骨科创伤医院感染革兰阳性球菌的分布及药敏结果

目的 探讨湖北地区3所医院骨科创伤医院感染革兰阳性球菌的菌种分布及对抗菌药物的耐药率,为临床医师控制医院感染选择使用抗菌药物提供实验室依据.方法 感染性标本采集、运送和革兰阳性球菌分离培养严格遵照《全国临床检验操作规程》规则操作；革兰阳性球菌鉴定采用法国生物梅里埃公司生产的VITEK-2 Compact分析仪和配套鉴定卡；药敏监测采用KB法标准.结果 感染性标本中培养出249株革兰阳性球菌,检出前3位的为金黄色葡萄球菌、凝固酶阴性葡萄球菌及粪肠球菌,分别占34.1％ 、25.3％及14.1％；革兰阳性球菌对临床常用抗菌药物的耐药率出现不同程度的上升趋势,但检出的所有革兰阳性球菌对糖肽类抗菌药物100.0％的敏感,未发现糖肽类耐药菌株.结论 骨科创伤医院感染革兰阳性球菌的耐药性已十分严重,大型综合医院应强化抗菌药物的管理工作,预防与控制多药耐药革兰阳性球菌医院感染发生与暴发流行.

Gram-positive cocci causing nosocomial infections in orthopedic trauma patients:antibiotic susceptibility and control measures

OBJECTIVE To approach the distribution and antibiotic susceptibility of gram-positive cocci(GPC) causing nosocomial infections isolated from orthopedic patients in 3 hospitals in Hubei and so as to offer the experimental evidence for clinical use of antibiotics.METHODS Reffering to National Guide to Clinical Laboratory Procedures,the collection and delivery of infectious specimens and the bacterial isolation and culture were performed.The VITEK compact 2 system(France,BioMerieux) and identification cards were used to identify the gram-positive cocci.The drug susceptibility testing was performed by KB methods recommended by CLSI.RESULTS Totally 249 strains of gram-positive cocci were isolated from the infectious specimens;the top 3 bacteria with the highest positive rates were Staphylococcus aureus(34.1%),coagulase-negative Staphylococci(25.3%),and Enterococcus faecalis(14.1%);the drug resistance of gram-positive cocci to commonly used antibiotics showed increasing tendency in varying degree,however,all gram-positive cocci isolated were 100.0% susceptible to carbapenem antibiotics,and no glycopeptide-resistant strains were found.CONCLUSION The antimicrobial resistance of gram-positive cocci causing nosocomial infections in orthopedic trauma patients has been distinctly serious;the large-scale general hospitals should strengthen the management of antibiotics so as to prevent and control the outbreak and prevalence of nosocomial infections caused by multidrug-resistant gram-positive cocci.