革兰阳性球菌耐药性监测研究

目的　监测临床分离革兰阳性球菌的耐药情况 ,为合理使用抗菌药物提供依据。方法　采用K -B方法和微量肉汤稀释法 ,对 1999年 1月～ 2 0 0 3年 12月临床分离的 2 10 4株革兰阳性球菌进行药敏试验。结果　 2 10 4株革兰阳性球菌中 ,金黄色葡萄球菌占 2 0 5 % ,凝固酶阴性葡萄球菌占 4 2 8% ,肠球菌占 32 9%。 2 0 0 3年 ,甲氧西林耐药金黄色葡萄球菌和甲氧西林耐药凝固酶阴性葡萄球菌检出率分别为 19 4 %和 81 1% ,高于 1999年的检出率(17 1%和 6 5 4 % ) ;其中 ,甲氧西林耐药凝固酶阴性葡萄球菌有显著性差异 ,P <0 0 5。未发现对万古霉素耐药的金黄色葡萄球菌和凝固酶阴性葡萄球菌 ,有 4株凝固酶阴性葡萄球菌对替考拉宁耐药。 1999～ 2 0 0 3年 ,万古霉素耐药肠球菌检出率分别为 9 8% ,7 7% ,5 0 % ,4 1%和 6 7% ,无明显增加。 6 7 1%～ 76 7%粪肠球菌对氨苄西林敏感 ,但耐氨苄西林屎肠球菌发生率较高 (6 6 7%～ 89 7% )。 2 0 0 1～ 2 0 0 3年 ,耐替考拉宁的肠球菌分别为 2 1% ,3 5 %和5 5 %。结论　 2 0 0 3年 ,耐甲氧西林金黄色葡萄球菌、耐甲氧西林凝固酶阴性葡萄球菌和耐氨苄西林屎肠球菌与 1999年比有增加趋势。

Surveillance on antibiotic resistance of gram-positive cocci

Objective To investigate the drug-resistance of gram-positive cocci islated from patients in the First Affiliated Hospital,China Medical University.Methods Antimicrobial susceptibility of 2104 clinical isolated from 1999-2003 was tested by K-B method and Broth microdilution method.Results Of 2104 clinical isolates,staphylococcus aureus accounted for 20.5%,coagulase-negative staphylococci 42.8%,enterococci 32.9%.The detectable rates of methicillin-resistant staphylococcus aureus and methicillin-resistant coagulase-negative staphylococci in 2003 were 19.4% and 81.1%,which were higher than those in 1999(17.1% and 65.4%).The difference in methicillin-resistant coagulase-negative staphylococci was significantly during 1999-2003( P <0.05).Neither strains of staphylococcus aureus nor strains of coagulase-negative staphylococci were found resistant to vancomycin.4 strains of coagulase-negative staphylococci showed resistance to teicoplanin.No significant changes in vancomycin-resistant entrococci were found from 1999 to 2003.The prevalence of vancomycin-resistant enterococci (1999-2003) were 9.8%,7.7%,5.0%,4.1%,and 6.7% respectively.67.1-76.7 percent of E.faecalis isolates were sensitive to ampicillin,but ampicillin-resistant E.faecium were higher(66.7%-89.7%).The prevalence of teicoplanin-resistant enterococci was 2.1%,2.5% and 5.5% respectively.Conclusion Multidrug-resistant gram-positive cocci including methicillin-resistant staphylococcus aureus and methicillin-resistant coagulase-negative staphylococci and ampicillin-resistant E.faecium are increasing.