2006-2011年无乳链球菌的临床分布及药敏监测

Clinical distribution and drug sensitivities of Streptococcus agalactiae in hospital

目的调查分析无乳链球菌(GBS)的耐药情况及其临床分布,为临床合理用药提供依据。方法对临床各科室送检各类标本进行无乳链球菌的培养,经ATB-Expression细菌分析系统进行鉴定和药敏试验;所有资料采用WHONET 5.6软件进行回顾性分析。结果共分离448株GBS,临床标本分离率最高的是泌尿生殖道分泌物(86.8%),科室检出最多的是妇产科(85.0%);药敏结果显示:耐药率最高的是四环素94.9%,其次是红霉素80.1%和克林霉素62.7%,其他耐药率分别为左旋氧氟沙星36.4%,奎奴普丁/达福普汀20.3%,氯霉素16.3%,头孢噻肟1.1%,青霉素0.2%;呋喃妥因、万古霉素和利奈唑胺耐药率均为0%;克林霉素耐药率表现出下降趋势,左旋氧氟沙星呈现上升趋势。结论加强无乳链球菌的培养检测,关注无乳链球菌的耐药趋势;提高临床重视并指导临床合理用药和治疗。

Objective To investigate the drug susceptibility and distribution of the Streptococcus agalactiaes and provide the evidence for clinical drug usage. Methods Various types of clinical specimens were cultured for Streptococcus agalactiae examination. 448 clinical isolates of Streptococcus agalactiaes （GBS） were identified and their drug sensitivities were determined by ATB-Expression system, and all of the data was analyzed by WHONE TS. 6 Software. Results A total of 448 strains were isolated; the isolation rate of urogenital tract secretion was the highest （86.8%）, and most of the strains came from the department of Obstetrics and Gynecology （85.0%）. The resistance rates of GBS to tetracycline was the the highest （94.9%）, followed by erythromycin （80.1% ） and clindamycin （62.7%）. The resistance rates to other antibiotics were as follows： levofloxacin 36.4%, moxifloxacin 20.8%, quinupristin/dalfopristin 20.3%, chloramphenicol 16.3%, cefotaxime 1.1%, peni- cillin 0.2% ; nitrofurantoin, vancomycin and linezolid 0%. The resistance rate to Clindamycin showed a downward trend, while that to levofloxacin showed an upward trend. Conclusion The detection of Streptococcus agalactiae and their resistance trend should be paid close attention for improving and guiding the clinical rational medication and treatment.