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1.
目的了解和探讨凝固酶阴性葡萄球菌(CNS)医院感染及耐药现状,为临床合理使用抗菌药物提供实验室依据。方法运用血平板进行常规接种培养,CNS鉴定及药敏试验使用梅里埃ATB自动细菌分析仪进行测定,鉴定条采用ID32STAPH葡萄球菌鉴定试剂条。结果分离到表皮、溶血、里昂、模仿、腐生、耳、头状、施氏、木糖葡萄球菌等CNS共9种,其中表皮葡萄球菌居首位(51.7%)。CNS对青霉素耐药率为93.3%,对苯唑西林CNS耐药率为55.8%,且呈多重耐药状态。尚未发现耐万古霉素CNS。结论 CNS医院感染率及耐药性呈增高趋势,应予以重视。  相似文献   

2.
慢性前列腺炎中凝固酶阴性葡萄球菌感染及耐药性分析   总被引:6,自引:3,他引:3  
目的:探讨慢性前列腺炎中凝固酶阴性葡萄球菌(CNS)感染及对抗生素的耐药情况。方法:对慢性前列腺炎患者的前列腺液进行细菌培养和药敏试验,并对CNS进行统计分析。结果:从232例前列腺液中共检出CNS64株,阳性率为27.59%(64/232),其中耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)38株,占CNS的59.38%(38/64)。药敏结果显示,CNS对多种抗生素耐药,其中万古霉素、磷霉素和利福平的耐药性最低,可作为治疗的首选药物。MRCNS的耐药性明显高于甲氧西林敏感的凝固酶阴性葡萄球菌(MSCNS)(P<0.01)。结论:慢性前列腺炎中CNS的感染率较高,耐药性较严重,病原菌检查和药敏试验对临床诊断和治疗具有重要作用。  相似文献   

3.
目的探讨凝固酶阴性葡萄球菌(CNS)致新生儿败血症的病原学及耐药性现状,以指导临床合理选择有效的抗生素。方法从288例新生儿血培养阳性瓶中分离出204株CNS,共分离出11个菌种。应用纸片扩散法测定了CNS对青霉素等12种抗生素的耐药性。结果共分离出细菌288株,阳性率为14%(288/2057),CNS 204株,占总分离菌株的70.8%,其中溶血葡萄球菌87株,占42.6%;表皮葡萄球菌61株,占29.9%;腐生葡萄球菌34株,占16.7%;其他葡萄球菌22株,占10.8%。耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)176株,分离率为86.3%;MRCNS药敏结果显示多重耐药。结论 CNS已成为新生儿血液感染居第1位的病原菌,MRCNS检出率高且呈多重耐药。万古霉素是目前治疗耐甲氧西林葡萄球菌全身感染最敏感的药物,但不能随便使用,临床医生应根据CNS感染的种类和药敏结果合理使用抗生素。  相似文献   

4.
老年患者医院下呼吸道感染凝固酶阴性葡萄球菌耐药分析   总被引:3,自引:1,他引:2  
甘丹 《检验医学与临床》2009,6(3):165-166,170
目的了解老年患者医院下呼吸道感染凝固酶阴性葡萄球菌(CNS)的分布及耐药性特点。方法收集2003-2007年本院老年患者医院下呼吸道感染CNS,进行菌株鉴定和药敏试验,按美国国家临床实验室委员会(NCCLS)标准判断。结果分离出CNS142株,检出率明显超过金黄色葡萄球菌,以溶血葡萄球菌和表皮葡萄球菌为主,分离率最高的是溶血葡萄球菌(43.0%)。甲氧西林耐药率(MR)高达97.9%,万古霉素耐药率为0.0%,2003-2007年,四环素、红霉素、克拉霉素、克林霉素、环丙沙星耐药率呈增高趋势,β-内酰胺类抗生素均呈高水平耐药。结论耐甲西林凝固酶阴性葡萄球菌(MRCNS)成为老年患者下呼吸道医院感染的主要致病菌,多重耐药性现象严重,应加强耐药监测。  相似文献   

5.
凝固酶阴性葡萄球菌(coagu lase-negativeStaphylococ-ci,CNS)是一类重要的条件致病菌,是医院内感染的主要病原菌。为了解CNS在临床感染的分布情况及对抗生素的耐药性,我们回顾分析了近2年从临床送检的各类标本中分离到的139株CNS。一、材料和方法1.菌株来源2001~2002年本院门诊及住院患者的血液、尿液、脓液、痰液、前列腺液、宫颈口分泌物、男性尿道分泌物等共139株。2.鉴定及药敏试验用ATB Expression细菌鉴定仪及配套ID32 STAPH、ATB STAPH 5试条进行鉴定及药敏试验。3.耐甲氧西林CNS(MRCNS)鉴定按美国临床实验室标准化…  相似文献   

