我院2007～2009年常见革兰阳性菌耐药性分析

In 2007～2009 resistance of common gram-positive bacteria

目的了解我院2007～2009年常见革兰阳性菌耐药的情况,为临床合理选用抗菌药物提供参考依据。方法收集我院细菌室2007年1月至2009年12月在临床标本中分离革兰阳性菌,分析它们的分布及耐药情况。结果 2007～2009年共分离了1131株革兰阳性菌,检出比例在前四位的革兰阳性菌有金黄色葡萄球菌415株(36.69%),表皮葡萄球菌174株(15.38%),粪肠球菌129株(11.41%),屎肠球菌120株(10.61%),这四种菌占所检出的革兰阳性菌的74.09%。检出的革兰阳性菌对万古霉素都保持百分百的敏感,对利奈唑胺、替考拉宁也保持高度的敏感率,奎奴普丁/达福普汀除了对粪肠球菌耐药外,对其他三种常见菌都保持高度敏感;磷霉素产生耐药的速度和幅度都比较大;莫西沙星只对表皮葡萄球菌保持较高的敏感性;氨基糖苷类能保持一定的活性,对肠球菌有一定的协同作用。结论应当严格掌握适应证,动态监测本院细菌分布和耐药性的特点,合理使用抗菌药物才能有效控制耐药细菌的产生。

Objective To investigate the resistance of commonGram-positive bacteria,and propose rational use of antibiotics in clinic practice. Methods The gram-positive bacteria was collected cultured from the patients in hospital from 2007 to 2009,and the drug resistance was analyzed. Results In the 1131 strains there were 415 strains of staphylococcus aureus （ 36. 69% ） ,174 strains of staphylococcus epidermidis （ 15. 38% ） , 129 strains of enterococcus faecalis （ 11. 41% ） ,120 strains of enterococcus feces （ 10. 61% ） ,these four bacteria account for the detection of gram-positive bacteria 74. 09% . The detection of Gram-positive bacteria have maintained a hundred percent of vancomycin-sensitive,linezolid,teicoplanin had a high degree of sensitivity rates quinupristin/dalfopristin resistance in enterococcus faecalis in addition to,but on the other three had high sensitivity to common bacteria fosfomycin resistant speed and range than the larger,Moxifloxacin only to maintain a high sensitivity of staphylococcus epidermidis; aminoglycosides can maintain a certain activity,for a certain synergy enterococcus. Conclusion Indications should be strictly controlled,dynamic monitoring of hospital bacteria distribution and drug resistance characteristics,rational use of antibiotics can effectively control the production of resistant bacteria.