凝固酶阴性葡萄球菌分布及耐药变迁

Drug-resistance of coagulase negativeStaphylococcus isolated clinically in our hospital these years

目的探讨凝固酶阴性葡萄球菌(CNS)感染分布及其耐药趋势与变迁,为临床治疗CNS感染提供正确选药依据。方法收集本院2001～2003年484株CNS与2004～2007年间512株CNS进行对比分析,采用Kirby-Bauer法进行药敏试验,高盐琼脂扩散法对苯唑西林耐药的菌株作耐甲氧西林葡萄球菌(MRS)测定,按临床实验室标准化委员会(CLLSI/LNCCLS)2007年标准判断结果。结果996株凝固酶阴性葡萄球菌中,未发现万古霉素耐药菌株,分别对青霉素、红霉素、苯唑青霉素、阿莫西林/克拉维酸、克林霉素、头孢唑啉、头孢曲松、头孢吡肟等抗生素耐药率均大于70%;两组比较差异有统计学意义(P<0.05);对利福平、呋喃妥因、阿米卡星、四环素、复方新诺明耐药率均小于50%,差异无统计学意义(P>0.05)。结论近3年临床分离的CNS耐药谱与前3年相比,有很大的改变。临床医生应根据实验室药敏结果,合理使用抗生素,有效控制凝固酶阴性葡萄球菌的感染。

Objective To investigate the distribution and the characteristics of drug resista-nce of coagulase negative Staphylococcus, and to provide the reference for properly choosi-ng antibiotic therapy of coagulase negative Staphylococcal infecs. Methods Contrasted 484 coagulase negative Staphylococcus （CNS） species isolated in hospital from 2001 to 2003 and 512 species from 2004 to 2007. Nosocomial CNS was identified and then drug resistance test was performed by K-B method , Nitrocefin method was utilized to delect β-lactamase. Clinical and Laboratory Standards Institute. Perfor-mance Standards forantimicro bial susceptibility testing; Fifteenth information supplement. CLSI/ NCCLS document M100- S17[J]. Clinical and Laboratory Standards. Results The drug-resistant rate of . CNS to penicillin, erythromycin, oxacillin, amoxicillin/elavulanate, clindamycin, cepzolin, eeftriaxone and cefepime was high （ 〉 70 % ）, whereas that to rifampin, nitrofurantoin, amikacin, tetracycline and trimethop-rim/sulfamethoxazole was low（〈50% ）. No drug-resistant CNS strains to vancomycin weta found. Conclusions,and no outstanding imparity from two groups. Conclusion The pattern of resistance has changed greatly in the past 3 years. Clinical physicians should pay attention to properly choosing and using antibiotics.