常见G+球菌的分布及其耐药性

目的：了解G^ 球菌的分布及其耐药性，指导临床合理用药。方法：收集引起临床感染的G^ 球菌369株进行耐药性分析，MRS株、VRE株、HLAR株及体外药敏试验的检测均采用K—B法。结果：葡萄球菌的分离主要来自脓汁及分泌物，肠球菌的分离主要来自尿标本。MRSA株的检出率为33．8％；MRSCON株的检出率为78．6％；VRE株的检出率为28．8％，其中粪肠球菌的VRE株检出率高于屎肠球菌；HLAR株的检出率为69．0％，其中粪肠球菌的HLAR株检出率低于屎肠球菌；未检出VRS株。葡萄球菌对氨基糖甙类、头孢唑啉、氨苄西林／舒巴坦有良好的活性，对喹诺酮类药物金黄色葡萄球菌的敏感性高于凝固酶阴性葡萄球菌；除万古霉素外，屎肠球菌的耐药性均高于粪肠球菌。结论：G^ 球菌的耐药性不容忽视，应结合体外药敏试验及特殊耐药株的报告，合理选择抗生素。

The Distribution and Drug Resistance of Common G+ Coccus

Objective:To investigate the distribution and drug resistance of G + coccus,soas to guide clinical drug treatment.Methods:The drug resistance of 369 G + coccus induced clinical infection was analyzed.Both the special bacteria such as MRS,VRE,HLAR and the drug sensitivity test in vitro were tested by K-B method.Results:Staphylococci were mainly isolated from pus and secretion,and enterococci from urine.The detectable rate of MRSA,MRSCON,VRE and HLAR was 33 8%,78 6%,28 8%and 69 0%,respectively.The detectable rate of VRE of Enterococcus faecalis was higher than that of Enterococcus faecium,while the detectable rate of HLAR of Enterococcus faecalis was lower than that of Enterococcus faecium.VRS was not detected.Staphylococcus has well activity against aminoglycosides,cefazolin and ampicillin or sulbactam.The sensitivity of Staphylococcus aureus to quinolones was higher than that of Coagulase-negative staphylococcus.All the drug resistance of enterococcus faecium was higher than that of enterococcus faecalis except for vancomycin resistance.Conclusion:The drug resistance of G + coccus should not be ignored.The correct application of antimicrobial is based on the result of drug sensitivity test in vitro and special drug resistant strain.