prevalence of methicillin-resistant S.aureus（MRSA） was 51.7%.The resistance rates of MRSA strains were higher than 67.4% except vancomycin,teicoplanin and linezolid.The resistance rates of the methicillin-sensitive S.aureus（MSSA） strains were lower than 30.0% to most antibiotics.No strains were found resistant to vancomycin,teicoplanin or linezolid during 2008-2010.The resistance rates of Enterococcus spp.strains were higher than 57.1% to all the antibiotics except vancomycin,teicoplanin and linezolid,and no strains of linezolid-resistant Enterococci were detected.CONCLUSION The drug resistance of gram-positive cocci in the elderly patients is serious.It is very important for the reasonable use of antibiotics to enhance the monitoring of drug resistance.

关 键 词：革兰阳性球菌 耐药性 抗菌药物 药敏试验 

分 类 号：R378[医药卫生—病原生物学]