2012年中国西南地区Whire Union革兰阳性球菌耐药性监测  

Whire Union survey of antimicrobial susceptibility of Gram-positive cocci isolated in Southwestern China in 2012

作　　者：刘宝[1] 杨焕婕[1] 杜艳[2] 单斌[2] 谢轶[3] 康梅[3] 费樱[1] 

机构地区：[1]贵阳医学院附属医院微生物免疫科,贵阳550004 [2]昆明医科大学第一附属医院医学检验科,昆明650032 [3]四川大学华西医院实验医学科,成都610041

出　　处：《中国抗生素杂志》2014年第7期529-533,共5页Chinese Journal of Antibiotics

基　　金：贵州省实验教学示范中心(黔教高发[2010]167号)

摘　　要：目的了解2012年中国西南地区Whire Union监测网络医院临床分离的革兰阳性球菌临床分布及耐药情况。方法西南地区3家教学医院对临床分离的革兰阳性球菌采用VITEK-2微生物自动鉴定仪(生物梅里埃,法国)或Walkaway 96SI微生物自动鉴定仪(西门子,德国)以及相应复合药敏板卡进行细菌鉴定和药敏试验。采用WHONET 5.5和SPSS16软件进行统计分析。结果分离革兰阳性球菌4071株,其中葡萄球菌属占67.9%(2764株),肠球菌属占20.2%(822株),链球菌属4.9%(199株)。阳性标本3933份,位列前3位的标本分别为分泌物/脓(27.4%),血液(19.3%)和痰液(17.5%)。MRSA和MRCNS的分离率分别为38.4%和83.9%。未发现万古霉素和利奈唑胺耐药的葡萄球菌。屎肠球菌总体耐药率高于粪肠球菌。屎肠球菌和粪肠球菌对万古霉素的耐药率分别为5.9%和0.8%;对利柰唑胺的耐药率分别为2.7%和2.1%。青霉素对肺炎链球菌仍具有较高的敏感率(>95%)。结论革兰阳性球菌引起的感染在临床占有一定的比例,万古霉素和利奈唑胺对葡萄球菌、肠球菌、链球菌仍有很高抗菌活性。治疗粪肠球菌引起的严重感染可选择联合用药方案,以减少糖肽类抗生素的耐药压力。青霉素仍是治疗肺炎链球菌相关肺炎的首选药物。分析革兰阳性球菌耐药信息可为临床提供治疗参考,也有利于控制细菌耐药性蔓延。Objective To investigate the clinical distribution and antibiotics sensitivity of the Grampositive cocci isolated in southwestern China in 2012.Methods Gram-positive cocci isolated from 3 hospitals in Southwestern China were characterized and their sensitivity to antimicrobial agents was determined using automatic microbiology systems （BioMérieux and Siemens） as well as antibiotic susceptibility testing cards.The WHONET 5.5 and SPSS16 softwares were used for data analysis.Results A total of 4,701 Gram-positive cocci isolates were collected,including staphylococci （2764,67.9%）,enterococci （822,20.2%） and streptococci （199,4.9%）.All of the Gram-positive cocci in this study were isolated from 3,933 samples.Of 24.7% samples were isolated from secretions/ pus,19.3% samples were isolated from blood and 17.5% samples were from sputum.The prevalence of methicillinresistant Staphylococcus aureus （MRSA） and methicillin-resistant coagulase-negative staphylococci （MRCONS） was 38.4% and 83.9%,respectively.No staphylococcal isolates resistant to vancomycin and linezolid were identified.Vancomycin-resistant enterococci were 5.9% in E.faecium and 0.8% in E.faecalis.The resistant rate of linezolid in enterococci were 2.7% （E.faecium） and 2.1% （E.faecalis）.The most of Streptococcus pneumoniae were sensitive to penicillin（〉95%）.Conclusions Clinical infections caused by Gram-positive cocci were still seriously.Linezolid and vancomycin remain highly sensitive to staphylococci,enterococci and streptococci.Combination drug therapy is the effective treatment to serious infections cause by E.faecalis,in order to reduce resistance pressure in glycopeptide antibiotics.Penicillin is still the most sensitive drug for treatment for pneumococcal pneumonia.To provide treatment for clinical reference and control the spread of antibiotic resistance,and analysis resistance of Gram-positive coccus is one of the most important information.

关 键 词：耐药性 革兰阳性球菌 葡萄球菌 肠球菌 肺炎链球菌 

分 类 号：R378[医药卫生—病原生物学]