血浆凝固酶阴性葡萄球菌菌种分布及耐药性研究

Study of strain distribution of coagulase-negative staphylococci and its drug resistance

目的了解凝固酶阴性葡萄球菌(CNS)的感染分布情况及耐药性状况,为临床治疗及耐药性检测提供指导方法。方法按《全国临床检验操作规程》培养分离菌种,用法国梅里埃微生物鉴定系统鉴定菌种及K-B单片琼脂做药敏试验,对本院178株CNS进行分析。结果表皮葡萄球菌检出率最高,占71.92%,其中CNS在泌尿生殖道感染率最高,为66.86%;在血液中感染率为14.04%;在痰液中感染率为11.24%。CNS对青霉素耐药率较高,而万古霉素和替考拉宁对CNS显示较强的抗菌活性。结论从感染部位看,CNS在泌尿生殖道感染率最高,其中以表皮葡萄球菌引起的医院感染最为常见,预防和控制CNS传播应成为医院感染的重要课题。药敏试验结果显示万古霉素是CNS感染的最佳抗生素,其次为替考拉宁,对CNS感染联合用药是非常必要的。

Objective To study the coagulase-negative staphylococci（CNS） infection and drug resistance a- mong the outpatients and inpatients ,and to provide the instruction and methods for the clinical treatment. Methods To cultivate and isolate bacteria according to the Clinical Laboratory Operation Regulation. Bacteria were identified with the Merieux Microbiological system in France. The drug susceptibility was performed with the method of single split agardiffusion. Results Of 178 strains of CNS in hospital, 71.92% were staphylococous epidermidis. The infection of CNS through urinary and genital tract was the highest, accounting for 66. 86%. The infection through blood was 14.04%, the infection through sputum was 11.24%. Most of CNS resisted to penicillin, but CNS were sensitive to vancomycin and teicoplanin. Conclusion Preventing the spread of CNS is very important for controlling the nosocomial infection. As far as the infective site, most of the patients are infected through genital tract. The commonest inpatient infection is staphylococous epidermidis. As far as the drug susceptibility, vancomycin is the best antibiotic, the next is teicoplanin. It is necessary to use combined drugs for the CNS infection.