革兰阳性球菌医院感染的临床分布及耐药性分析  

Clinical distribution and drug resistance of gram-positive cocci causing nosocomial infections

作　　者：王娜[1] 常世卿[1] 李少侠[1] 张莎莎[1] 

机构地区：[1]河南省洛阳正骨医院检验科,河南洛阳471002

出　　处：《中华医院感染学杂志》2014年第13期3152-3154,共3页Chinese Journal of Nosocomiology

基　　金：河南省中医药科研基金资助项目(2013ZY04007)

摘　　要：目的探讨革兰阳性球菌医院感染的标本分布及耐药率,为临床合理使用抗菌药物、减少医院感染提供科学依据。方法回顾性调查医院2008年5月-2012年10月革兰阳性球菌感染的临床现状,对246株革兰阳性球菌的耐药性进行分析;采用WHONET5.4统计软件对培养结果进行统计分析。结果 246株革兰阳性球菌感染患者的标本,主要来源于脓液95株占38.6%、伤口分泌物56株占22.8%、穿刺液43株占17.5%;分离的246株革兰阳性球菌中金黄色葡萄球菌158株占64.2%、凝固酶阴性葡萄球菌61株占24.8%、肠球菌属27株占11.0%;革兰阳性球对青霉素、克林霉素和红霉素的耐药率均>60.0%,对其他抗菌药物也产生了不同的耐药性,对万古霉素和替考拉宁具有高敏感性;耐甲氧西林金黄色葡萄球菌(MRSA)与耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)分别检出122株与40株,检出率分别为77.2%和65.6%。结论临床医师应根据患者标本的细菌学检查结果,合理应用抗菌药物,采取有效措施积极预防和控制革兰阳性球菌感染。OBJECTIVE To explore the distribution and drug resistance rates of the gram-positive cocci causing nos- ocomial infections so as to provide guidance for reasonable clinical use of antibiotics and reduction of incidence of nosocomial infections. METHODS From May 2008 to Oct 2012, a retrospective survey was conducted to investigate the incidence of infections caused by the gram-positive cocci, then the drug resistance of 246 strains of gram-posi- tive cocci was analyzed, and the results of culture were statistically analyzed with the use of WHONET5.4 soft- ware. RESULTS Of the 246 strains of gram-positive cocci isolated from the specimens of the patients with infec- tions, 95 （38.6%） strains were isolated from the pus specimens, 56 （22.8%） strains from the wound secretions specimens, 43 （17.5%） strains from the puncture fluid specimens. Among the 246 strains of isolated gram-posi- tive cocci, there were 158 （64.2%） strains of Staphylococcus aureus, 61 （24.8%） strains of coagulase-negative Staphylococcus, and 27 （11.0%） strains of Enterococcus. The drug resistance rates of the gram-positive cocci to penicillin, clindamycin, and erythromycin were more than 60. 0%, and the strains varied in the drug resistance to other antibiotics and were highly susceptible to vancomycin and teicoplanin. Totally 122 strains of methicillin- resistant S. aureus （MRSA） and 40 strains of methicillin-resistant coagulase-negative Staphylococcus （MRCNS） have been isolated with the isolation rates of 77.2% and 65.6%, respectively. CONCLUSION It is necessary for the clinicians to reasonably use antibiotics according to the result of bacteriological examination for the patients and take effective measures for prevention and control of the gram-positive cocci infections

关 键 词：革兰阳性球菌 医院感染 构成比 耐药性 

分 类 号：R378[医药卫生—病原生物学]