襄阳市中医医院临床分离革兰阳性球菌的分布与耐药性

发布时间：2018-09-05 06:49

【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}0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VA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.
[Abstract]:Objective to investigate the clinical distribution and drug resistance of Gram-positive cocci isolated from hospitals in 2014 and to guide rational drug use. Methods Gram-positive cocci isolated from Xiangyang traditional Chinese Medicine Hospital of Hubei Province from January to December 2014 and drug resistance rate were statistically analyzed. Results among the 751 strains of Gram-positive cocci isolated from the hospital, Staphylococcus aureus (Staphylococcus aureus), coagulase-negative staphylococcus (all isolated from blood and aseptic body fluid) and Enterococcus were among the top 3 strains. The detection rates of MRCNS and 16.2%.MRSA were 44.5% and 36.5%, respectively. The detection rates of MRCNS were 59.3% and 59.3%, respectively. The resistance rate of MSSA-MSCNS to antimicrobial agents was low. MRSA-MRCNS showed multidrug resistance to penicillin, erythromycin, clindamycin, and fosfomycin. The resistance rate of amikacin to trimethoprim-sulfamethoxazole was lower than that of staphylococci resistant to vancomycin and linazolamide in MSSA,. The drug resistance rate of Enterococcus faecium was generally higher than that of Enterococcus faecalis. The resistance rate of Enterococcus to levofloxacin, vancomycin, teicoplanin and linazolamide was lower than that of Enterococcus faecium. A strain of Enterococcus faecium resistant to vancomycin was found. 48 strains of Streptococcus pneumoniae were detected according to the inflexion of non-meningitis strain, among which penicillin resistant Streptococcus pneumoniae was 2.1%. Conclusion it is very important to strengthen the surveillance of Gram positive coccus drug resistance and to master the drug resistance characteristics of Gram positive cocci.
【作者单位】：湖北中医药大学附属医院襄阳市中医医院检验科;
【分类号】：R446.5

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