心内科患者耐万古霉素金黄色葡萄球菌血流感染的临床分析  

Clinical analysis of vancomycin-resistant Staphylococcus aureus infection in patients of cardiology department

作　　者：万冬宇[1] 张志 刘恒亮[1] 耿国英[1] 

机构地区：[1]郑州人民医院心内科二病区,河南郑州450003 [2]郑州颐和医院心肺功能科,河南郑州450003

出　　处：《中华医院感染学杂志》2014年第24期6084-6085,6093,共3页Chinese Journal of Nosocomiology

基　　金：河南省卫生厅专项基金资助项目(HW-2010B-019);河南省郑州市科技基金资助项目(083SGYS33238)

摘　　要：目的探讨分析异质性万古霉素中介金黄色葡萄球菌(h-VISA)的分离检测方法,提高临床诊断率。方法选择2010年3月-2013年3月住院患者血流感染标本中金黄色葡萄球菌50株,采用简易菌群分析法筛选h-VISA,筛选阳性后检测耐甲氧西林金黄色葡萄球菌(MRSA)对万古霉素的MIC值。结果全部50株试验菌株中共有2株在4μg/ml万古霉素的M-H培养基培养48h后生长频率≥10-6,且在不含万古霉素的M-H平板上培养9代后MIC值仍能保持在中介耐药范围内,判定为h-VISA,检出率为4.0%。结论系统地监测h-VISA的流行情况,选择有效的检测方法,对指导临床正确使用万古霉素,有效控制h-VISA的传播有重要意义。OBJECTIVE To explore the isolation and detection of the heterogeneous vancomycin‐intermediate Staph‐ylococcus aureus （h‐VISA） so as to raise the rate of clinical diagnosis .METHODS A total of 50 strains of Staphy‐lococcus aureus were isolated from the specimens of patients with bloodstream infections who were hospitalized from Mar 2010 to Mar 2013 ,then a simple flora analysis method was employed to screen out the h‐VISA strains , and the MICs of vancomycin to methicillin‐resistant Staphylococcus aureus （MRSA） strains were determined after the positive screening .RESULTS Among all the 50 test strains ,there were 2 strains with the growing frequency of 10-6 after they were cultured in the 4μg/ml vancomycin of M‐H medium for 48 hours ,the MICs maintained in the intermediate and resistance range after 9 generations of culture in the M‐H plate without containing vancomycin , then the strains were identified as the h‐VISA strains with the detection rate of 4 .0% .CONCLUSION It is of great significance in the effective control of spread of h‐VISA to systematically monitor the prevalence of h‐VISA , choose effective detection method ,and reasonably use vancomycin .

关 键 词：万古霉素 异质性中介 金黄色葡萄球菌 

分 类 号：R978.1[医药卫生—药品]