601株凝固酶阴性葡萄球菌临床分布及耐药性调查

Coagulase Negative Staphylococcus:Clinical Distribution and Drug Resistance of 601 Strains

目的了解医院近年来凝固酶阴性葡萄球菌(CNS)的临床分布及其耐药情况,用以指导临床合理使用抗菌药物。方法采用ATB Expresson细菌鉴定及药敏系统对2006年1月-2008年12月住院患者各类标本中分离到的CNS进行鉴定和药敏试验。结果 3年共分离到CNS 601株,以表皮葡萄球菌(33.66%、28.62%、22.12%)、溶血葡萄球菌(37.62%、36.40%、29.95%)、模仿葡萄球菌(6.93%、8.83%、11.52%)为主;其对β-内酰胺酶抑制剂类抗菌药物、青霉素G、氨苄西林、红霉素、苯唑西林及头孢唑林的平均敏感率较低,分别为0、2.61%、3.38%、17.75%、18.24%、22.1%,对万古霉素、利奈唑胺、喹努普汀/达福普汀的平均敏感性较高,分别为100.00%、97.62%和93.78%,万古霉素未发现耐药中介的菌株。结论 CNS是医院感染的重要病原菌,耐药情况严峻,应做好CNS的耐药性监测,及时掌握细菌耐药最新动态,为合理使用抗菌药物提供依据,延缓其耐药性的产生。

OBJECTIVE To study the distribution and drug resistance of coagulase negative Staphylococcus（CNS）,so as to provide the reference for the rational use of antimicrobial agents.METHODS Totally 601 strains of isolated CNS in recent three years（Jan 2006-Dec 2008） were identified and tested by ATB expression and drug sensitivity system.RESULTS A total of 601 strains of CNS were isolated.The most common pathogens were Staphylococcus epidermidis（33.66%,28.62% and 22.12%）,S.hemolyticus（37.62%,36.40% and 29.95%） and S.simalans（6.93%,8.83% and 11.52%）.The drug sensitivity rates to penicillin,erythromycin and oxacillin were 2.61%,17.75% and 18.24%,respectively,but to clindamycin and second generation quinolones were both 〉70%,and to fusidicacid,minocycline and teicoplanin were low.The susceptible rate of CNS to vancomycin was 100%.CONCLUSIONS CNS are the important kinds of pathogens to cause nosocomial infection.The condition of drug resistance of CNS is very severe,laboratory should strengthen the monitoring of the drug resistance and update in time to provide evidence for the rational use of antimicrobial agents and to leave the occurrence of drug resistance.