2002-2004年广州地区葡萄球菌药敏监测结果分析

Surveillance Analysis of Antimicrobial Resistance of Staphylococcus in Guangzhou District from 2002-2004

目的了解广州地区2002-2004年金黄色葡萄球菌和凝固酶阴性葡萄球菌的耐药性变迁的趋势,以指导临床合理用药。方法统一采用纸片扩散法进行实验,以美国NCCLS文件为判断标准,每次监测均有质控数据。结果广州地区2002-2004年对金黄色葡萄球菌耐药率最低的是糖肽类抗生素万古霉素(0%)和替考拉宁(平均0.6%),其次是利福平(平均11.0%),氯霉素(平均23.3%),复方磺胺甲唑(平均38.9%),庆大霉素(平均60.0%),环丙沙星(平均63.8%),红霉素(平均79.5%),苯唑西林(平均61.9%),青霉素(平均93.3%),氨苄西林(平均92.5%)。对凝固酶阴性葡萄球菌耐药率最低的是糖肽类抗生素万古霉素(0%)和替考拉宁(平均0.7%),其次是利福平(平均22.1%),氯霉素(平均37.8%),复方磺胺甲唑(平均55.9%),庆大霉素(平均45.4%),环丙沙星(平均58.2%),红霉素(平均78.7%),苯唑西林(平均81.0%),青霉素(平均92.8%),氨苄西林(平均92.4%)。结论葡萄球菌治疗效果最好的是糖肽类抗生素(万古霉素和替考拉宁),其次是利福平、氯霉素,可选择应用复方磺胺甲唑和庆大霉素,其余抗生素耐药率均很高,临床合理谨慎应用。广州地区葡萄球菌对抗生素的耐药性总体上处于相对稳定的时期,这是一个值得注意的现象。

Objective To investigate the antimicrobial resistance of staphylococcus in Guangzhou district from 2002 - 2004. Methods The disk diffusion method was used and the surveillance results were analyzed according to the standard of NCCLS with quality control data. Results The lowest resistant rates of staphylococcus aureus were vancomycin （0%） and teicoplanin （average 0.6% ）, followed by rifampin （average 11.0%）, chloramphenicol （average 23.3% ）, SMZ ＋ TMP （average 38.9%）, gentamycin （average 60.0%）, ciprofloxacin （ average 63.8%）, erythromycin （ average 79.5%）, oxacillin （ average 61.9%）, penicillin （average 93.3% ） and ampicillin （average 92.5%）.The lowest resistant rates of coagulase-negative Staphylococcus were vancomycin （0%） and teicoplanin （average 0.7% ）, followed by rifampin （average 22.1%）, chlorampbenicol （average 37.8% ）, SMZ ＋ TMP （average 55.9% ）, gentamycin （ average 45.4% ）, ciprofloxacin （ average 58.2% ）, erythromycin （ average 78.7% ）, oxacillin （average 81.0%）, penicillin （average 92.8%） and ampicillin （average 92.4%）. Conclusion For Staphylococcus, Polypeptide drugs （vancomycin and teicoplanin） could be most effective in clinical therapy, which is followed by rifampin and chloramphenicol. Sometimes SMZ ＋ TMP and gentamycin could also be selected. Since the resistance rates of the other antibiotics are high, they should be carefiully used in therapy.The resistance rates of Staphylococcus to antibiotics in Guangzhou district are steady.