6.
577株凝固酶阴性葡萄球菌菌种分布及耐药性分析   总被引:12,自引:1,他引:11  
张扬  赵毅 《上海医学检验杂志》2000,15(3):179-179,173
凝固酶阴性葡萄球菌(CNS)是院内机会感染的重要病原菌。近年来引起感染的该类菌种日益增多。本文报道我院1992年至1998年间从临床标本中分离出CNS577株。在复鉴后对其菌种分布和耐药性进行了分析。材料和方法一、标本来源 1992年7月至1998年7月,从临床各科送检样品中分离出的CNS577株。二、菌种鉴定 按照文献[1]的分组鉴定方法进行。以17种生理生化试验为依据。三、药敏试验 采用K-B纸片扩散法,参照NCCLS操作标准。耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的鉴定,取苯唑西林纸片(1μg/片)在4%NaClM-H琼脂平板上,进行24小时培养,抑…  相似文献   

7.
凝固酶阴性葡萄球菌的临床分布及耐药性分析   总被引:1,自引:1,他引:0  
目的:了解和探讨凝固酶阴性葡萄球菌(CNS)的感染分布及耐药现状,指导临床合理用药。方法:运用血平板进行常规接种培养,用MICROSCAN进行菌种鉴定及药敏试验,采用苯唑西林纸片扩散法检测耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)。结果:临床标本分离CNS共166株,其中前列腺液培养分离出89株(53.6%),痰培养分离出33株(19.9%),尿培养分离出27株(16.3%),血培养分离出10株(6.0%),另外7株(4.2%)来源于伤口分泌物培养。分离出的致病性CNS主要有溶血性葡萄球菌63株、表皮葡萄球菌42株、腐生葡萄球菌16株、施氏葡萄球菌16株、其他CNS共29株。MRCNS分离率61.6%,药敏显示多重耐药。万古霉素仍然保持高度的敏感性;利福平、复方新诺明、呋喃妥因对MRCNS有一定的敏感性。结论:CNS已成为临床上最为常见的条件致病菌,同时也是医院获得性感染的主要致病菌之一。可引起前列腺、呼吸道、伤口、血液等有关感染,体外药敏试验显示CNS大多呈多重耐药,对青霉素和大环内酯类抗菌药物高度耐药,对糖肽类抗菌药物较敏感,提示万古霉素仍然是治疗MRCNS感染时的首选药物。  相似文献   

8.
[目的]探讨不同方法检测凝固酶阴性葡萄球菌(Coagulase Negative Staphylococcus,CNS)的药物敏感性,并对其耐药性进行分析。[方法]对收集的26株CNS进行头孢西丁纸片法耐药表型筛选以及PCRmecA基因检测,并用WHONET4软件进行耐药性分析。[结果]在26株CNS中,共分离出6种葡萄球菌。表皮葡萄球菌、溶血葡萄球菌检出率最高,分别为42.3%、38.5%。科室分布依次为ICU、神经内科、外科。耐药分析显示:表皮葡萄球菌对氨苄青霉素、青霉素、红霉素明显耐药(〉90%)。对环丙沙星、克林霉素头孢唑林、阿莫西林、耐药率在50%-80%之间。溶血葡萄球菌对β-内酰胺酶类、喹诺酮类、大环内脂类等耐药,耐药率在60%-100%之间。本次实验未发现万古霉素耐药菌株。[结论]CNS对各种抗菌素均产生高耐药,给医院感染造成很大压力,临床医生应了解抗菌素的应用指征以防止对其滥用,根据药敏结果选择对病原菌敏感的药物,重视药敏试验对临床的指导意义。  相似文献   

