320株葡萄球菌的临床分布与耐药性分析

目的了解葡萄球菌的临床分布和耐药特性,为临床合理使用抗感染药物提供依据.方法回顾性调查320株葡萄球菌对13种抗感染药物的耐药性.结果 320株葡萄球菌中,金黄色葡萄球菌48株、表皮葡萄球菌121株、溶血葡萄球菌114株,甲氧西林耐药率分别为29.2%、73.6%、和67.5%;万古霉素、呋喃妥因、复方磺胺对葡萄球菌具有较强的抗菌活性.结论凝固酶阴性葡萄球菌是临床主要病原菌,而且对常用抗感染药物比金黄色葡萄球菌更具耐药性,耐甲氧西林葡萄球菌的耐药性比甲氧西林敏感葡萄球菌明显增强.     

金黄色葡萄球菌医院感染分布及耐药性调查

目的调查医院临床分离的金黄色葡萄球菌的耐药性,为临床医生合理使用抗菌药物提供科学依据。方法对166株金黄色葡萄球菌的分布和耐药性进行调查分析,使用WHONET5.4软件进行数据的统计学分析。结果医院耐甲氧西林金黄色葡萄球菌分离率为62.0%;耐甲氧西林金黄色葡萄球菌(MRSA)对抗菌药物的耐药率均高于甲氧西林敏感金黄色葡萄球菌。未发现对万古霉素和利奈唑胺耐药的金黄色葡萄球菌株。结论加强金黄色葡萄球菌耐药性的监控工作,是预防医院感染的有效措施。     

县级医院分泌物中金黄色葡萄球菌的耐药性监测

目的通过对我院2014年临床送检分泌物培养分离出的金黄色葡萄球菌进行耐药性分析,旨在为基层医院临床医生诊断、治疗和预防金黄色葡萄球菌导致的感染提供依据。方法采用MIC方法检测金黄色葡萄球菌对临床常用抗菌药物的耐药性,用WHONET软件对其耐药性进行统计分析。结果 70株金黄色葡萄球菌对青霉素耐药率达98.1%,对红霉素、阿奇霉素和克拉霉素等大环内酯类耐药率均超过了75%,克林霉素耐药率为74.1%,复方新诺明为61.1%,对氟喹诺酮类如环丙沙星、左氧氟沙星和氨基糖苷类抗生素如庆大霉素的耐药率均10%,耐甲氧西林金黄色葡萄球菌(MRSA)检出率为16.7%,MRSA对上述药物的耐药率均高于甲氧西林敏感金黄色葡萄球菌(MSSA),未检出万古霉素耐药株。结论金黄色葡萄球菌特别是MRSA对临床常用抗生素都显示出了很高的耐药性,临床医生应根据耐药监测数据进行抗感染治疗。     

203株临床分离葡萄球菌耐药性分析

目的了解葡萄球菌属临床分离株的耐药情况,为临床抗感染治疗提供选药依据。方法用苯唑西林检测葡萄球菌临床分离株的敏感性,用纸片扩散法检测葡萄球菌属对四环素、红霉素、庆大霉素、氨苄青霉素、环丙沙星、头孢吡肟、复方新诺明、万古霉素、替考拉宁、利福平、克林霉素等抗菌药物的耐药结果。结果203株葡萄球菌中,共检出耐甲氧西林金黄色葡萄球菌（MRSA）73株（72．3％）,耐甲氧西林凝固酶阴性葡萄球菌63株（61．8％）。未发现万古霉素耐药菌株,耐甲氧西林的葡萄球菌对抗菌药物的耐药率显著高于对甲氧西林敏感的葡萄球菌。结论葡萄球菌对万古霉素全部敏感,万古霉素是临床治疗重症葡萄球菌感染的首选药物。加强对MRSA的检测和耐药性监测对指导临床合理使用抗菌药物具有重要意义。     

