摘要
目的逐年分析耐甲氧西林金黄色葡萄球菌(methicillin-resistant Staphylococcus aureus,MRSA)对万古霉素、替考拉宁及利奈唑胺的最低抑菌浓度(minimum inhibitory concentration,MIC)值变化,评估是否存在万古霉素MIC漂移。方法收集6家三甲医院2007-2011年临床分离的MRSA菌株,头孢西丁纸片法确认MRSA,微量肉汤稀释法测定菌株对万古霉素、替考拉宁、利奈唑胺及头孢西丁的MIC,计算MIC50、MIC90、MIC值几何均数、敏感率及耐药率。结果 2007-2011年,共收集非重复MRSA 1 219株,所有菌株对万古霉素、替考拉宁及利奈唑胺均敏感。各年MRSA对万古霉素MIC几何均值分别为0.952、0.956、0.947、1.013、1.040μg/mL,呈渐进性上升趋势(P<0.05),MIC>1μg/mL菌株比例分别为23.5%、21.6%、27.8%、30.6%和42.8%,有逐年上升趋势(P<0.05)。替考拉宁对MRSA菌株几何均值分别为0.739、0.749、0.743、0.768、0.973,也呈渐进性上升趋势(P<0.05)。利奈唑胺对MRSA菌株几何均值分别为1.414、1.422、1.386、1.410、1.221,无渐进性上升趋势(P>0.05)。结论我国临床分离株MRSA对万古霉素存在MIC漂移现象,呈逐年上升趋势。
Objective To assess whether there is vancomycin minimum inhibitory concentration （MIC） creep in methicillin-resistant Staphylococcus aureus （MRSA） from 6 large-scale hospitals in China by analyzing the MIC of the bacterium to vancomyein, teicoplanin and linezolid over a 5-year period. Methods MRSA isolates were collected from 6 hospitals in China during the period from 2007 to 2011. Their MIC to vancomyein, teicoplanin and linezolid was determined by broth mierodilution according to the procedure by the National Committee for Clinical Laboratory Standards. MICs0, MIC90 and geometric-mean-MIC were calculated for all isolates in each year. Results A total of 1 219 clinical isolates of MRSA were determined in this study, All the isolates were susceptible to vancomycin, linezolid and teicoplanin. Overall, the vancomycin geometricmean-MIC was 0. 952, 0.956, 0.947, 1. 013 and 1. 040 μg/mL respectively in the 5 consecutive years, with a significantly increased trend over years （P 〈 0.05 ）. The percentages of MRSA isolates with a vancomycin MIC above 1 μg/mL （MIC 〉 1 μg/mL） were 23.5%, 21.6%, 27. 8%, 30.6% and 42.8% annually, and increased with time（P 〈 0.05 ）. The teicoplanin geometric-mean-MIC was 0. 739,0. 749, 0. 743, 0. 768 and 0. 973 μg/mL, and also in an increased trend over years （ P 〈 0.05 ）. The linezolid geometric-mean-MIC was 1.414, 1.422, 1.386, 1.410 and 1.221 i.~g/mL, and MIC trend was not found （P〉0.05）. Conclusion Vancomycin MIC creep in MRSA has emerged in China in this study.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2013年第23期2513-2515,共3页
Journal of Third Military Medical University
基金
卫生公益性行业科研专项(201002021)~~
关键词
金黄色葡萄球菌
万古霉素
敏感性
MIC漂移
Staphylococcus aureus
vancomycin
susceptibility
minimum inhibitory concentrationcreep
