革兰阳性球菌医院感染的体外耐药性监测

In vitro Drug Resistance of Gram-positive Organisms in Nosocomial Infection

目的了解本院革兰阳性球菌的临床分布与耐药现状,为临床医师用药提供依据。方法采用常规分离技术从临床标本中培养分离病原菌,并按《全国临床检验操作规程》鉴定到种;采用纸片扩散法(KB法)进行药物敏感试验。结果3年中从临床标本分离出186株革兰阳性球菌,分离部位来源于泌尿道、创伤和术后感染的标本最多,分别占标本总量的30.1%和22.0%;186株菌中,检出耐甲氧西林金黄色葡萄球菌(MRSA)17株,占20.7%;检出耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)25株,占凝39.1%;未检出耐万古霉素革兰阳性球菌。结论MRSA和MRCNS耐药率明显高于甲氧西林敏感葡萄球菌,临床应高度重视革兰阳性球菌的耐药性监测。

OBJECTIVE To investigate the distribution and drug resistance of Gram-positive organisms infection in our hospital and offer scientific basis for reasonable usage of antibiotics. METHODS The organisms were ~isolated from the specimens by the routine methods. The drug susceptivity was tested by K-B method. ~RESULTS A total of 186 strains of Gram-positive organisms were isolated from the clinical specimens during ~the last 3 years. These organisms were mostly came from urological tract infection and surgical or wound site ~infection. they were ~accounted for 30.1% and 22.0%, ~respectively. Among the 186 strains, meticillin-resistant ~Staphylococcus aureus (MRSA) were 17 strains, which were 20.7% of the total S. aureus; Meticillin-resistant coagulase-~negative S. aureus (MRCNS) were 25 strains, which meant 39.1% of the total coagulase-negative ~S. aureus (CNS); the vancomycin-resistant Gram-positive strain was not detected. CONCLUSIONS The rate of drug-resistance among MRSA and MRCNS was higher than meticillin-susceptive S. aureus (MSSA), so we should attach importance to supervise the drug-resistance of Gram-positive organism.