2008-2009年革兰阳性球菌敏感性监测

Monitoring of drug susceptibility of gram-positive cocci in 2008-2009

目的监测深圳地区革兰阳性球菌的耐药情况。方法细菌鉴定和药敏试验采用MicroScan40/96全自动微生物鉴定仪,数据分析采用MicroScan Labpro 2.41软件进行统计分析。结果 2008-2009年共检出革兰阳性球菌605株,其中葡萄球菌属466株,未检出耐万古霉素、利奈唑胺、喹奴普汀/达福普汀葡萄球菌;182株金黄色葡萄球菌中,耐甲氧西林金黄色葡萄球菌(MRSA)检出56株,检出率为30.8%,对磺胺甲噁唑/甲氧苄啶、氯霉素有较高的抗菌活性,敏感率分别为98.5%和81.5%;155株表皮葡萄球菌中,耐甲氧西林表皮葡萄球菌检出123株,检出率为79.4%,对利福平、氯霉素和克林霉素有较高的抗菌活性,敏感率分别为88.5%、80.5%、79.5%;74株溶血葡萄球菌中,耐甲氧西林溶血葡萄球菌检出70株,检出率为94.6%,对利福平和四环素有较高的抗菌活性,敏感率分别为94.5%和71.5%;47株人葡萄球菌中,耐甲氧西林人葡萄球菌检出30株,检出率为63.8%,对左氧氟沙星、环丙沙星和利福平有较高的抗菌活性,敏感率分别为91.0%、91.0%和88.5%;86株肠球菌属中未发现耐万古霉素肠球菌,粪肠球菌对青霉素、氨苄西林、利奈唑胺、喹奴普汀/达福普汀和万古霉素的敏感率均为100.0%。结论甲氧西林敏感金黄色葡萄球菌(MSSA)和甲氧西林敏感凝固酶阴性葡萄球菌(MSCNS)对多数抗菌药物有较高的抗菌活性,MRSA和MRCNS呈多药耐药性,且凝固酶阴性葡萄球菌不同种对苯唑西林和多种抗菌药物的敏感率有较大差异;屎肠球菌亦呈多药耐药性。

OBJECTIVE To monitor the drug resistance of gram-positive cocci in Shenzhen.METHODS MicroScan automatic microbiological identification system was used to perform the bacterial identification and drug susceptibility test.MicroScan Lappro2.41 software was used for statistical analysis.RESULTS A total of 605 strains of gram-positive cocci were identified during 2008-2009,including 466 strains of Staphylococcus,among which no isolates resistant to vancomycin,linezolid and quinupristin/dalfopristin were found.Among 182 strains of S.aureus,there were 56 strains of MRSA detected with the detection rate of 30.8%,against which trimethoprim/sulfamethoxazole and chloramphenicol had relatively high antibacterial activity with the susceptibility rates of 98.5% and 81.5%.Among 155 strains of S.epidermidis,there were 123 strains of methicillin-resistant S.epidermidis detected with the detection rate of 79.4%,against which rifampicin,chloramphenicol and clindamycin had relatively high antibacterial activity with sensitive rates of 88.5%,80.5% and 79.5% respectively.Among 74 strains of S.haemolyticus,there were 70 strains of methicillin-resistant S.haemolyticus with the detection rate of 94.6% against which rifampicin and tetracycline had relatively high antibacterial activity with susceptibility rates of 94.5% and 71.5% respectively.Among 47 strains of S.hominis,there were 30 strains of methicillin-resistant S.hominis detected with the detection rate of 63.8%,against which levofloxacin,ciprofloxacin and rifampicin had relatively high antibacterial activity with the susceptibility rates of 91%,91%and 88.5%,respectively;among 86 strains of Enteroroccus,no strains resistant to vancomycin were found.The susceptibility rates of E.faccalis to penicillin,ampicillin,Linezolid,Quinupristin/dalfopristin and vancomycin were all 100.0%.CONCLUSION Most antibiotics have relatively high antibacterial activity against MSSA andMSCNS,which present multi-drug resistance;different species of CNS have different susceptibility rate to oxacillin and most antibiotics;E.faccium also presents multi-drug resistance.