葡萄球菌属的分离及耐药性研究

目的　对 1 974株临床分离的葡萄球菌的耐药性进行研究 ,以观察葡萄球菌属的耐药现状。方法　药敏试验采用纸片扩散法 (K -B法 )。结果　临床分离到的葡萄球菌中 ,MRSA的分离率为 2 0 .8% (66/ 31 7) ,MRCNS的分离率为 66 .9% (1 1 0 9/ 1 657) ,MRSA主要来源于生殖道分泌物、痰、伤口分泌物 ,分别占 2 7.3 % ,2 2 .7% ,1 8.2 % ;血液标本中MRSA和MRCNS分别占总分离数的 0 .2 5 %和 4 .9% ,而MRSA只占 0 .2 5 %。MRSA和MRCNS对红霉素、庆大霉素、氯霉素、克林霉素、环丙沙星、复方磺胺甲恶唑、四环素的耐药率分别为 86 .2 %、47.6 %、50 .8%、61 .3 %、54 .5 %、83 .3 %、66 .1 %和 84.9%、37.5 %、45 .9%、53 .7%、58.2 %、84.9%、67.6 % ;MSCNS中环丙沙星、复方磺胺甲恶唑、四环素、氯霉素的耐药率分别为 33 .0 %、64 .1 %、58.5 %、2 7.8%均高于MSSA的 1 4 .6 %、42 .8%、41 .5 %、1 7.7% ,但对于MSS环丙沙星、庆大霉素、氯霉素、克林霉素有较高的敏感性。结论　重视对葡萄球菌的耐药性监测 ,合理使用抗生素、特别是合理使用糖肽类抗生素是非常必要的。

A Study of Antimicrobial Resistance of Clinical Isolates of Staphylococcus Species in Clinical Infection

Objective To study on antimicrobial resistance of 1974 clinical isolates of staphylococcus species in my hospital. Methods Antimicrobial susceptibility test was conducted by disk diffusion technique (K-B method). Results The frequency of methicillin-resistant staphylococcus aureus (MRSA) was 20.8% in clinical isolates. And the frequency of methicilllin resistant coagulase negative Staphylococci (MRCNS) was 66.9%. Most of Staphylococcus aureus were isolated genital tract and respiratory tract and wound secretions. The isolated rates were 27.3%, 22.7%, 18.2%. The isolated rates of MRSA and MRCNS from blood were 0.25% and 4.9%. Resistant rates of MRSA, MRCNS isolates to erythromycin, gentamicin, chloramphenicol, clindamycin, ciprofloxacin, trimethoprim/sulfamethoxazole and tetracycline were 86.2%, 47.6%, 50.8%, 61.3%、54.5%, 83.3%, 66.1% and 84.9%, 37.5%, 45.9%, 53.7%, 58.2%, 84.9%, 67.6%. Resistant rates of MSSA, MSCNS isolates to ciprofloxacin, trimethoprim/sulfamethoxazole, tetracycline, chloramphenicol were 33.0%, 64.1%, 58.5%, 27.8% and 14.6%, 42.8%, 41.5%, 17.7%. Resistant rates of MSCNS higher than MSSA. But resistant rates of MSS remain sensitive to most of antimicrobial agents routinely used in clinical practice including ciprofloxacin, gentamicin, chloramphenicol and clindamycin. Conclusons It is very important to monitor the antimicrobial resistant of staphylococcus species and rational made use of antimicrobial agents, in especial, rational made use of glycopeptides.