表皮葡萄球菌对夫西地酸耐药性研究

Resistance of clinical Staphylococcus epidermidis to fusidic acid

目的研究表皮葡萄球菌对夫西地酸的耐药性,为临床合理选择抗菌药物提供依据。方法收集医院2012-2014年分离的表皮葡萄球菌498株,采用VITEK-2Compact全自动微生物分析仪对其进行菌种鉴定和药敏试验,并用K-B法测定其对夫西地酸的耐药性。结果 498株表皮葡萄球菌中,检出耐夫西地酸表皮葡萄球菌24株,检出率4.8%;24株耐夫西地酸表皮葡萄球菌标本来源以痰液、导管、血液为主,占62.4%;科室分布主要为ICU、新生儿和烧伤/创伤科,占37.5%;24株耐夫西地酸表皮葡萄球菌对喹奴普汀/达福普汀、万古霉素、利奈唑胺和呋喃妥因均表现为敏感,对青霉素、红霉素和磺胺甲噁唑/甲氧苄啶耐药率均>60.0%。结论夫西地酸仍对表皮葡萄球菌表现出较好的体外抗菌活性,出现的耐药性问题不容忽视。

OBJECTIVE To investigate the resistance of clinical Staphylococcus epidermidis（S.epidermidis）isolates to fusidic acid so as to provide reference for clinical rational choice of antibitics.METHODS Totally 489 S.epidermidis isoliates were isolated from the various specimens of patients in the First Affiliated Hospital of Wenzhou Medical University from the year 2012 to 2014.The identification and antimicrobial susceptibility testing of S.epidermidisisolates were determined by VITEK-2compact full automated microbiology analyzer.The sensitivity of 489 S.epidermidisisolates to fusidic acid was determined by kirby-bauer test.RESULTS Among 489 S.epidermidis isolates,24strains（the detection rate 4.8%）of S.epidermidis were resistant to fusidic acid.The24 isolates mainly came from specimens of sputum,tube and blood,accounting for 62.4% and mainly distributed in departments of ICU,newborns and burn/trauma,accounting for 37.5%.All fusidic acid-resistant S.epidermidis isolates were sensitive to quinupristin/dalfopristin,vancomycin,linezolid and nitrofurantoin,while more than 60.0% of fusidic acid-resistant isolates were resistant to penicillin,erythromycin and trimethoprim/sulfamethoxazole.CONCLUSIONFusidic acid is an effective agent against S.epidermidis isolates in vitro.However,the emergence of fusidic acid resistance among clinical S.epidermidis isolates is of concern.