革兰阳性球菌的耐药性调查分析

目的 了解2010年住院患者感染性标本中分离的革兰阳性球菌分布及耐药特征,为临床抗感染治疗选择抗菌药物提供实验室参考依据.方法 革兰阳性球菌培养及鉴定严格按照《全国临床检验操作规程》,采用常规方法进行；药敏试验和结果判断采用CLSI推荐的K-B法进行.结果 分离的178株革兰阳性球菌以金黄色葡萄球菌居多,占62.9％,其次是凝固酶阴性葡萄球菌、肠球菌属,占22.5％、14.6％；革兰阳性球菌对常用抗菌药物大多数呈现多药耐药现状,耐甲氧西林葡萄球菌(MRS)检出率为60.5％,未发现对糖肽类抗菌药物中介和耐药的葡萄球菌属,耐万古霉素肠球菌属检出率为3.8％.结论 临床医师应及时送检感染性标本进行病原菌培养和药敏试验,根据病原菌类型及耐药特征合理选择使用抗菌药物.

Investigation and analysis of drug resistance of gram-positive cocci

OBJECTIVE To approach the constituent ratios and antimicrobial resistance of gram-positive cocci isolated from infectious specimens of hospitalized patients in 2010 and provide experimental basis for clinical use of antibiotics for anti-infection chemotherapy.METHODS Referring to National Guide to Clinical Laboratory Procedures,bacterial culture and identification were performed by the routine methods.The drug susceptibility test was performed by K-B method recommended by CLSI.RESULTS Among the 178 strains of gram-positive cocci isolated,Staphylococcus aureus isolates were the dominant pathogens,accounting for 62.9%,followed by coagulase-negative Staphylococcus(22.5%) and Enterococcus(14.6%);gram-positive cocci were resistant to the most of commonly used antibiotics,the detection rate of methicillin-resistant S.aureus(MRSA) was 60.5%,and no Staphylococcus isolates intermediate or resistant to glycopeptide antibiotics were found.CONCLUSION The clinician should perform the bacterial culture and drug susceptibility testing for the submitted specimens in a timely manner and prescribe antibiotics in accordance with the species of the pathogens and the characteristics of drug resistance.