无乳链球菌的临床分布与耐药性分析

Clinical Distribution and Drug Resistance of Streptococcus Agalactiae

目的:分析无乳链球菌的临床分布及耐药性,为临床合理用药提供指导。方法:选取2017年~2019年我院临床分离的无乳链球菌107株,采用MALDI-TOF MS(Bruker)进行菌种鉴定,应用纸片法或MIC法进行药敏试验。结果:107株无乳链球菌样本来源主要为尿液(42.06%)、生殖道分泌物(25.23%)、创口分泌物(8.41%)。无乳链球菌感染中女性79例(73.83%),男性28例(26.17%),主要分布科室是产科(24.30%)、泌尿外科(15.89%)、肛肠科(6.54%)。药敏结果显示无乳链球菌对万古霉素、利奈唑胺敏感,对青霉素G、氨苄西林、头孢曲松的耐药率较低,均在10%以下;对红霉素、克林霉素、左氧氟沙星的耐药率较高,均在60%以上。结论:无乳链球菌感染最常见的是泌尿生殖道感染,女性患者高于男性患者,青霉素和氨苄西林可以作为无乳链球菌感染的首选一线药物,红霉素、克林霉素、左氧氟沙星慎重选用。

Objective:To investigate the clinical distribution and drug resistance of clinical Streptococcus agalactiae and provide guidance for the rational use of antibiotics.Methods:107 Streptococcus agalactiae were isolated from our hospital during 2017-2019.The VITEK-2 automaticbacteria identification and drug sensitivity analyzer were used for the corresponding analysis of Streptococcus agalactiae.Results:The isolates were mainly from urine(42.06%),genital tract(25.23%)and wound secretion(8.41%).They were obtained from 79 female patients(73.83%)and male patients(26.17%).The Streptococcus agalactiaestrains were mainly distributed in department of maternity/obstetrical department,urology department and anorectal department.The drug resistance rate to penicillin G,vancomycin,linezolid,ampicillin and ceftriaxoneare all less than 10%,the drug resistance rate to erythromycin,clindamycin and levofloxacin are higher than 60%.Conclusion:Streptococcus agalactiaestrains are mainly derived from urinary tract and genitourinary tract.Penicillin G and Ampicillinare still the first choice for the treatment of Streptococcus agalactiae infection.Clinicians should use Erythromycin,clindamycin and levofloxacinwith caution.