眼表常见耐药葡萄球菌对不同抗生素的敏感性比较  

Comparison study on sensitivity of five ophthalmic antibiotics to common drug-resistant Staphylococci on ocular surface

作　　者：岳娟 吕奇学 司玮 王春梅 刘素素 谢艳亭 韩雷 孙声桃 张红敏 Yue Juan;Lyu Qixue;Si Wei;Wang Chunmei;Liu Susu;Xie Yanting;Han Lei;Sun Shengtao;Zhang Hongmin(Henan Provincial People's Hospital of Ophthalmology,Henan Provincial Ophthalmology Hospital&Henan Institute of Ophthalmology,School of Clinical Medicine,Henan University,People's hospital of Zhengzhou University,Henan Provincial Key Laboratory of Ophthalmology and Visual Science,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院眼科,河南省立眼科医院,河南省眼科研究所,河南大学临床医学院,郑州大学人民医院眼科,河南省眼科学与视觉科学重点实验室,郑州450003

出　　处：《中华眼科杂志》2020年第8期621-625,共5页Chinese Journal of Ophthalmology

基　　金：国家自然科学基金(81770902);河南省科技创新人才计划(144100510015)。

摘　　要：目的:探讨眼表感染细菌中耐药葡萄球菌对左氧氟沙星、妥布霉素、头孢唑林钠、克林霉素及夫西地酸5种眼科常用抗生素的体外敏感性,为临床选择用药提供参考。方法:实验研究。收集河南省立眼科医院微生物室2018年1月至2019年5月眼表分离的67株耐药葡萄球菌,包括耐药表皮葡萄球菌(28株)、耐药金黄色葡萄球菌(17株)、耐药中间葡萄球菌(15株)及少数其他种类耐药葡萄球菌(7株)。采用微量液基法测定左氧氟沙星、妥布霉素、头孢唑林钠、克林霉素及夫西地酸对67株耐药葡萄球菌的最小抑菌浓度(MIC),并依据美国临床和实验室标准化研究所的M100标准进行敏感性判定。采用卡方检验和Fisher精确检验对数据进行统计学分析。结果:28株耐药表皮葡萄球菌中,17株mecA基因阳性者有14株对夫西地酸敏感,与左氧氟沙星比较,差异有统计学意义(P=0.032);17株耐药金黄色葡萄球菌中,14株产β内酰胺酶者分别有14、11株对头孢唑林钠和夫西地酸敏感,两种药物与左氧氟沙星相比较,差异均有统计学意义(P=0.000,0.007);15株耐药中间葡萄球菌中,10株mecA基因阳性者分别有6、5株对头孢唑林钠和夫西地酸敏感,与左氧氟沙星相比,差异均有统计学意义(P=0.011,0.033);7株其他耐药葡萄球菌中,5株mecA基因阳性者有4株对头孢唑林钠敏感,与左氧氟沙星相比,差异有统计学意义(P=0.048)。67株耐药葡萄球菌中,分别有54、48株对头孢唑林钠和夫西地酸敏感,敏感率为80.1%和71.6%,敏感性明显高于左氧氟沙星、妥布霉素、克林霉素3种药物,药物敏感性差异均有统计学意义(χ2=18.377,9.940;P=0.000,0.003)。结论:耐药葡萄球菌对头孢唑林钠和夫西地酸的敏感性优于左氧氟沙星、妥布霉素和克林霉素,可为临床治疗眼部耐药葡萄球菌感染的经验用药提供指导。(中华眼科杂志,2020,56:621-625)Objective To investigate the in vitro antibacterial sensitivity of levofloxacin,tobramycin,cefazolin sodium,clindamycin and fusidic acid to 67 strains of Staphylococci in ocular surface infection.The purpose of this study is to provide reference for clinical selection of drugs.Methods Experimental study.Sixth-seven strains of drug-resistant Staphylococci isolated from the Department of Microbiology,Henan Provincial Ophthalmic Hospital during January 2018 and May 2019 were collected.There were 67 strains of Staphylococci including 28 strains of drug-resistant Staphylococcus epidermidi,17 strains of drug-resistant Staphylococcus aureus,15 strains of drug-resistant Staphylococcusintermedius and a few other kinds of drug-resistant Staphylococci.The minimum inhibitory concentrations(minimum inhibitory concentration,MIC)of levofloxacin,tobramycin,cefazolin sodium,clindamycin and fusidic acid in 67 strains of drug-resistant Staphylococci were determined by microliquid-based method.The sensitivity was determined according to the American CLSI-M100 standard.The statistical analysis of the data was carried out by using two-dimensional test and Fisher accurate test.Results Fourteen strains of fusidic acid were sensitive to 17 strains of MRS-Meca-resistant Staphylococcus epidermidis,the difference between fusidic and levofloxacin is statistically significant;14 strains of cefazolin sodium and 11 strains of fusidic acid were sensitive to 14 strains ofβ-Lac enzyme-producing Staphylococcus aureus,and there were significant differences between the two drugs and levofloxacin;6 strains of cefazolin sodium and 5 strains of fusidic acid were sensitive to 10 strains of MRS-Meca-resistant Staphylococcus intermedius,as compared to levofloxacin,there were significant differences between cefazolin sodium and levofloxacin(P=0.011,0.033).Cefazolin sodium was sensitive to 5 strains of MRS-Meca-positive other drug-resistant Staphylococci,which was significantly different from levofloxacin(P=0.048);54 and 48 strains of cefazolin sodium and f

关 键 词：抗菌药 抗药性 多种 细菌 葡萄球菌属 微生物敏感性试验 角膜 

分 类 号：R446.5[医药卫生—诊断学]