2009年中国12家教学医院革兰阳性球菌耐药性研究

An antimicrobial resistance surveillance of gram-positive cocci isolated from 12 teaching hospitals in China in 2009

目的 调查2009年我国革兰阳性球菌临床分离株的耐药性.方法 收集2009年6-12月9个城市12家教学医院临床分离的1169株非重复革兰阳性球菌.采用琼脂稀释法测定抗菌药物的最低抑菌浓度（MIC）值.结果 金黄色葡萄球菌和凝固酶阴性葡萄球菌中耐苯唑西林菌株分别占45.3%（211/466）和89.5%（214/239）;不同标本苯唑西林耐药金黄色葡萄球菌（MRSA）分离率为33.3%～68.1%.未发现对替考拉宁、万古霉素和利奈唑胺耐药的葡萄球菌.5.5%（7/128）的屎肠球菌对万古霉素耐药,未发现万古霉素耐药的粪肠球菌;粪肠球菌和屎肠球菌对利奈唑胺的敏感率约为99.1%（108/109）.肺炎链球菌中青霉素中介株（P1SP）分离率为21.6%（48/222）,仅发现1株青霉素耐药株（PRSP）,占0.5%（1/222）;未发现对替考拉宁、万古霉素和利奈唑胺耐药的肺炎链球菌.结论 葡萄球菌中苯唑西林耐药菌株仍有较高的分离率,不同标本类型MRSA的分离率有所不同.替考拉宁、万古霉素和利奈唑胺对葡萄球菌、粪肠球菌、屎肠球菌和肺炎链球菌具有很好的抗菌活性.

Objective To investigate antimicrobial resistance among gram-positive cocci in China in 2009. Methods From June to December 2009, 1169 consecutive and non-repetitive gram-positive cocci were collected from 12 teaching hospitals at 9 cities. The minimal inhibitory concentration （MIC） of antibacterial agents was determined by agar dilution method. Results The prevalences of methicillinresistant Staphylococcus aureus （MRSA） and methicillin-resistant coagulase-negative Staphylococci （MRCoNS） were 45.3% （211/466） and 89. 5% （214/239）, respectively. The isolation rate of MRSA was 33. 3%-68. 1% from different samples. All Staphylococci isolates were susceptible to vacomycin, teicoplanin and linezolid. Five point five percent （7/128） E. faecium strains were resistant to vacomycin. All E.faecalis strains were susceptible to vacomycin. About 99. 1% （108/109） of E. faecalis and E. faecium were susceptible to linezoild. The prevalence of penicillin-intermediate Streptococcus pneumoniae （PISP） was 21.6% （48/222）. Only 1 （0. 5%, 1/222） Streptococcus pneumoniae strain was resistant to penicillin.Teicoplanin, vancomycin, linezolid and tigecycline were the most active agents against Streptococcus pneumoniae （susceptible rate 100% ）. Conclusions The high prevalence of methicillin-resistance is among Staphylococcus strains. Different samples show a different MRSA prevalence. Teicoplanin, vancomycin and linezolid show very high activity to Staphylococci,E. faecalis, E. faecium and Streptococcus pneumoniae.