革兰阳性菌分布及其对常用抗生素的耐药性监测

Surveillance of Gram-positive bacterial distribution and drug resistance

目的分析南京医科大学第一附属医院2012年临床标本分离革兰阳性菌的分布及其对常用抗生素的耐药性。方法细菌鉴定采用API系统及VITEK2自动鉴定仪;细菌药物敏感试验采用纸片扩散法(K-B法);根据美国临床和实验室标准协会2014版判断结果。WHONET 5.5软件进行统计分析。结果 2012年共分离出病原菌5791株;其中革兰阳性菌1120株(19.3%),排名前3位的分别是金黄色葡萄球菌(8.0%)、凝固酶阴性的葡萄球菌(5.3%)和肠球菌属(4.0%)。耐甲氧西林金黄色葡萄球菌和耐甲氧西林凝固酶阴性葡萄球菌的菌株检出率分别为60.7%和66.9%,未发现对万古霉素耐药的葡萄球菌,检出11株对利奈唑胺耐药的葡萄球菌,2株对替考拉林耐药的葡萄球菌,23株对替考拉宁中介的葡萄球菌。耐万古霉素的肠球菌检出率为3.9%,未发现对利奈唑胺耐药的肠球菌。结论进行细菌耐药性监测有助于了解细菌耐药性变迁,指导临床用药。

Objective To investigate the clinical isolated Gram-positive bacterial distribution and resistance profile to antimicrobial agents in the First Affiliated Hospital of Nanjing Medical University during 2012.Methods Species identification was confirmed by API system and the VITEK2 automatic identification system.Disk diffusion susceptibility test was used to determine the antimicrobial agent susceptibility.The results were estimated by CLSI 2014.All data were analyzed by WHONET 5.5software.Results Of the 5791 clinical isolates,Gram-positive bacteria accounted for19.3%（1120/5791）,in which the top three pathogens were S.aureus（8.0%）,coagulase-negative Staphylococci（5.3%）and Enterococcus（4.0%）.Methicillin-resistant strains in Staphylococcus（MRSA and MRCoNS）accounted for 60.7%and 66.9%.None of staphylococci isolates was found to be resistant to vancomycin,while 11 strains were resistant to linezolid,2strains were resistant to teicoplanin,and 23 strains were intermediary sensitive to teicoplanin.Vancomycin-resistant strains in Enterococcus accounted for 3.9%.None of Enterococcus isolates was found to be resistant to linezolid.Conclusion Surveillance of antimicrobial agent is helpful in understanding the changes of bacterial resistance and guiding clinical use of antibiotics.