2011—2015年四川省金黄色葡萄球菌对万古霉素及利奈唑胺耐药性变迁

目的了解四川省金黄色葡萄球菌对万古霉素、利奈唑胺耐药情况，为临床抗感染治疗提供参考依据。方法收集四川省71所医院2011-2015年临床分离的金黄色葡萄球菌、耐甲氧西林金黄色葡萄球菌（MRSA），并计算每年万古霉素与利奈唑胺对金黄色葡萄球菌、MRSA的最低抑菌浓度（MIC）值。结果5年共收集51 976株金黄色葡萄球菌，包括MRSA 14 361株，MRSA检出率由2011年的36.02%下降至2015年的25.56%，呈下降趋势(χ2=160.72，P＜0.05）。2011-2015年万古霉素对金黄色葡萄球菌的MIC50值分别为：1、0.5、0.5、1、1 μg/mL，MIC90值由1 μg/mL上升至2 μg/mL；利奈唑胺MIC50值均为2 μg/mL，MIC90值由2 μg/mL上升至4 μg/mL。2011-2015年万古霉素对MRSA的MIC50、MIC90值变化较明显，分别由0.5、1 μg/mL上升至2 μg/mL；利奈唑胺MIC50值均为2 μg/mL，MIC90值由2 μg/mL上升至4 μg/mL。结论MRSA的检出率有下降趋势，但万古霉素、利奈唑胺对其MIC50及MIC90值总体有上升趋势，需继续加强细菌耐药监测，为临床合理应用抗菌药物提供帮助。

Changes in resistance of Staphylococcus aureus to vancomycin and linezolid in Sichuan Province in 2011-2015

ObjectiveTo investigate the resistance of Staphylococcus aureus (S. aureus) to vancomycin and linezolid in Sichuan Province, and provide reference for clinical anti infection treatment. MethodsS. aureus and methicillin resistant S. aureus(MRSA) from 71 hospitals in Sichuan Province in 2011-2015 were collected, minimum inhibitory concentration（MIC） values of vancomycin and linezolid against S. aureus and MRSA in each year were calculated. ResultsA total of 51 976 strains of S. aureus were collected in 5 years, 14 361 of which were MRSA, isolation rate of MRSA decreased from 36.02% in 2011 to 25.56% in 2015, which showed a downward trend (χ2=160.72，P＜0.05）. From 2011 to 2015, MIC50 of vancomycin against S. aureus were 1, 0.5, 0.5, 1, and 1μg/mL respectively，MIC90 increased from 1μg/mL to 2μg/mL；the mean MIC50 of linezolid was 2μg/mL，MIC90 increased from 2μg/mL to 4μg/mL. Change in MIC50 and MIC90 of vancomycin against MRSA in 2011-2015 were obvious, which increased from 0.5, 1μg/mL to 2μg/mL respectively；the mean MIC50 of linezolid was 2μg/mL，MIC90 increased from 2μg/mL to 4μg/mL. ConclusionThe isolates rate of MRSA had a decreasing trend，but there is a upward trend of MIC50 and MIC90 of vancomycin and linezolid against MRSA, bacterial resistance surveillance needs to be strengthened to provide evidence for rational clinical antimicrobial therapy.