2010—2012年万古霉素对耐甲氧西林金黄色葡萄球菌MIC值的变化

Vancomycin MIC values in methicillin-resistant Staphylococcus aureus clinical isolates from 2010 to 2012

目的了解万古霉素对不同标本来源的耐甲氧西林金黄色葡萄球菌(MRSA)最低抑菌浓度(MIC)值的变化。方法收集某院2010—2012年临床分离的MRSA菌株,测定MRSA万古霉素MIC值;并按不同标本来源,对菌株万古霉素MIC值进行分析。结果 3年共收集金黄色葡萄球菌1 434株,其中分离自痰标本857株,血液标本239株,其他标本338株;2010—2012年MRSA检出率分别为41.12%(169/411)、44.96%(214/476)和48.08%(263/547)。2010—2012年血液标本分离的金黄色葡萄球菌MRSA检出率分别为29.03%、30.86%、30.21%,痰标本分离的金黄色葡萄球菌MRSA检出率分别为46.89%、51.03%、57.10%;3年间痰标本MRSA检出率均高于血液标本(χ2值分别为6.41、10.36、21.43,均P<0.05)。血液及痰标本分离的MRSA对万古霉素均敏感。2010—2012年血液标本分离的MRSA万古霉素MIC≥1.00μg/mL菌株分别占38.89%(7株)、40.00%(10株)及37.93%(11株),3年间比较,差异无统计学意义(χ2=0.02,P=0.999);痰液分离的MRSA万古霉素MIC≥1.00μg/mL菌株分别占36.28%(41株)、40.94%(61株)及49.73%(92株),3年比较,差异亦无统计学意义(χ2=5.72,P=0.057)。结论该院2010—2012年临床MRSA检出率呈增高趋势。痰标本的MRSA检出率及万古霉素MIC值有所增高;血液标本的MRSA检出率及万古霉素MIC变化不明显。

Objective To analyze vancomycin minimum inhibitory concentration（MIC）in methicillin-resistant Staphylococcus aureus（MRSA）isolated from different clinical specimens.Methods From2010 to 2012,MRSA were identified and vancomycin MIC in MRSA was determined by VITEK2 COMPACT;vancomycin MIC values were analyzed.Results A total of 1 434 isolates of Staphylococcus aureus were detected,including 857 sputum specimens,239 blood specimens,and338 other specimens;MRSA isolation rate of all specimens was 41.12%（169/411）,44.96%（214/476）and 48.08%（263/547）respectively.MRSA isolation rate of blood specimens was29.03%,30.86%and 30.21%respectively,and sputum was 46.89%,51.03% and 57.10% respectively;MRSA isolation rate of sputum was higher than that of blood specimens（χ2= 6.41,10.36,21.43 respectively,all P0.05）.All strains were sensitive to vancomycin.The percentage of vancomycin MIC≥1.00μg/mL in MRSA from blood specimens was 38.89%（7 isolates）,40.00%（10 isolates）and 37.93%（11 isolates）in 2010-2012 respectively（χ2=0.02,P=0.999）,and from sputum specimens was 36.28%（41 isolates）,40.94%（61 isolates）and 49.73%（92isolates）respectively（χ2=5.72,P=0.057）.Conclusion The detection rate of MRSA clinical isolates has shown an increased trend from2010 to 2012.Detection rate of MRSA from sputum was higher than that of blood specimens;detection rate and vancomycin MIC value of MRSA from sputum specimens increased a little;detection rate and vancomycin MIC value of blood specimens didn＇t change obviously.