溶血葡萄球菌临床分布及耐药性分析

目的 了解临床标本中溶血葡萄球菌(SHA)分布及对20种抗生素的耐药性和敏感性,指导临床合理治疗SHA感染。方法 常规培养分离细菌,用美国BD Phoenix-100全自动微生物鉴定及药敏仪进行鉴定菌种和药敏试验,药敏试验全部使用该仪器的微量肉汤稀释法,按美国CLSI2015^[1]规定标准执行。结果 162株SHA从年龄段的分布看,1岁以下的幼儿占比最高,占比为30.9%; 从科室分布看,主要分布在儿科(30.9%)、重症医学科(22.2%)、内科(17.3%)、外科(12.3%); 从标本类型分布看,主要分布在血液(33.3%)、痰液(25.9%)、伤口(11.1%)、分泌物(9.9%)。在162株SHA中甲氧西林耐药溶血葡萄球菌(MRSH)占比为93.8%,其中152株MRSH中多重耐药(MDR)发生率高达61.8%, MRSH比甲氧西林敏感溶血葡萄球菌(MSSH)的抗生素耐药率明显偏高,前者对氨苄西林、头孢西丁、青霉素G、红霉素的耐药率极高,都超过了98.7%; 两者对利奈唑胺、万古霉素、阿米卡星的敏感率均为100%,对夫西地酸、替考拉宁、呋喃妥因的敏感率也很高,都超过了95.5%。结论 利奈唑胺、万古霉素、阿米卡星、夫西地酸、替考拉宁及呋喃妥因均可作为SHA感染的经验用药,除此外其他抗生素选用要参照药敏试验进行。

Clinical Distribution and Antibiotic ResistanceAnalysis of Staphylococcus Haemolyticus

Objective To understand clinical specimen hemolysis Staphylococcus(SHA)distribution characteristics and resistance and sensitivity to 20 kinds of antibiotics,reasonable to guide the clinical treatmentof SHA infection.Methods Routinely cultured and isolated bacteria.Used the United States BD Phoenix-100 automated microbial identification and susceptibility instrument to identify bacteria and susceptibility testing,and susceptibility testing all used the instrument broth dilution method,according to the USA CLSI2015 ^[1] regulations standards.Results162 strains of SHA from the distribution of age,children under theage was one of the highest(30.9%),and from the distribution department,mainly distributed in pediatrics(30.9%),department of critical care medicine(22.2%),medicine(17.3%),surgery(12.3%).From the specimen type distribution,were mainly distributed in the blood(33.3%),sputum(25.9%),wound(11.1%)and discharge(9.9%).In the 162 strains of SHA,the proportion of the MRSH was 93.8%,of which 152 strains of MRSH incidence of multiple drug resistance(MDR)was as high as 61.8%.Compared with MSSH,antibiotic resistance rate of MRSH was significantly higher.The resistance rate of MRSH to ampicillin,cefoxitin,penicillin G,erythromycin was extremely high,more than 98.7% the former ofcefoxitin,penicillin G,ampicillin,erythromycin resistance was extremely high,more than 98.7%.The sensitive rate of both to rina thiazole amine,vancomycin,amikacin was 100%,and the rate to Fusidic acid,teicoplanin,nitrofurantoinwas also high,more than 95.5%.Conclusion Linezolid,Vancomycin,Amikacin,Fusidic acid,Teicoplanin and Nitrofurantoin because all can be used as empiricaluse of SHA infection,other antibiotics chooses to in addition to drug sensitivity tests results.