2011—2014年革兰阳性菌的分布及耐药性变迁研究

目的 分析医院革兰阳性菌的分布及耐药性变迁，为临床合理使用抗菌药物提供依据。方法 采用VITEK-2 Compact微生物分析系统进行菌株鉴定及药敏试验。使用SIMCA-P+软件建立主成分分析(principal component analysis, PCA)模型。通过构建主成分得分图，结合主成分载荷图，对革兰阳性菌耐药性的变迁进行整体评价，筛选耐药率上升趋势较显著的菌株。结果 2011—2014年共分离出5 436株革兰阳性菌，包括金黄色葡萄球菌、粪肠球菌、溶血葡萄球菌、表皮葡萄球菌、人葡萄球菌和头状葡萄球菌，分别占59.1%，12.3%，12.2%，10.3%，3.7%和2.3%。其中人葡萄球菌、金黄色葡萄球菌和溶血葡萄球菌对克林霉素耐药率的上升趋势较为显著。结论 医院应加强对克林霉素使用的管理，加强葡萄球菌属对克林霉素耐药率的监测。

Study on the Distribution and Drug Resistance Variance of Gram-positive Bacteria in 2011-2014

OBJECTIVE To provide information for the rational application of antibiotics, the distribution and drug resistance variance of gram-positive bacteria in hospital were investigated. METHODS The identification of strains and the drug susceptibility testing were performed using a VITEK-2 Compact system. A principal component analysis(PCA) model was established with the use of SIMCA-P+ software. The principal component scores plot in combination with principal component loading plot was applied to monitor the drug resistance variance of gram-positive bacteria. The bacterial strains, which showed significant upward trend in drug resistances, were screened. RESULTS A total of 5?436 strains of gram-positive bacteria were isolated in 2011-2014, including staphylococcus aureus(59.1%), enterococcus faecalis(12.3%), staphylococcus haemolyticus (12.2%), staphylococcus epidermidis(10.3%), staphylococcus hominis(3.7%) and staphylococcus capitis(2.3%). Among these, the drug resistance rates of staphylococcus hominis, staphylococcus aureus and staphylococcus haemolyticus to clindamycin showed significant upward trend. CONCLUSION This study demonstrates that the management of clindamycin should be strengthened by hospital. The monitoring of drug resistance rates of staphylococcus to clindamycin should also be further strengthened.