913株凝固酶阴性葡萄球菌临床分离株耐药性分析

Monitoring of drug resistance of coagulase-negative staphylococcus isolates in 2008-2011

目的了解2008-2011年广州医学院第二附属医院临床分离的凝固酶阴性葡萄球菌感染状况及其耐药性变迁,为临床合理使用抗菌药物提供依据。方法凝固酶阴性葡萄球菌培养与鉴定严格按照《全国临床检验操作规程》进行;药敏试验采用K-B法,结果依据NCCLS最新折点进行评价。结果共检出革兰阳性球菌3 319株,其中凝固酶阴性葡萄球菌913株,占革兰阳性球菌的27.51%。耐甲氧西林凝固酶阴性葡萄球菌647株,占凝固酶阴性葡萄球菌的70.86%。CNS对青霉素耐药率最高,高达99.1%,对克林霉素、复方新诺明、庆大霉素、喹诺酮类药的耐药率次之,对利福平、夫西地酸、万古霉素等耐药率均较低。结论CNS对多种抗菌药物的耐药率不断提高,应及时监测,指导临床医师合理使用抗菌药物,延缓耐药菌株的产生,同时加强控制感染工作,阻止耐药菌株的传播。

Objective To understand the infecting status and the drug resistance of coagulase-negative staphylococcus （CNS） isolated from the Second Affiliated Hospital of Guangzhou Medical College during 2008-2011. Methods Referring to National Guide to Clinical Laboratory Procedures, CNS was cultured and indentified. The drug susceptibility testing was performed by K-B method. The results were assessed according to the latest version of NCCLS breakpoints. Results A total of 913 CNS strains were isolated （accounted for 27.51%）. There were 647 MRCNS strains（accounted for 70.86% of CNS）. The drug-resistance rates of CNS isolates to penicillin was the highest （99.1%）, followed by clindamycin, trimethoprim and sulphame-thoxazole, gentamicin and generation quinolones etc. The drug-resistance rates to rifampin, fusidate sodium and norvancomycin were the lowest. Conclusion The resistance rates of CNS to most antibacterial agents are incessantly increased and monitoring of drug resistance be conducted to guide the clinical reasonable use of antibiotics, delay the occurrence of drug resistance and control the spread of resistant strains.