2002年临床常见细菌耐药性监测

目的　调查国家细菌耐药性监测网临床常见细菌对各种抗菌药物的耐药性现状。方法　药物敏感性试验采用纸片扩散法 ,耐药性数据分析采用WHONET5软件。结果　 2 0 0 2年国家细菌耐药性监测网 8个省、市、自治区的 5 7家三级甲等医院共收集患者首次分离株 4 0 379株 ;大肠埃希菌、绿脓假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌和表皮葡萄球菌是最常见菌 ;甲氧西林耐药金黄色葡萄球菌 (MRSA)和甲氧西林耐药的凝固酶阴性的葡萄球菌 (MRCNS)对临床常用抗菌药物的耐药率明显高于甲氧西林敏感金黄色葡萄球菌 (MSSA)和甲氧西林敏感的凝固酶阴性葡萄球菌(MSCNS) ;屎肠球菌对青霉素、氨苄西林及高浓度庆大霉素和链霉素的耐药率明显高于粪肠球 ;2 4 8%的肺炎链球菌对青霉素耐药 ;肠杆菌科细菌对亚胺培南和美洛培南的耐药率最低 ;产超广谱 β内酰胺酶 (ESBLs)的大肠埃希菌和肺炎克雷伯菌株的检出率分别为 18 2 %和 2 2 6 % ;除大肠埃希菌外 ,环丙沙星和左氧氟沙星对其他肠杆菌科细菌的耐药率均低于 30 % (0～ 2 9 7% ) ;绿脓假单胞菌对亚胺培南和美洛培南的耐药率分别为 19 1%和 15 2 % ,而鲍曼不动杆菌对碳青霉烯类抗生素较敏感。结论　细菌耐药性问题是抗感染治疗的主要威胁 ,合理使用抗菌药物以降低耐药性和采取     

153株金黄色葡萄球菌的分布及耐药性分析

目的分析近两年医院住院患者耐甲氧西林金黄色葡萄球菌（MRSA）分离株的临床分布及耐药性特点。方法2010年1月-2012年1月从临床标本中分离的153株金黄色葡萄球菌,进行分离鉴定及药敏试验。结果153椿金黄色葡萄球菌主要来自痰液,占66．O％;其次为伤口分泌物占17．O％。153株金黄色葡萄球菌中,检出耐甲氧西林金黄色葡萄球菌75株,检出率为49．O％。耐甲氧西林金黄色葡萄球菌对临床常用杭茼药物具有较高耐药性,其中对膏霉素、氨苄青霉素、苯唑青霉素、红霉素、氯林可霉素、四环素、庆大霉素和环丙沙星的耐药率均高于90％;对万古霉素的耐药率为0。结论临床分离的金黄色葡萄球茼对临床常用抗菌药物均有较高的耐药性,尤其MRSA对常用抗菌药物表现为多药耐药,应引起临床高度重视,合理使用抗生素。     

金黄色葡萄球菌耐药基因及致病毒素基因的相关性研究

目的研究携带TSST-1和PVL基因的金黄色葡萄球菌耐药特点、分布特征及与致病性的关系。方法临床收集74株金黄色葡萄球菌,采用PCR法检测TSST-1、PVL和mecA基因,纸片扩散法进行17种抗菌剂的耐药性检测。结果 74株金黄色葡萄球菌中mecA基因检出率为55.4%,其中22株检出PVL基因(30.3%),PVL阳性的耐甲氧西林金黄色葡萄球菌(MRSA)为15株(36.6%),甲氧西林敏感的金黄色葡萄球菌(MSSA)为7株(21.2%),两者间差异无统计学意义(P>0.05)。5株金黄色葡萄球菌中检出TSST-1基因(6.3%),均为MRSA。MRSA耐药性严重,并呈多重耐药性,携带基因PVL和TSST-1的MRSA除对万古霉素敏感外,对其他抗菌剂均耐药。结论携带基因TSST-1和PVL的金黄色葡萄球菌耐药性及致病力更强,增加了临床抗感染治疗的难度。     

耐甲氧西林金黄色葡萄球菌临床耐药性分析

目的 为预防和控制医院感染的发生,对耐甲氧西林金黄色葡萄球菌的临床分布和耐药性进行分析.方法 使用ATB细菌鉴定分析仪进行细菌鉴定,用纸片扩散法鉴定耐甲氧西林金黄色葡萄球菌,药敏试验用K-B法.结果 在各临床科室中,由耐甲氧西林金黄色葡萄球菌引起的医院感染,ICU的比例最高,下呼吸道是最常见的感染部位,52株耐甲氧西林金黄色葡萄球菌对多种抗菌药物耐药,没有发现耐万古霉素菌株.结论 由耐甲氧西林金黄色葡萄球菌引起的医院感染以ICU病人最多见,以下呼吸道感染为主,耐甲氧西林金黄色葡萄球菌除对万古霉素敏感外对多种抗菌药物耐药.因此,临床医生要合理使用抗菌药物.     

