革兰阳性球菌和鲍氏不动杆菌对替加环素及常用抗菌药的耐药状况分析  

Analysis on tigecycline and commonly used anti-bacterial agents resistance in Gram-positive cocci and Acinetobacter baumannii

作　　者：陈高莉 辛力华[1,2] 杨玲[1,2] 

机构地区：[1]成都中医药大学附属医院 [2]四川省中医院检验科,四川成都610072

出　　处：《国际检验医学杂志》2014年第9期1143-1144,1163,共3页International Journal of Laboratory Medicine

摘　　要：目的了解革兰阳性球菌和鲍氏不动杆菌对替加环素及常用抗菌药的耐药状况。方法收集445株革兰阳性球菌及83株鲍氏不动杆菌,采用VITEK 2Compact全自动微生物鉴定及药敏分析系统对革兰阳性球菌和鲍氏不动杆菌进行鉴定,采用微量肉汤稀释法微生物敏感性试验(MIC法)及纸片扩散抗菌试验(K-B)法检测二者对替加环素及常用抗菌药的敏感性。结果 445例革兰阳性球菌中发现金黄色葡萄球菌155例(34.8%),屎肠球菌78例(17.5%),溶血葡萄球菌56例(12.6%),表皮葡萄球菌45例(10.1%),粪肠球菌43例(9.7%),人葡萄球菌18例(4.1%),沃氏葡萄球菌16例(3.6%),鸟肠球菌8例(1.8%)及其他菌株26例(5.8%)。葡萄球菌对青霉素的耐药率达92.4%;对红霉素、克林霉素、苯唑西林、环丙沙星的耐药率超过50%。肠球菌对多种药物存在天然耐药,但对利奈唑胺、替加环素敏感。MIC法检测多重耐药及泛耐药鲍氏不动杆菌对替加环素的敏感率、中介率、耐药率分别为57.1%(47/83)、42.9%(36/83)及0.0%(0/83),K-B法检测分别为2.4%(2/83)、40.5%(34/83)、57.1%(47/83)。结论替加环素对革兰阳性球菌及鲍氏不动杆菌有较好的抗菌活性。Objective To understand tigecycline and commonly used anti-bacterial agents resistance in Gram-positive cocci and Acinetobacter baumannii .Methods 445 strains of Gram-positive cocci and 83 strains of Acinetobacter baumannii were collected . VITEK 2 Compact automated bacterial identification and susceptibility analysis system was employed to identify Gram-positive coc-ci and Acinetobacter baumannii and their bacterial sensitivities toward tigecycline and commonly used anti-bacterial agents were de-tected by broth microdilution method for antimicrobial susceptibility testing （MIC assay） and Kirby-Bauer disk diffusion susceptibil-ity test（K-B） ,respectively .Results 155（34 .8% ） strains of Staphylococcus aureus ,78（17 .5% ） Enterococcus feces ,56（12 .6% ） Staphylococcus haemolyticus ,45（10 .1% ） Staphylococcus epidermidis ,43（9 .7% ） Enterococcus faecalis ,18（4 .1% ） human Staphy-lococcus ,16（3 .6% ） Wolfowitz Staphylococcus ,8（1 .8% ） birds Enterococci and 26（5 .8% ）other strains were found in 445 cases of Gram-positive cocci .The rate of penicillin-resistant Staphylococci was 92 .4% and the rates of Staphylococci′s resistance to eryth-romycin ,clindamycin ,oxacillin and ciprofloxacin were all over 50% .Enterococci ,which was sensitive to linezolid and tigecycline ,was resistant naturally to many drugs .The tigecycline sensitive rate ,intermediate rate and resistance rate acquired by MIC assay for multi-drug resistant and pan-resistant Acinetobacter baumannii were 57 .1% （47/83） ,42 .9% （36/83） and 0 .0% （0/83） ,respec-tively ,while those by K-B methods were 2 .4% （2/83） ,40 .5% （34/83） and 57 .1% （47/83） ,respectively .Conclusion Tigecycline showes good antibacterial activity toward Gram -positive cocci and Acinetobacter baumannii .

关 键 词：革兰阳性球菌 鲍氏不动杆菌 抗菌药 抗药性 细菌 替加环素 

分 类 号：R446.5[医药卫生—诊断学]