儿童血培养标本中凝固酶阴性葡萄球菌的 分布及耐药性分析

摘要:目的　了解儿童血培养标本中凝固酶阴性葡萄球菌（Coagulase-Negative Staphylococcus，CNS）的分布及耐药性，为临床合理应用抗菌药物提供实验室依据。方法　收集2012年1月-2013年12月住院患儿血培养标本分离出CNS，对其进行菌株鉴定与药物敏感性测定，使用WHONET 5.4 软件进行数据统计分析。结果　2012-2013年儿童血培养标本共检出CNS 501株，分离率居前5位的依次是表皮葡萄球菌（46.99%、47.22%）、溶血葡萄球菌（23.69%、25.40%）、人葡萄球菌（19.68%、19.84%）、头状葡萄球菌（2.81%、1.98%）和沃氏葡萄球菌（4.42%、3.97%）。耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）检出率为67.35%～89.83%。CNS对青霉素耐药率为87.76％～94.96%，对红霉素耐药率为76.07％～95.31%；对莫西沙星、庆大霉素、利福平、四环素和呋喃妥因耐药率均低于30%，未发现利奈唑胺耐药株，检出对万古霉素耐药的表皮葡萄球菌和人葡萄球菌各1株。结论　儿童血培养标本中MRCNS检出率高，已发现耐万古霉素的CNS，应该继续重点监测。

Distribution and drug resistance of coagulase-negative staphylococcus isolated from children with positive blood culture

Abstract: Objective To investigate the distribution and drug resistance of coagulase -negative staphylococcus isolated from children with positive blood culture so as to provide laboratory evidence for rational use of antibacterial drugs. Methods Retrospective analysis was conducted from all the coagulase- negative staphylococcus isolated from Children with positive Blood culture from Jan. 2012 to Dec. 2013, and the strains were identified and the antibiotic tested. The data were analyzed with WHONET 5.4. Results A total of 501 strains of CNS were isolated from isolated from Children with positive Blood culture. The top five species with high isolation rate were staphylococcus epidermi dis (46.99%, 47.22%), staphylococcus haemolyticus (23.69%, 25.40%), staphylococcus hominis (19.68%, 19.84%), staphylococcus capitis (2.81%, 1.98%) and staphylococcus warneri (2.41%, 1.59%). The detection rate of Methicillin resistant CNS varied between 67.35% and 89.83%. The resistance rates of CNS to penicillin and erythromycin varied between 87.76% and 94.96%, 76.07% and 95.31%, respectively. While the resistance rate of CNS to moxifloxacin, gentamicin, tetracycline, rifampicin and nitrofurantoin was less than 30.00%. No linezolid resistant isolate was found. A vancomycin resistant strain was found in both staphylococcus epidermidis and staphylococcus hominis. Conclusion The detection rate of MRCNS is high and more attention should be paid to the vancomycin resistant strain in CNS.