医院内感染葡萄球菌属耐药情况分析

目的了解葡萄球菌属细菌的耐药情况,为临床合理使用抗生素提供参考。方法对本院2004年1月至2007年6月住院患者各类标本分离到的葡萄球菌属做药敏试验和耐甲氧西林测定。结果共分离到葡萄球菌属656株,金黄色葡萄球菌241株,耐甲氧西林葡萄球菌检出率为49.8%;凝固酶阴性葡萄球菌415株,耐药凝固酶阴性葡萄球菌检出率为51.1%;主要分离自血液、痰液、脓及伤口分泌物及尿液标本;以儿科、重症监护室和肿瘤患者为主;60岁和13岁的患者居多。结论葡萄球菌属感染逐年增长,耐甲氧西林菌株检出率高,耐药性强,且呈多重耐药性,做好感染监测,合理使用抗感染药物,提高治愈率。     

葡萄球菌耐药性监测

目的 监测本院葡萄球菌属临床分离株的耐药性,为临床抗感染治疗提供依据.方法 用K-B法测定葡萄球菌属对8种常用抗生素的敏感性,进行D试验测定大环内酯、林可和B型链阳霉素耐药表型.结果 在85株葡萄球菌属中,耐甲氧西林金葡菌和耐甲氧西林凝固酶阴性葡萄球菌分别占12.2%和77.3%.未发现万古霉素耐药菌株,耐甲氧西林葡萄球菌对抗生素的耐药率显著高于甲氧西林敏感葡萄球菌.对红霉素耐药但对克林霉素敏感的葡萄球菌中,4株为诱导型克林霉素耐药.结论 应加强对葡萄球菌的耐药性监测,指导临床合理使用抗生素.     

147株金黄色葡萄球菌耐药现状分析

目的 研究金黄色葡萄球菌(SAU)临床分离株的耐药性,为合理使用抗菌药物提供依据.方法 采用VITEK 2 Compact型全自动微生物分析系统进行菌株鉴定和药敏试验,统计分析147株SAU的标本分布及耐药率.结果 分泌物标本SAU检出率最高;耐甲氧西林金黄色葡萄球菌(MRSA)分离率达40.1%(59/147).SAU对多种抗菌药物具有不同程度的耐药性,对呋喃妥因、利奈唑胺、奎努普汀/达福普汀、替加环素、万古霉素敏感率为100.0%.结论 SAU临床分离株耐药现状严重,MRSA的耐药情况更为严重,临床微生物实验室应加强MRSA监测工作.     

3968株常见病原菌耐药情况统计分析

目的：对我院临床微生物实验室2003年分离的3968株临床常见病原菌,进行耐药分析,为临床感染性疾病的抗菌药物选择提供实验室依据。方法：菌株经美国Dade公司MicroSean鉴定所得。药物敏感试验采用微量肉汤稀释法进行。结果：临床常见病原菌中,仍以革兰阴性杆菌占优势,前三位为大肠埃希菌、铜绿假单胞菌、鲍曼／溶血不动杆菌。8种病原菌对常用抗菌药物的耐药率均较高。阴沟肠杆菌,大肠埃希菌,对氨苄西林的耐药率均超过90%。革兰阴性杆菌,除嗜麦芽窄食单孢菌外,亚胺培南的耐药率最低,其次为阿米卡星。结果还表明,金黄色葡萄球菌的耐药率较表皮葡萄球菌低,金黄色葡萄球菌对苯唑西林的耐药率为57．17％;而表皮葡球菌对苯唑西林的耐药率为84．15％,二者均呈上升趋势,应引起临床高度重视。还可看出,金黄色葡萄球菌和表皮葡萄球菌对万古霉素的耐药率为0,我院尚未发现对万古霉素耐药的菌株。结论：临床常见病原菌中,仍以革兰阴性杆菌占优势,且耐药率较高。对革兰阴性杆菌,除嗜麦芽窄食单胞菌外,亚胺培南的耐药率最低。金黄色葡萄球菌的耐药率较表皮葡萄球菌低,我院尚未发现对万古霉素耐药的菌株。     

