凝固酶阴性葡萄球菌医院感染180例临床分析

目的　探讨我院凝固酶阴性葡萄球菌 (CNS)医院感染的临床分布及耐药现状。方法　回顾分析近 3年(1998～ 2 0 0 0年 ) 180例CNS医院感染者临床及耐药情况 ,并与前 3年 (1995～ 1997年 )感染状况比较。结果　近3年医院感染中葡萄球菌分离率占医院感染总分离菌株的 30 8% ,较明显增高 (P <0 0 5 % ) ,其中CNS占17 92 % ,显著高于前 3年的 6 2 2 % (P <0 0 1) ;感染者多有严重的基础疾病 ,细菌分离数较多的依次为尿、烧伤创面和痰 ;CNS对多种抗菌药物耐药 ,对万古霉素敏感 ,对利福霉素、复方新诺明、环丙沙星 (除溶血葡萄球菌外 )耐药率相对较低。结论　近年医院感染中CNS分离率显著增高 ,感染部位广泛 ,CNS菌株对多种抗菌药物耐药。

Hospital-acquired Infections due to Coagulase-negative Staphylococci:A Clinical Analysis of 180 Cases

OBJECTIVE To determine the clinical distribution and antimicrobial resistance of coagulase-negative staphylococci(CNS) isolated from hospital-acquired infections in our hospital. METHODS A total of 180 cases with hospital-acquired CNS infections in recent three years(1998-2000) were retrospectively studied and the CNS isolation rate was compared with that of former three years(1995-1997). RESULTS Of 1 044 hospital-acquired isolates, staphylococci accounted for 30.8%,CNS for 17.92%, both higher than those in former three years (P<0.05 and P<0.01 , respectively). Most CNS infected cases had serious underlying diseases and most CNS strains were isolated from samples of urine (87 strains) , burn wounds(56 strains) and sputum(26 strains). The CNS strains were resistant to multiple antibiotics but sensitive to vancomycin. The drug-resistant rate of CNS (except S.haemolyticus ) to rifampicin, trimethoprim/sulfamethoxazole and ciprofloxacin was relatively lower. CONCLUSIONS The result indicated that isolation rate of CNS in hospital-acquired infections is higher in recent years than in the past. CNS can cause infections of many sites and show multi-drug resistance.