9.
新生儿凝固酶阴性葡萄球菌败血症的临床及耐药性分析   总被引:5,自引:0,他引:5  
庞毅  李桦  杨涛毅  彭珉娟 《华西医学》2005,20(4):722-723
目的:探讨新生儿凝固酶阴性葡萄球菌(CNS)败血症的临床及耐药现状以指导临床诊断及合理用药.方法: 对我院近年来60例新生儿CNS败血症的临床表现及药物敏感试验进行回顾性分析,所有菌株经法国生物梅里埃公司Vitek32型全自动微生物分析系统及API鉴定系统进行鉴定及配套试剂进行药敏试验、耐甲氧西林葡萄球菌的分离及β-内酰胺酶测定. 结果:新生儿CNS败血症的临床表现缺乏特异性,起病隐匿,表现多较轻微;60株CNS中,表皮葡萄球菌38株(占63.3%),溶血葡萄球菌12株(占20%),木糖、头状、沃氏、华纳氏、耳葡萄球菌各2株(共占16.7%);耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)占68.0%(34/50),产β-内酰胺酶CNS检出率为75.0%(24/32),多重耐药菌株达90.0%(54/60);CNS对青霉素、阿莫西林/棒酸、氨苄西林/舒巴坦、红霉素、氯洁霉素、四环素、庆大霉素、复方新诺明、头孢唑林、头孢他定的耐药率高,达50~89.1%,对环丙沙星、丁胺卡那霉素、头孢噻腭的耐药率分别为42.0%、 43.1%、42.0%,仅对万古霉素、呋喃妥因、左氧氟沙星、利福平耐药率低,分别为6.3%、10.4%、22.7%、22.9%;MRCNS的耐药率明显高于甲氧西林敏感凝固酶阴性葡萄球菌(MSCNS),其中对青霉素、阿莫西林/棒酸、氨苄西林/舒巴坦、红霉素耐药率均为100%、对环丙沙星、氯洁霉素耐药率分别为60%、76.9%,耐药率明显高于MSCNS(P<0.01).结论:新生儿CNS败血症诊断需加强认识、提高警惕性,CNS耐药率高,表现为多重耐药,万古霉素仍然是新生儿MRCNS败血症最理想的抗菌药物,但也有耐药株出现,在用抗生素前积极抽送血培养及药敏试验以快速确诊并指导合理用药非常重要.  相似文献   

10.
为了研究凝固酶阴性葡萄球菌(CNS)在慢性前列腺炎中的地位,探讨前列腺液中CNS检测的临床意义及对常用药物的耐受性,进一步验证头孢菌素类药物用于CNS已毫无意义。本文对107例慢性前列腺炎患者作前列腺液细菌培养并作药敏试验,结果63例(58.88%)分离出细菌。革兰阳性菌50例(79.36%),其中葡萄球菌41例(41/63,65.08%),CNS 25例(25/63,39.68%):CNS中以表皮葡萄球菌为主,占21例(33.33%),是最常见的CNSNIH-CPSI积分与细菌培养结果无明显相关。CNS对常用抗菌药物(β-内酰胺类、大环内酯类、氨基糖苷类、喹诺酮类、头孢菌素类)耐药率较高(51.8%~100%),对万古霉素、利福平耐药率较低(0~18.2%)。结论CNS为慢性前列腺炎的主要致病菌,应引起医学界的高度重视;前列腺炎细菌学监测及药敏试验对临床诊断和治疗慢性前列腺炎具有十分重要意义,应作为临床常规检查;CNS应用头孢类药物已毫无意义。  相似文献   

11.
The antimicrobial susceptibility of 239 coagulase-negative staphylococci (CNS) isolates consecutively collected from blood culture in patients admitted in a 600-bed teaching hospital was evaluated. The isolates were identified to the species level by conventional methods and the MicroScan Positive Combo Panel type 6 system, and their susceptibility to vancomycin, teicoplanin, and oxacillin were tested by agar dilution, disk diffusion, and MicroScan-WalkAway system. The species distribution was as follows: Staphylococcus epidermidis 120 (50.2%), S. hominis 29 (12.1%), S. haemolyticus 24 (10.0%), S. cohnii 14 (5.9%), and isolates from other CNS species 52 (21.8%). The percentage of resistance to oxacillin was 74.5% by agar dilution. The highest percentages of oxacillin resistance were found among S. haemolyticus (95.8%) and S. epidermidis (80.8%). Teicoplanin resistance (MIC > or = 32 micrograms/mL) was detected in five S. haemolyticus isolates, whereas intermediate resistance (MIC = 16 micrograms/mL) was detected in nine strains. These isolates with reduced susceptibility to teicoplanin were resistant to oxacillin, but remained susceptible to vancomycin (MIC < or = 4 micrograms/mL). Two isolates, one S. haemolyticus and one S. epidermidis, showed a vancomycin MIC of 8 micrograms/mL, and both MicroScan and disk diffusion methods classified these isolates as susceptible. Our results showed that glycopeptide resistance is emerging among CNS isolates in our institution and the disk diffusion method may not detect isolates with decreased susceptibility to these antimicrobial agents.  相似文献   

