革兰阳性球菌耐药性监测

Antimicrobial resistance surveillance of gram positive cocci

目的监测和探讨从感染患者中分离出的革兰阳性球菌的耐药情况。方法收集2007年1～12月分离的非重复阳性球菌420株，采用国际标准琼脂稀释法测定最小抑菌浓度。结果耐甲氧西林金黄色葡萄球菌（MRSA）和耐甲氧西林表皮葡萄球菌（MRSE）分别占40％（24／60）和70％（49／70）。未发现MRSA或MRSE对万古霉素和替考拉宁耐药菌株。耐青霉素肺炎链球菌的总耐药率为32．5％（耐药2．5％，中敏30％）。肠球菌40株，耐青霉素粪肠球菌占40％，而屎肠球菌对青霉素100％耐药。粪肠球菌和屎肠球菌对高浓度庆大霉素耐药率分别为55％（30％～86％）和78％（50％～100％）。未发现对万古霉素、替考拉宁耐药的肠球菌。结论大部分抗菌药物耐药率与国内报道一致，替考拉宁和万古霉素对革兰阳性球菌仍然保持很高的抗菌活性。

Objective To monitor and analyze the status of antimicrobial resistance of gram positive coccus isolates from our hospital. Methods The minimal inhibitory concentrations （MICs） of antibacterial agents were determined by agar dilution method according to the criteria of guideline of CLSI for 420 strains of non-repetitive gram positive coccus isolates from our hospital from Jan to Dec 2007. Results The detection rate of methicillin-resistant Staphylococcus aureus （MRSA） and methicillin-resistant Staphylococcus epidermidis （MRSE） was 40% and 70% respectively. No vancomycin or teicoplanin-resistant MRSA and MRSE were detected. The total resistant rate of penicillin-resistant Streptococcus pneumoniae was 32.5N （R%： 2.5%; 1%： 30%）. A total of 40 strains of Enterococci were isolated. The resistant rate of penicillin-resistant E. faecalis was 40% and E faecium was 100%. 50%（30%- 86%） of E. faecalis and 78% （50%-100%） of E. faeeium were highly resistant to high concentration of gentamicin. No enterococcus strain was found resistant to vancomycin and teicoplanin. Conclusion The resistance of gram-positive cocci to most antibiotics is coincident with that of domestic reports. Teicoplanin and vancomycin remained to possess high antimicrobial activity on gram-positive cocci.