天津地区革兰阳性球菌耐药情况分析

Antimicrobial resistance analysis of gram-positive cocci in Tianjin

目的对天津市革兰阳性球菌耐药情况进行分析。方法收集2015年1月-12月教学医院住院患者2 451株非重复革兰阳性球菌。琼脂稀释法测定抗菌药物的最小抑菌浓度,回顾性研究病原菌耐药率。结果肺炎链球菌对头孢呋辛、利福平、利奈唑胺、万古霉素均不耐药,80%以上肺炎链球菌对红霉素、四环素耐药,70%以上菌株对克林霉素耐药。不同年龄组葡萄球菌的体外抗菌活性分析显示,幼儿组对庆大霉素、环丙沙星、左旋氧氟沙星、莫西沙星的耐药率低于成人组和老年组,成年组低于老年组,差异均有统计学意义(P<0.05)。屎肠球菌对替加环素、利奈唑胺、万古霉素敏感率分别为100.0%、99.3%、95.3%,粪肠球菌对以上药物的敏感率为100.0%、98.4%、99.7%。结论革兰阳性球菌耐药性存在年龄差异,万古霉素、利奈唑胺、奎奴普丁/达福普汀敏感性较高,不受年龄限制。

Objective To analyze the antimicrobial resistance of gram-positive cocci in Tianjin. Methods From January to December in 2015,2 451 consecutive and nonrepetitive gram-positive cocci were collected from teaching hospitals. The minimal inhibitory concentration（MIC） of antibacterial agents was determined by agar dilution method. A retrospective study was conducted on the resistance rates of antimicrobial agents. Results Streptococcus pneumonia was not resistant to cefuroxime,rifampicin,vancomycin,linezolid. More than 80% of Streptococcus groups were resistant to erythromycin and tetracycline. More than 70% of Streptococcus groups were resistant to clindamycin. The resistance rates of Staphylococcus to gentamicin,ciprofloxacin,ofloxacin,moxifloxacin in children were significantly lower than that in the adult group and the elderly group,and that in the adult group was lower than that of the elderly group,with the differences above statistically significant in different age groups（P 〈 0. 05）. The sensitivity of enterococcus faecalis to the above drugs was 100. 0%,98. 4%,99. 7%,respectively. Conclusion There is an age difference in the resistance of gram-positive coccus,which is high sensitive to vancomycin,linnazole,quinuprin/dafutin,not restricted by age.