29株血流感染凝固酶阴性葡萄球菌的临床分析和耐药性研究

Analysis of 29 strains of coagulase negative staphylococcus from blood culture

目的分析29株血流感染凝固酶阴性葡萄球菌(CNS)的临床意义及耐药性。方法回顾性分析从2011年1月—2011年12月煤炭总医院临床送检血培养标本中分离出的64株凝固酶阴性葡萄球菌,其中29株确定为血流感染致病菌。结果 64株CNS中,35株CNS判断为污染菌,污染率54.7%。29株血流感染致病菌中,表皮葡萄球菌15株最多,占到51.7%。耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)20株占69.0%,全部产β-内酰胺酶;甲氧西林敏感凝固酶阴性葡萄球菌(MSCNS)9株占31.0%,其中有7株产β-内酰胺酶(产酶率77.8%)。MRCNS除了对万古霉素和利奈唑胺还保持敏感外,对绝大多数抗生素都有较高的耐药率。结论 CNS已为血流感染重要致病菌,污染率高,耐药情况严峻。临床应严格无菌操作,抽双侧两套血培养瓶送检,合理使用抗生素。

Objective To detect the clinical significance of Coagulase negative Staphylococcus and their resistance to drugs.Methods Retrospective analysis of 64 strains of CNS isolated from blood culture between Jan 2011 and Dec 2011,in which 29 were determined as the bloodstream infection pathogens.Results Of all 64 CNS strains isolated,35 CNS were judged for contaminating bacteria,accounting for 54.7%.In 29 pathogens,the most common pathogens was Staphylococcus epidermidis,accounting for 51.2%.There were 20 strains of MRCNS and 9 strains of MSCNS.Among the MRCNS and MSCNS strains,the positive rates of the β-lactamase were 100.0% and 77.8%,respectively.MRCNS were found to be sensitive to vancomycin and linzolid,but most reluctant to other antibiotics.Conclusions CNS has important pathogen contamination rate in bloodstream infections and the drug resistance situation is grim.Asepsis showld be strictly followed clinically.Two sets of blood culture can be drawn from two sides for inspection and antibiotics should be rationally used.