革兰阳性球菌1914株耐药性监测

目的：了解上海地区临床分离革兰阳性球菌对常用抗菌药物的敏感性。方法：Kirby-Bauer法检测2002年3—5月上海10所医院1914株临床分离革兰阳性球菌对20种抗菌药物的耐药性，并采用微量稀释法、琼脂平板稀释法和E试验对部分菌株进行万古霉素和替考拉宁的最低抑菌浓度(MIC)测定。结果：替考拉宁和万古霉素抗菌活性最强，只有2株细菌(1株溶血葡萄球菌和1株华纳葡萄球菌)对替考拉宁中介(E试验)。无替考拉宁和万古霉素耐药株(稀释法)。结论：替考拉宁和万古霉素对革兰阳性球菌的抗菌活性最强，两的抗菌活性相似。临床微生物实验室在遇到K-B法结果为替考拉宁和万古霉素中介或耐药时，必须采用稀释法或E试验以确证其是否耐药。

Surveillance of bacterial resistance in Gram-positive cocci

Objective: To investigate the susceptibility of clinical isolates of Gram-positive cocci in Shanghai hospitals. Methods : Bacterial susceptibility testing was carried out on 1 914 strains of Gram-positive cocci isolated from ten hospitals in Shanghai from March to May 2002 using Kirby-Bauey methods. 20 different types of antibiotic disks including teicoplanin and vancomycin were used. MICs of vancomycin and teicoplanin were determined on some of the strains by microdilution, agar dilution and E test methods. Results:Both teicoplanin and vancomycin were the most active agents against Gram-positive cocci, only one strain of Staphylococcus haemolyticus and S. warneri respectively were found to be intermediate susceptible to teicoplanin by E test, no strains resistant to teicoplanin and vancomycin were found by dilution methods. Conclusions: Both teicoplanin and vancomycin are the most active agents against Gram-positive cocci. Strains nonsusceptible to teicoplanin or vancomycin determined by Kirby-Bauer method should be confirmed by E test or dilution methods.