12.
Twelve clinical strains of Staphylococcus haemolyticus (eight methicillin resistant and three methicillin susceptible), isolated from blood cultures between 1982 and 1997, were investigated for teicoplanin and vancomycin susceptibility profiles. On the basis of conventional MIC tests and breakpoints, four isolates were susceptible (MICs, 1 to 8 microgram/ml) and eight were resistant (MICs, 32 to 64 microgram/ml) to teicoplanin while all were susceptible to vancomycin (MICs, 1 to 2 microgram/ml). All four strains for which the conventional teicoplanin MICs were within the range of susceptibility expressed heterogeneous resistance to teicoplanin and homogeneous vancomycin susceptibility. Of the eight strains for which the conventional teicoplanin MICs were within the range of resistance, six expressed heterogeneous and two expressed homogeneous teicoplanin resistance while seven showed heterogeneous vancomycin resistance profiles (with subpopulations growing on 8 microgram of the drug per ml at frequencies of >/=10(-6) for six strains and 10(-7) for one) and one demonstrated homogeneous vancomycin susceptibility. Of six bloodstream isolates of other staphylococcal species (S. aureus, S. epidermidis, and S. simulans), for all of which the conventional teicoplanin MICs were >/=4 microgram/ml and the vancomycin MICs were 相似文献   

13.
Empirical combination therapy with β-lactams and glycopeptides is recommended for patients with presumed staphylococcal bloodstream infection (BSI). While coagulase-negative staphylococci (CNS) remain susceptible to vancomycin, such isolates have become less susceptible to teicoplanin. The aim of this retrospective study was to evaluate the clinical efficacy of teicoplanin in the treatment of BSI caused by methicillin-resistant CNS according to teicoplanin susceptibility. Inclusion criteria were patients with intravascular-catheter related BSIs caused by methicillin-resistant CNS (positive for two or more specimens); teicoplanin therapy; and at least one of the signs or symptoms caused by BSI. Antimicrobial resistance was defined as minimum inhibitory concentration (MIC) ≥8 μg/mL. The primary efficacy endpoint was clinical success evaluated 2 weeks after the completion of teicoplanin therapy [test of cure (TOC)]. Resistant rate of CNS was 0% for vancomycin and 22.9% for teicoplanin, and geometric mean MICs were 1.31 μg/mL and 3.41 μg/mL, respectively (p < 0.001). The catheter was removed in all patients except one, and high early clinical response at 72 h after starting therapy was obtained irrespective of teicoplanin susceptibility. The clinical success rate at TOC was 60% in patients with BSIs caused by teicoplanin-resistant strains, while 90% in patients with BSIs caused by susceptible strains (p = 0.052). In multivariate analyses, teicoplanin resistance was significant factor for decreased clinical success at TOC (adjusted odds ratio 0.138, 95% confidence interval 0.020–0.961, p = 0.045). Because of the poor clinical efficacy of teicoplanin against teicoplanin-resistant CNS, combination therapy comprising vancomycin and β-lactam antibiotics should be considered in presumed staphylococci BSI.  相似文献   

14.
目的分析老年下呼吸道感染患者病原菌的分布及耐药性,为临床防治提供依据。方法回顾性分析2012年2月—2013年11月在北京市隆福医院呼吸科住院的老年下呼吸道感染438例痰标本培养分离的病原菌种类及其药物敏感试验结果。结果 438例标本中共检出病原菌392株,其中革兰阴性菌226株(57.7%),以肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌为主;革兰阳性菌125株(31.9%),以金黄色葡萄球菌、溶血葡萄球菌、表皮葡萄球菌为主;真菌41株(10.5%),以白假丝酵母菌为主。药物敏感试验结果显示:肺炎克雷伯菌和大肠埃希菌对亚胺培南的耐药率最低,鲍曼不动杆菌对头孢哌酮钠-舒巴坦钠及亚胺培南耐药率较低,铜绿假单胞菌对阿米卡星耐药率最低。金黄色葡萄球菌、溶血葡萄球菌和表皮葡萄球菌对万古霉素、替考拉宁全部敏感。结论老年下呼吸道感染病原菌以革兰阴性菌为主,细菌耐药性严重,应根据药物敏感试验结果选用合适的抗菌药物。  相似文献   

