2010-2011年血液中金黄色葡萄球菌药敏分析

Spectrum of drug susceptibility of Staphylococcus aureus isolated from blood from 2010 to 2011

目的动态分析和监测2010年与2011年住院患者血液中分离的金黄色葡萄球菌耐药性,为临床合理使用抗菌药物提供依据。方法采用全自动微生物分析仪VITEK-32进行细菌鉴定,用K-B法进行药敏试验,并用WHONET5.5对其耐药性进行分析。结果 2010年与2011年分别在住院患者血液中分离出33株和43株金黄色葡萄球菌;其对万古霉素、替考拉宁、利奈唑胺、呋喃妥因的敏感率达100.0%,对磺胺甲噁唑/甲氧苄啶的药物敏感性增加,2010年对氨苄西林/舒巴坦的敏感率为80.0%,2011年其敏感性降低至56.1%(P<0.01);2010年对红霉素的敏感率为27.3%,2011年其敏感性降低至23.3%(P<0.05);2010年对利福平的敏感率为92.9%,2011年其敏感性降低至75.6%(P<0.01);在临床常用的14种抗菌药物中,有9种均产生了明显的耐药性,差异有统计学意义(P<0.05或P<0.01)。结论连续两年血液中金黄色葡萄球菌耐药性逐年出现了明显增加趋势,并呈不断上升,但对万古霉素、替考拉宁、利奈唑胺仍保持较高的敏感性。

OBJECTIVE To dynamically analyze and monitor the drug resistance of 76 strains of Staphylococcus au-reus causing bloodstream infections in the whole years of 2010 and 2011 so as to provide basis for the reasonable clinical use of antibiotics. METHODS VITEK automated system was applied to identify the bacteria, the drug sus-ceptibility testing was performed with Kirty Bauer method, and the data were statistically analyzed by WHONET 5.5 software. RESULTS Thirty-three and forty-three strains of S. aureus were respectively identified in 2010 and 2012. The fourteen types of common antibiotics were widely used, and only vancomycin, teicoplanin, linezolid, furadantin were 100. 0% sensitive to S. aureus and with increased drug sensitivity to sulfamethoxazole/trime-thoprim. In 2010, 80.0 % of the S. aureus strains were sensitive to ampicillin/shubatan while decreased to 56.1 in 2011（P〈0.01）. In 2010, 27.3% of the S. aureus strains were sensitive to erythromycin while decreased to 23.3% in 2011 （P〈0.05）. In 2010, 92.9% of the S. aureus strains were sensitive to rifampicin while decreased to 75.6% in 2011（P〈0.01）. Among 14 commonly used antibiotics in China, the strains have produced significant drug resistance to 9 antibiotics. CONCLUSION The drug resistance of S. aureus increases obviously in the succes-sive two years, keeping an upward trend, but the strains remain to be highly sensitive to vancomycin, teicoplanin, and linezolid.