宁夏地区主要阳性球菌对大环内酯类、四环素类抗菌药物及克林霉素的耐药性分析

Analysis of Resistance of Main Positive Cocci to Macrolides,Tetracyclines and Clindamycin in Ningxia

目的了解2014-2018年宁夏地区临床分离主要革兰阳性球菌对大环内酯类、四环素类抗菌药物及克林霉素的耐药情况。方法收集宁夏地区30家耐药监测成员单位的上报数据,采用WHONET 5.6和SAS 9.4软件分析主要革兰阳性球菌对红霉素、阿奇霉素、四环素、克林霉素的药物敏感性。结果宁夏地区临床分离主要革兰阳性球菌为金黄色葡萄球菌、凝固酶阴性葡萄球菌、肺炎链球菌和肠球菌属;金黄色葡萄球菌的四种药物的耐药率都呈降低趋势,凝固酶阴性葡萄球菌对阿奇霉素、四环素耐药率呈降低趋势,对克林霉素和红霉素耐药率保持稳定;肺炎链球菌对大环内酯类及四环素类抗生素耐药率都很高,均在50%以上,但耐药率呈降低趋势;肠球菌属对红霉素的耐药率呈降低趋势,而四环素的耐药率保持在相对稳定状态。结论宁夏地区主要革兰阳性球菌对大环内酯类和四环素类抗菌药物耐药率大多呈降低趋势,但耐药率普遍较高,使用该类药物需要根据药敏结果选择。

Objective To investigate antibiotic resistance of clinical gram-positive bacterial isolates to macrolides and tetracycline from hospitals in Ningxia from 2014 to 2018.Methods Antimicrobial susceptibility testing was carried out by means of Kirby-Bauer method or minimal inhibitory concentration.Antimicrobial resistance rates to erythromycin,azithromycin,tetracycline,clindamycin were analyzed by using WHONET 5.6 and SAS 9.4 software.Results The most gram-positive frequently isolated species were Staphylococcus aureus(S.aureus),Coagulase negative staphylococcus(ConS),Streptococcus pneumoniae(s.pneumoniae)and Enterococcus.Antimicrobial resistance rates of S.aureus to the four antibiotics decreased.The resistance rate of ConS to azithromycin and tetracycline decreased as well,and the resistance rate to clindamycin and erythromycin remained stable with no statistical difference.s.pneumoniae had a high rate of resistance to macrolides and tetracyclines,both of which are above 50%,but the resistance rate decreased.The resistance rate of Enterococcus to erythromycin decreased,while tetracycline resistance remained relatively stable.Conclusion The resistance rates of gram-positive bacteria to most macrolides and tetracycline decreased,but still too high to use as experience using drugs.