摘要
目的了解2014年度医院分离革兰阳性球菌的临床分布及耐药现状,指导临床合理用药。方法对湖北襄阳市中医医院2014年1-12月細菌培养分离的革兰阳性球菌及耐药率进行统计分析。结果医院分离革兰阳性球菌751株,其中金黄色葡萄球菌(金葡菌)、凝固酶阴性葡萄球菌(均分离自血液和无菌体液)和肠球菌属居前3位,检出率分别是44.5%,30.8%和16.2%。MRSA检出率为36.5%,MRCNS的检出率为59.3%。MSSA、MSCNS对抗菌药物耐药率较低。MRSA、MRCNS多表现为多重耐药,对青霉素、红霉素、克林霉素耐药率较高,对磷霉素、阿米卡星耐药率相对较低。MRSA对甲氧苄啶-磺胺甲噁唑的耐药率低于MSSA,未发现耐万古霉素和利奈唑胺的葡萄球菌。屎肠球菌耐药率普遍高于粪肠球菌,肠球菌属对左氧氟沙星、万古霉素、替考拉宁、利奈唑胺耐药率较低。发现1株耐万古霉素屎肠球菌。检出肺炎链球菌48株,按非脑膜炎株折点判读,其中耐青霉素肺炎链球菌为2.1%。结论加强革兰阳性球菌耐药性监测,掌握其耐药特点对指导临床合理用药有非常重要的意义.
Objective To understand the distribution and antibiotic resistance profile of gram positive cocci in the period from January to December 2014 to guide rational antibiotic use.Methods A statistical analysis was conducted for the gram positive strains isolated during the period from January to December 2014 to clarify the distribution and antibiotic resistance profile in this hospital.Results A total of 751 strains of gram positive cocci were collected.Coagulase negative Staphylococcus（44.5%）,Staphylococcus aureus（30.8%） and Enterococcus（16.2%） were the most frequently isolated pathogens.The prevalence of MRSA and MRCNS was 36.5%and 59.3%,respectively.MSSA and MSCNS strains were relatively more susceptible than MRSA and MRCNS strains.MRSA and MRCNS strains usually showed resistance to multiple antimicrobial agents,high resistance rate to penicillin,erythromycin,and clindamycin,but relatively low resistance rate to fosfomycin and amikacin.MRSA strains showed low resistance rate to trimethoprim-sulfamethoxazole than MSSA.No staphylococcal strains were found resistant to vancomycin or linezolid.E.faecium strains were more resistant than E.faecalis.Enterococcus isolates were relatively susceptible to levofloxacin,vancomycin,teicoplanin,and linezolid.One strain of E.faecium was resistant to vancomycin.One（2.1%） of the 48 strains of nonmeningitis S.pneumoniae was penicillin-resistant S.pneumoniae.Conclusions It is very important to monitor the antibiotic resistance in gram positive bacteria for better control of gram-positive infection and rational antibiotic use.
出处
《中国感染与化疗杂志》
CAS
CSCD
北大核心
2016年第6期751-754,共4页
Chinese Journal of Infection and Chemotherapy
关键词
医院感染
革兰阳性球菌
耐药性
hospital infection
gram positive coccus
antimicrobial resistance