结核病患者医院获得性金黄色葡萄球菌感染110例耐药性分析

目的分析结核痛患者医院获得性感染金黄色葡萄球菌（Staphylococcus aureus）的耐药情况。方法收集我院住院肺结核、结核性胸膜炎、结核性脑膜炎患者痰、胸水、脓汁、血液标本110例,进行培养、鉴定,以Kirby—Baure（K—B）法进行药敏试验,依据美国临床实验室标准化委员会（CLSI）2007版标准进行判断,以头孢西丁（30μg／片）纸片扩散法筛选耐甲氧西林金黄色葡萄球菌（methicillin resistant Staphyloococcus sureus MRSA）。结果110例金黄色葡萄球菌中,耐甲氧西林金黄色葡萄球菌（MRSA）76株,检出率69．09％。所有分离菌株对万古霉索敏感、对青霉素耐药;阿奇霉素、红霉素、头孢西丁、克林霉素、妥布霉素、左氧氟沙星、庆大霉素、利福平、四环素、复方新诺明、阿米卡星、米诺环素的耐药率分别为85．71％、82．69％、69．09％、68．57％、65．63％、61．54％、56．00％、55．10％、48．78％、47．06％、35．90％、25．81％。耐甲氧西林金黄色葡萄球菌（MRSA）株耐药率明显高于甲氧西林敏感的金黄色葡萄球菌（MSSA）,差异有统计学意义。结论医院获得性感染金黄色葡萄球菌不容忽视,尤其是MRSA株,可同时对多种抗菌药物耐药,提示临床应该规范合理使用抗生素,加强耐药监测,发现MRSA株及时隔离,控制医源性感染。     

金黄色葡萄球菌临床监测与葡萄球菌A蛋白快速检验研究

目的分析临床金黄色葡萄球菌(SA)分布特征及耐药性,并建立可用于检测葡萄糖球菌A蛋白(SPA)的新方法。方法分析132株SA菌株的分布特征与耐药性。构建金属螯合免疫磁性微球,对其表面形态、大小、表面基团吸收峰进行测定,用该磁性微球分离SPA,并用于SA检测。结果 132株SA分离自痰液74株(占56.06%)、分泌物43株(占32.58%)、血液10株(占7.57%)、胆汁3株(占2.23%)、器械导管2株(占1.52%)。检出甲氧西林敏感SA(MSSA)61株(占46.21%),对青霉素G、左氧氟沙星、庆大霉素、克林霉素、红霉素的耐药率分别为93.12%、13.23%、23.12%、56.87%、54.23%;甲氧西林耐药SA(MRSA)71株(占53.79%),对青霉素G、复方磺胺甲噁唑、左氧氟沙星、庆大霉素、克林霉素的耐药率分别为92.12%、21.21%、61.21%、29.21%、76.23%。磁性微球分散性良好,对SA样品的检测灵敏度可达100CFU,在一定条件下可维持高活性3周。结论 SA菌株耐药性较强;免疫磁性微球技术可用于SA的快速检测,值得推广应用。     

Responses of tolerant and nontolerant Staphylococcus aureus strains to methicillin treatment in an experimental infection in mice.

Staphylococcus aureus strains can be divided into tolerant and nontolerant strains on the basis of their survival in vitro in the presence of high concentrations of methicillin (greater than or equal to 64 micrograms/ml). A strain is defined as tolerant if more than 2% of the inoculum survives under these conditions. The response of five susceptible and five tolerant S. aureus strains to treatment with methicillin was studied in an experimental thigh infection in mice. Animals were treated with one and two injections of methicillin (2.5 mg per mouse). At the end of treatment, the number of CFUs in the thigh muscles infected with the susceptible strains was found to be significantly lower than that in the thigh muscles infected with the tolerant     

Mathematical modeling of antimicrobial susceptibility data of Staphylococcus haemolyticus for 11 antimicrobial agents, including three experimental glycopeptides and an experimental lipoglycopeptide.

Antimicrobial MIC data were obtained for 96 strains of Staphylococcus haemolyticus and the following 11 antimicrobial agents: methicillin, gentamicin, rifampin, fusidic acid, ciprofloxacin, vancomycin, teicoplanin; three experimental glycopeptides, MDL 62,873, MDL 62,208, and MDL 62,224; and an experimental lipoglycopeptide, ramoplanin. Resistance to methicillin and gentamicin was present in over 50% of the strains, although resistance to the other agents was present in less than 10%. It is shown how application of mathematical modeling techniques can add to the understanding of such MIC data. MICs of methicillin and gentamicin were highly correlated, suggesting that evolutionary pressures for development of resistance to these agents were similar. The structural relationships among the glycopeptides were accurately reflected in their spatial relationships within the model. MICs of ramoplanin were negatively correlated with MICs of some other antimicrobial agents, particularly gentamicin, suggesting that this agent is more active against gentamicin-resistant strains. Methicillin-resistant strains were more tightly clustered than were methicillin-susceptible strains, suggesting that methicillin-resistant strains were more closely related to each other than were methicillin-susceptible strains. Mathematical modeling techniques enable more detailed analysis of MIC data.     

