革兰阳性菌临床分布与耐药性监测  

Distribution of clinical isolates of gram-positive bacteria and drug resistance surveillance

作　　者：牛小斌[1] 荆鹏伟[2] 李永伟[1] 

机构地区：[1]河南省中医院检验科,河南郑州450002 [2]河南中医学院第一附属医院检验科,河南郑州450000

出　　处：《中华医院感染学杂志》2015年第15期3395-3396,3445,共3页Chinese Journal of Nosocomiology

基　　金：河南省科技攻关基金资助项目(132102310244)

摘　　要：目的了解2012年革兰阳性菌流行病学与临床分离菌对抗菌药物的耐药性,为临床合理用药提供依据。方法收集2012年1月1日-12月31日临床分离的革兰阳性菌596株,采用VITEK-2Compact测定抗菌药物对革兰阳性菌的MIC,用WHONET 5.6软件进行统计分析。结果 596株革兰阳性菌中以下呼吸道检出为主,共254株占42.6%;596株革兰阳性菌中以金黄色葡萄球菌为主,共121株占20.3%,其次为表皮葡萄球菌,共75株占12.1%;金黄色葡萄球菌、表皮葡萄球菌及溶血葡萄球菌对青霉素、氨苄西林耐药率较高,均>98.0%;屎肠球菌对青霉素、氨苄西林耐药率较高,耐药率均>95.0%,粪肠球菌对喹奴普汀/达福普汀和四环素耐药率较高,耐药率均>90.0%。结论利奈唑胺、万古霉素和替考拉宁对葡萄球菌属、肠球菌属、链球菌属仍有很高抗菌活性,耐青霉素肺炎链球菌检出率有增高趋势,应重视细菌耐药监测并加强抗菌药物的合理使用。OBJECTIVE To investigate the distribution of clinical isolates of gram‐positive bacteria and their drug resistance so as to provide references for clinical rational use of antibiotics .METHODS A total of 596 strains of gram‐positive bacteria isolated clinically from Jan . to Dec .2012 were collected . The strains were tested by VITEK‐2 compact and the susceptibility data were processed with WHONET 5 .6 software .RESULTS A total of 596 non‐duplicate gram‐positive bacteria were isolated ,with 254 strains （42 .6% ） mainly detected from respiratory tract .Streptococcus aureus with 121 strains hold the majority of pathogens ,accounting for 20 .3% ,followed by Staphylococcus epidermidis with 75 strains ,accounting for 12 .1% .Streptococcus aureus ,Staphylococcus epi‐dermidis and Staphylococcus haemolyticus were highly resistant to penicillin and ampicillin ,with the resistance rate of over 98% . Enterococcus faecium were highly resistant to penicillin and ampicillin with the rate of over 95% .Enterococcus f aecalis were highly resistant to quinupristin/dalfopristin and tetracycline with the rate of over 90 .0% .CONCLUSION Linezolid ,vancomycin and teicoplanin remain high drug resistance against Staphylococ‐cus ,Enterococcus and Streptococcus .The detection rate of PRSP tends to rise .We should pay attention to the drug resistance surveillance and the rational use of antibiotics .

关 键 词：革兰阳性球菌 耐药性 抗菌药物 

分 类 号：R378[医药卫生—病原生物学]