2008年-2016年临床分离革兰阳性球菌的分布及耐药性分析

Clinical distribution and drug resistance of Gram-positive cocci during 2008-2016

目的了解贵州医科大学附属医院2008年-2016年革兰阳性球菌的临床感染分布及耐药情况。方法采用WHONET5.6软件回顾性分析9年内革兰阳性球菌的检出情况、标本类型分布及耐药情况。结果 9年间共分离出10 478株革兰阳性球菌,其中葡萄球菌属占78.22%(8 196株),肠球菌属占18.05%(1 891株),肺炎链球菌占1.36%(142株),MRSA、MRCNS和VRE的检出率分别为41.86%、78.63%和1.43%。肺炎链球菌对青霉素、左氧氟沙星、奎奴普汀/达福普汀和氯霉素的敏感率较高,均>80%,未发现对万古霉素和利奈唑胺耐药的肺炎链球菌。结论应尽早区分葡萄球菌是否耐甲氧西林,以便合理选用抗生素;对于肠球菌感染,尽量选择非糖肽类药物,以减轻该类药物的使用压力;肺炎链球菌对青霉素敏感性高,临床上可考虑使用。

Objective To comprehend the distribution of clinical infection and drug resistance of Gram-positive cocci isolated from the Affiliated Hospital of Guizhou Medical University from 2008 to 2016. Methods The detection rates of Gram-positive cocci,distribution of specimen type and drug resistance during the 9 years were analyzed retrospectively by WHONET 5. 6.Results A total of 10 478 clinical strains of Gram-positive cocci were isolated during the nine years,including Staphylococci（ 8 196,78. 22%）,Enterococci（ 1 891,18. 05%） and Streptococcus pneumoniae（ 142,1. 36%）. The detection rate of MRSA,MRCNS and VRE were 41. 86%,78. 63% and 1. 43%,respectively. Streptococcus pneumoniae had higher sensitivity to penicillin,levofloxacin,quinupristin/dapapricin,chloramphenicol,and all the sensitivity rates were greater than 80%. No Staphylococcus and Streptococcus pneumoniae resistant to vancomycin and linezolid were found. Conclusion Staphylococcus should be detected whether it is methicillin-resistant as early as possible. When treating enterococci infection,non-glycopeptide drugs should be chosen to reduce the use pressure of such drugs. The sensitivity of Streptococcus pneumoniae to penicillin is high,which can be considered in clinical use.