摘要
目的分析新疆医科大学第一附属医院住院患者常见革兰阳性球菌耐药率5年变迁情况,为临床合理用药提供参考。方法从2009—2013年新疆医科大学第一附属医院住院患者各类送检标本中分离出培养阳性的耐甲氧西林金黄色葡萄球菌(MRSA)、粪肠球菌(EFA)、屎肠球菌(EFM),剔除重复菌后共1 652株,采用法国生物梅里埃公司全自动微生物分析仪VITEK-2及配套试剂进行细菌鉴定和药敏试验。所有数据使用WHONET 5.4软件进行统计分析。结果 MRSA对青霉素、苯唑西林、庆大霉素、左氧氟沙星、克林霉素、利福平、红霉素的耐药率均在60%以上,对复方磺胺甲噁唑的耐药率平均为21.8%,对万古霉素、替考拉宁、利奈唑胺未发现耐药。EFA对常用抗菌药物的耐药率均低,EFM对常用抗菌药物的耐药率均呈上升趋势,且耐药率均在60%以上,并检出了对万古霉素、替考拉宁的耐药菌株,对利奈唑胺未发现耐药。结论万古霉素、替考拉宁和利奈唑胺仍是治疗多药耐药性葡萄球菌属感染的重要药物,而EFM对于抗菌药物的耐药性越来越严重,临床用药时需加以重视。
Objective To analyze the changes of drug resistance of gram-positive cocci in the nearest five years in the First Affiliated Hospital of Xinjiang Medical University. Methods From 2009 to 2013,a total of 1 652 strains of gram-positive cocci were separated out from all kinds of samples of patients hospitalized in the First Affiliated Hospital of Xinjiang Medical University, including Xtaphylococcus Aureus （ MRXA ）, Enterococcus Faecalis （ EFA ） and Enterococcus Faecium （ EFM）. Automatic analyzer（ France Biomerieux Company,VITEK-2 type） and supplementary reagent was used to identify the strains,and drug sensitive test was carried out. WHONET5. 4 software was used to analyze the data. Results The drug resistant rate of MRXA was over 60% to penicillin, oxacillin, gentamicin, levofloxacin, clindamycin, rifampicin, erythromycin,respectively,the average drug resistant rate of MRXA to XMZ - TMP was 21. 8%, no resistant MRXA to vancomycin,teicoplanin and linezolid was found. The drug resistant rate of EFA was low to common antibacterial agents,but that of EFM was higher and higher to common antibacterial agents,average at over 60%,and resistant EFM to vancomycin and teicoplanin were found,but no resistant EFM to linezolid was found. Conclusion Vanomycin,teicoplanin and linezolid are important antibacterial agents for treating multidrug-resistant staphylococcus infection as usual,but the drug resistance of EFM was more serious,which should pay more attention to.
出处
《实用心脑肺血管病杂志》
2015年第1期53-55,共3页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
革兰阳性球菌
住院病人
耐药
Gram- positive cocci
Inpatients
Drug resistance