Evaluation of antibacterial sensitivity testing methods for methicillin-resistant Staphylococcus aureus in a dermatology outpatient population

Over a period of one year, 1986-1987, 116 strains of Staphylococcus aureus were isolated from patients attending two outpatient dermatology clinics in Houston, Texas. The purpose of this study was to evaluate the adequacy of routine antibiotic sensitivity testing methods for detecting methicillin-resistant Staphylococcus aureus (MRSA). The Kirby-Bauer disk diffusion method was compared with a commercially available screening medium containing 6 micrograms/ml of oxacillin and 4% NaCl. The minimal inhibitory concentration (MIC) of methicillin, oxacillin, and oxacillin with 4% NaCl to S aureus using the agar dilution method was also determined. Approximately 90% of S aureus strains produced beta-lactamase and were resistant to penicillin and ampicillin. By disk diffusion, no strains were resistant to methicillin, though diameters of zones of inhibition were between 10 and 14 mm in seven strains. All strains proved to be sensitive to methicillin by MIC determinations and on the oxacillin-NaCl screening medium. The MIC of methicillin was 2.5 micrograms/ml for the majority of strains of S aureus, between 0.16 and 0.31 microgram/ml for oxacillin, and 0.08 to 0.16 microgram for oxacillin with 4% NaCl. We concluded that the incidence of MRSA in an outpatient dermatology population is low, and a combination of disk diffusion and oxacillin-NaCl screening is adequate for testing sensitivity.     

县级医院临床感染212例金黄色葡萄球菌分布及耐药性分析

目的分析县级医院临床感染的212例金黄色葡萄球菌的分布及耐药情况,为临床合理使用抗菌药物提供依据。方法通过微生物分析系统进行鉴定和药敏试验,统计分析212例金黄色葡萄球菌的分布及耐药率。结果212株金黄色葡萄球菌主要来源于伤口分泌物、痰、脓液等。其中耐甲氧西林金黄色葡萄球菌（MRSA）138株（占65.09%）,检出的MRSA除对万古霉素、替考拉宁和呋喃妥因敏感外,对其他抗菌药物耐药率均大于60.0%。结论MRSA对多种抗菌药物耐药率较高,许多MRSA菌株为多重耐药菌,医院应加强对MRSA监测,以便合理使用抗菌药物。     

Commercially available technique for rapid laboratory detection of methicillin resistance among Staphylococcus aureus

The MRS test is a commercially available test for detection of methicillin resistance among Staphylococcus aureus (MRSA), which was compared to standard techniques for efficacy and speed. Among 119 S. aureus strains tested (71 resistant to methicillin), it detected 90% of MRSA strains in 4 hr. The MRS test may have a role as a rapid screening test for MRSA in selected situations.     

Staphylococcus saprophyticus beta-lactamase production and disk diffusion susceptibility testing for three beta-lactam antimicrobial agents.

beta-Lactamase production and MIC determinations for penicillin, methicillin, and cephalothin were assessed for 67 strains of Staphylococcus saprophyticus and correlated with results of disk diffusion susceptibility testing. Fifty-five (82%) of the 67 strains produced beta-lactamase, and 40 (77%) of these beta-lactamase-producing strains were susceptible (zone size, greater than 29 mm) by disk diffusion techniques. Although the range of zone sizes for beta-lactamase producers was broad (26 to 36 mm), all 38 strains with a zone size of less than 31 mm by disk diffusion testing were beta-lactamase producers compared with 17 (59%) of 29 with larger zone sizes (P = 0.0000008). The median penicillin MIC for 12 S. saprophyticus strains was 0.25 micrograms/ml and was not related to beta-lactamase production. Although the methicillin MICs for 15 strains were in the susceptible range (4.0 micrograms/ml), interpretation of disk diffusion testing for oxacillin varied greatly among laboratories using identically prepared media and standardized techniques. Criteria presently used to define susceptibility of Staphylococcus aureus to penicillin and oxacillin by disk diffusion are inappropriate for S. saprophyticus. The clinical significance of the beta-lactamase produced by these strains needs further evaluation.