耐甲氧西林的耳葡萄球菌与人葡萄球菌耐药性检测

目的 了解临床分离的耐甲氧西林耳葡萄球菌和人葡萄球菌的发生率及其对抗菌药物的耐药性.方法 采用头孢西丁纸片法检测耐甲氧西林菌株,琼脂稀释法测定耐甲氧西林菌株对多种抗菌药物的敏感性.结果耐甲氧西林耳葡萄球菌和人葡萄球菌的发生率分别为94.7%,91.7%;耐甲氧西林菌株对青霉素、四环紊、环丙沙星和克林霉素、头孢唑林、头孢呋辛、头孢曲松的耐药率均>20.0%;对阿米卡星、利福平较为敏感,对万古霉素、替考拉宁的耐药率为0.结论 临床分离的耐甲氧西林耳葡萄球菌和人葡萄球菌的发生率高,对多种抗菌药物耐药显著.     

金黄色葡萄球菌肺炎

金黄色葡萄球菌肺炎 (简称金葡菌肺炎 )是金黄色葡萄球菌引起的急性化脓性肺部感染 ,占医院外获得性肺炎的 5 %以下 ,医院内获得性肺炎的 10 %～ 30 % ,其病情重 ,病死率高。金葡菌经常寄居于正常人的鼻前庭和皮肤等处 ,在寄居部位营共生生活。社区健康人群持续带菌率为 2 0 % ,间歇带菌率可达60 % ,医务人员的金葡菌携带率更高 ,经手在人 -人间传播。金葡菌肺炎可经吸入口咽部分泌物或血行途径引起肺炎。吸入口咽部分泌物获肺炎者常有肺部基础疾患 (ＣＯＰＤ、肺癌或肺囊性纤维化 ) ,慢性病 (糖尿病、肾功能衰竭 )或病毒感染后 ,流感流行期…     

耐甲氧西林葡萄球菌及异质性万古霉素中介的检测与分析 FREE

方法 选择住院感染患者标本分离的葡萄球菌,采用BDphoenix100微生物自动分析系统进行鉴定及药敏试验,并以头孢西丁纸片扩散法检测MRS,肉汤稀释法测定无菌体液及分泌物标本分离的41株MRS对万古霉素的敏感性; 脑心浸液琼脂诱导异质性万古霉素中介株,进一步用E test试条检测万古霉素敏感性。结果 239株葡萄球菌中有160株MRS,痰液、脓液、血液及胸腹腔积液标本是其主要来源,耐甲氧西林的金黄色葡萄球菌和凝固酶阴性葡萄球菌均呈多重耐药性,但对利奈唑胺、呋喃妥因敏感率为100.00％,未发现对万古霉素高度耐药株。患者无菌体液及分泌物 h VIS检出率为14.63％（6/41）,其中金黄色葡萄球菌的分离率为7.14％（1/14）,血浆凝固酶阴性葡萄球菌分离率为18.52％（5/27）。结论 准确检测出MRS和h VIS,对临床有效控制感染极为重要。     

表皮葡萄球菌与金黄色葡萄球菌感染分布及耐药性分析

目的研究临床感染表皮葡萄球菌与金黄色葡萄球菌的药敏差异,为临床合理选用抗菌药物提供科学依据。方法对医院2010年6月-2013年12月临床标本中分离出的表皮葡萄球菌与金黄色葡萄球菌,按照《全国临床检验操作规程》进行病原菌鉴定,药敏试验采用K-B纸片法,应用SPSS19.0软件对数据进行统计分析。结果临床共分离表皮葡萄球菌183株占51.12%,金黄色葡萄球菌175株占48.88%,表皮葡萄球菌与金黄色葡萄球菌对常用抗菌药物耐药率均较高,对万古霉素、呋喃妥因、替考拉宁、利奈唑胺、米诺环素耐药率均较低<10.00%,表皮葡萄球菌与金黄色葡萄球菌对苯唑西林、阿莫西林/克拉维酸、克林霉素、红霉素、阿奇霉素、庆大霉素耐药率分别为68.85%与45.71%、20.77%与12%、49.18%与26.86%、73.22%与46.86%、68.85%与48.57%、50.27%与29.14%,差异有统计学意义(P<0.05)。结论表皮葡萄球菌耐药率高于金黄色葡萄球菌应引起重视,合理选用抗菌药物,减少耐药菌株产生。     

Colonization of hospitalized patients by Staphylococcus aureus, Staphylococcus epidermidis and enterococci

Patients admitted to a medical intensive care unit (29), a surgical intensive care unit (29) and a general medical ward (34) were studied to determine the frequency of colonization by Staphylococcus aureus, Staph. epidermidis and enterococci. Cultures of anterior nares, pharynx, axilla, periurethral tissues, and rectum were done within 24 h of admission and every 48-72 h thereafter for the duration of hospitalization. We found Staph. aureus colonization of pharynx, axilla, periurethral tissues and rectum to be equally frequent in patients with and without nasal colonization. Staphylococcus epidermidis was commonly recovered from all sites except the pharynx. The 49 strains of this organism acquired in the hospital were significantly more often resistant to nafcillin, cephalothin, chloramphenicol, trimethoprim-sulfamethoxazole and gentamicin than were 199 isolates recovered from patients at the time of admission. Enterococci were commonly isolated from rectal swabs and, less often, from other sites. Acquisition of enterococcal colonization during hospitalization was correlated significantly with antibiotic administration.     

Isolation of Staphylococcus aureus and antibiotic-resistant Staphylococcus aureus from residential indoor bioaerosols

OBJECTIVE: In this study we evaluated the levels of Staphylococcus aureus and antibiotic-resistant S. aureus in colony-forming units (CFU) per cubic meter of air. DESIGN: We used Andersen two-stage samplers to collect bioaerosol samples from 24 houses in El Paso, Texas, using tryptic soy agar as the collection media, followed by the replicate plate method on Chapman Stone selective medium to isolate S. aureus. The Kirby-Bauer disk diffusion method was used to determine antibiotic resistance to ampicillin, penicillin, and cefaclor, which represent two distinct classes of antibiotics. RESULTS: The average recovered concentration of respirable heterotrophic organisms found outside each home was 345.38 CFU/m3, with an average of 12.63 CFU/m3 for S. aureus. The average recovered concentration of respirable heterotrophic organisms found inside each home was 460.23 CFU/m3, with an average of 15.39 CFU/m3 for S. aureus. The respirable S. aureus recovered from inside each home had an average resistance of 54.59% to ampicillin and 60.46% to penicillin. Presence of cefaclor-resistant and of multidrug-resistant S. aureus was the same, averaging 13.20% per house. The respirable S. aureus recovered from outside each home had an average resistance of 34.42% to ampicillin and 41.81% to penicillin. Presence of cefaclor-resistant and of multidrug-resistant S. aureus was the same, averaging 13.96% per house. CONCLUSIONS: This study indicates that antibiotic-resistant bioaerosols are commonly found within residential homes. Our results also suggest that resistant strains of airborne culturable S. aureus are present in higher concentrations inside the study homes than outside the homes.