15.
Forty-two clinical isolates belonging to ten species of staphylococci were studied for their ability to develop single-step resistance, in vitro, to glycopeptide antibiotics. Selection was attempted through separate exposure to four glycopeptides (vancomycin, teicoplanin, and two investigational semisynthetic derivatives of the latter, TD-A3 and CTA-A1) on agar containing 10 mg/l of the test drug. No survivors from any test strain were recovered after exposure to TD-A3 or CTA-A1. After exposure to vancomycin or teicoplanin, surviving clones were only recovered from strains of three species, Staphylococcus aureus, S. epidermidis, and S. haemolyticus. Emergence of resistant clones was easier to observe from strains of S. haemolyticus exposed to teicoplanin. When tested for susceptibility, many survivors exhibited vancomycin and teicoplanin MICs below the drug concentration used for in-vitro selection, probably due to an inoculum effect in the plating procedure. In particular, the vancomycin MICs did not exceed 8 mg/l for S. aureus and S. epidermidis clones, and reached 16 mg/l for some clones from a S. haemolyticus strain. Teicoplanin MICs did not exceed 8 mg/l for S. aureus clones, but reached 64 mg/l for some clones of S. epidermidis, and were particularly high (64 to greater than or equal to 128 mg/l) for most clones of S. haemolyticus. In contrast, against all clones selected from all three species, the MICs of TD-A3 and CTA-A1 did not exceed 2 and 4 mg/l, respectively. Morphological investigations indicated that the colonies of a highly resistant S. haemolyticus clone were smaller and more butyraceous in consistency than those of the parent strain. In transmission and scanning electron microscopy studies, this same S. haemolyticus clone showed a more irregular cell wall than the parent strain.  相似文献   

16.
目的了解肠球菌感染分布特点及耐药性,为临床合理使用抗菌药物控制病原菌感染提供依据。方法对2010年12月至2015年12月临床送检全部标本采用梅里埃VITEK2全自动微生物仪进行菌株鉴定及药敏试验,个别药物用K-B纸片扩散法检测抗菌药物敏感性。采用SPSS18.0软件进行统计学分析。结果 5年共分离粪肠球菌423株、屎肠球菌191株,主要分布于尿液、痰液、泌尿生殖道分泌物和血液中。粪肠球菌和屎肠球菌对利奈唑胺、替考拉宁、万古霉素有很好的敏感性。结论粪肠球菌和屎肠球菌主要分布在尿液中,耐药率不断升高,近几年更出现了对万古霉素耐药的菌株,临床医生应该加强对粪肠球菌和屎肠球菌耐药性监测,合理使用抗菌药物,从而提高治疗效果。  相似文献   

17.
目的:探讨本地区女性生殖道支原体感染及对药物的敏感情况。方法:使用支原体培养及药敏试剂盒检测1435例女性生殖道的解脲支原体,并对10种抗生素的药敏试验进行分析。结果:698例检测出支原体属,阳性率为48.6%其中解脲脲支原体感染578例,占82.8%为最高。解脲脲支原体对多西环素、交沙霉素、克拉霉素较为敏感。而支原体属对氟喹诺酮类抗茵药物耐药率均高,因此本地区不宜选用。结论:本地区女性生殖道感染中支原体感染率为48.6%。多西环素、交沙霉素、克拉霉素是本地区女性生殖道支原体感染的首选药物。  相似文献   

18.
The prevalence of low-level resistance to glycopeptides (teicoplanin MIC > or = 8 microg/mL and vancomycin MIC > or = 4 microg/mL) among staphylococci was investigated over a 15 month period. A total of 2,279 isolates (1,519 S. aureus, 760 coagulase-negative staphylococcus (CNS)) were screened using inoculum of 10(6) CFU/mL and Mueller-Hinton agars supplemented with 8 microg/mL of teicoplanin. Of these, 218 isolates (136 S. aureus and 82 CNS) grew on the screening agar. For these isolates, teicoplanin and vancomycin MICs were determined by agar dilution method and a vancomycin agar screening method was evaluated. The prevalence of low-level resistance to teicoplanin and vancomycin was 7.8% and 0.1% for S. aureus and 8.8% and 0.8% for CNS, respectively. The brain heart infusion agar containing 4 microg/mL of vancomycin failed to detect two out of eight staphylococcal isolates with vancomycin MICs of 4 microg/mL. Furthermore, the method appeared to lack reproducibility. Considering the increasing incidence of vancomycin treatment failure in staphylococcal infection, a more reliable screening method is required.  相似文献   

19.
目的 探讨妇科病患者生殖道分泌物的支原体感染情况,分析药敏试验的耐药趋势,为临床诊治提供准确依据.方法 对2 168例患者的生殖道分泌物标本进行支原体培养,同时进行12种抗菌药物的药物敏感试验.结果 生殖道分泌物支原体感染以解脲支原体感染为主,阳性872例(40.22%).药物耐药率依次为环丙沙星(70.18%)、氧氟沙星(50.92%)和红霉素(38.99%).结论 妇科病感染的支原体对许多抗菌药物产生了很强的耐药性,药敏分析为临床治疗支原体感染提供了参考依据.  相似文献   

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