212株产β-内酰胺酶葡萄球菌的菌种分布及耐药分析

Species distribution and drug resistance of 212 strains of Staphlococcus producing beta-lactamase

目的对212株产β-内酰胺酶葡萄球菌的菌种分布和耐药性进行分析,为临床使用抗生素提供依据。方法用Phoenix-100全自动微生物鉴定/药敏系统鉴定分离到的葡萄球菌,并检测其产β-内酰胺酶情况及对20种药物的最低抑菌浓度。用WHONET5.4软件进行数据分析。结果 251株葡萄球菌中产β-内酰胺酶212株,产酶率为84.5%,以金黄色葡萄球菌131株(61.8%),表皮葡萄球菌32株(15.1%),溶血葡萄球菌30株(14.2%)为主。以上菌株除对万古霉素、利奈唑烷、替考拉宁、利福平、呋喃妥因、喹努普汀/达福普汀、甲氧苄胺嘧啶和莫匹罗星敏感外,对其他抗菌素均呈现不同程度耐药,其中青霉素、氨苄西林耐药率均为100%,红霉素为65.1%,苯唑西林53.3%,克林霉素为50.9%,四环素为47.6%。结论临床应积极进行病原学及耐药监测,并在药敏试验结果指导下合理选择抗生素;一旦出现耐甲氧西林金黄色葡萄球菌(MRSA),必须迅速采取控制措施,避免引起医院内感染的暴发流行。

Objective To analyze the species distribution and drug resistance of 212 strains of Staphlococcus producing beta-lactamase in order to provide evidence for proper clinical use of antibiotics.Methods Phoenix-100 automatic microbiological system was applied to perform bacrerial identification;minimal inhibitory concentration（MIC） of 20 antibiotics and beta-lactamase were detected.The results were analyzed by WHONET 5.4 statistical software.Results Among 251 strains of Staphylococcus,212 strains produced beta-lactamase（84.5%）,including 131 strains of Staphlococcus aureus（61.8%）,32 strains of Staphlococcus epidermidis（15.1%） and 31 strains of Staphlococcus haemolyticus（14.2%）.These strains were resistant to all the other antibiotics in various degree except to vancomycin,linezolid,nitrofurantoin,rifampin,quinupristin/dalfopristin,trimethoprim and mupirocin.The resistant rates to penicillin,ampicillin,erythromycin,oxacillin,clindamycin and tetracycline were 100%,100%,65.1%,53.3%,50.9% and 47.6%,respectively.Conclusion It is critically important to monitor clinically the infectious strains and antimicrobial resistance of Staphlococcus producing beta-lactamase.The antibiotics should be chosen rationally under the guidance of microbial sensitivity test.In the event of infections caused by methicillin resistant Staphylococcus aureus（MRSA）,the emergency controls must be taken at once to avoid the prevalence of hospital infection.