中华检验医学杂志
中華檢驗醫學雜誌
중화검험의학잡지
CHINESE JOURNAL OF LABORATORY MEDICINE
2008年
6期
635-642
,共8页
孙宏莉%王辉%陈民钧%孙自镛%俞云松%胡必杰%褚云卓%卓建生%廖康%徐英春%谢秀丽
孫宏莉%王輝%陳民鈞%孫自鏞%俞雲鬆%鬍必傑%褚雲卓%卓建生%廖康%徐英春%謝秀麗
손굉리%왕휘%진민균%손자용%유운송%호필걸%저운탁%탁건생%료강%서영춘%사수려
革兰阳性球菌%抗药性,细菌%药物监测%微生物敏感性试验%医院,教学
革蘭暘性毬菌%抗藥性,細菌%藥物鑑測%微生物敏感性試驗%醫院,教學
혁란양성구균%항약성,세균%약물감측%미생물민감성시험%의원,교학
gram-Positive cocci%Drug resistance,bacterial%Drug monitoring%Microbial sensitivity tests%Hospitals,teaching
目的 调查2006年我国革兰阳性球菌的耐药性.方法 收集2006年6-12月全国7家教学医院分离的非重复革兰阳件菌674株,以琼脂稀释法测定抗菌药物的MIC.结果 100株肺炎链球菌中,青霉素耐药的肺炎链球菌(PRSP)和青霉素中介的肺炎链球菌(PISP)分别占1%和19%.所有肺炎链球菌均对万古霉素和替考拉宁高度敏感;对左氧氟沙星和莫西沙星的敏感率分别为97%和98%;对阿莫西林/克拉维酸、头孢曲松和氯霉素的敏感率依次为96%、87%和73%;青霉素敏感的肺炎链球菌(PSSP)全部对头孢丙烯和头孢克罗的敏感率分别为62.0%和55.7%,而PISP和PRSP对这2种抗菌药物均耐药;所有肺炎链球菌埘大环内酯类、甲氧苄啶/磺胺甲恶(噁)唑(TMPCo)和四环素的敏感率均小于35%.金黄色葡萄球菌和凝固酶阴性葡萄球菌(SCON)中耐甲氧西林菌株分别占48%(33%～84%)和81%(69%～94%).耐甲氧西林金黄色葡萄球菌(MRSA)对TMPCo、氯霉素和利福平敏感率分别为72%、66%和45%;对大环内脂类、氨基糖苷类、四环素和氟喹诺酮类的敏感率低于18%.粪肠球菌和屎肠球菌对高浓度庆大霉素耐药率分别为56%(30%～86%)和80%(50%～100%).未发现对万古霉素和替考拉宁耐药的葡萄球菌和粪肠球菌;但在杭州发现对该2种抗菌药物同时耐药的屎肠球菌.除氯霉素和四环素外,粪肠球菌对其他所测抗菌药物的敏感率均高于屎肠球菌.结论 各地区革兰阳件耐药性有所差异,且对大部分抗菌药物的耐药率较2005年本项目的 监测结果有所升高.替考拉宁和万古霉素对革兰阳性球菌仍保持很高的抗菌活性.
目的 調查2006年我國革蘭暘性毬菌的耐藥性.方法 收集2006年6-12月全國7傢教學醫院分離的非重複革蘭暘件菌674株,以瓊脂稀釋法測定抗菌藥物的MIC.結果 100株肺炎鏈毬菌中,青黴素耐藥的肺炎鏈毬菌(PRSP)和青黴素中介的肺炎鏈毬菌(PISP)分彆佔1%和19%.所有肺炎鏈毬菌均對萬古黴素和替攷拉寧高度敏感;對左氧氟沙星和莫西沙星的敏感率分彆為97%和98%;對阿莫西林/剋拉維痠、頭孢麯鬆和氯黴素的敏感率依次為96%、87%和73%;青黴素敏感的肺炎鏈毬菌(PSSP)全部對頭孢丙烯和頭孢剋囉的敏感率分彆為62.0%和55.7%,而PISP和PRSP對這2種抗菌藥物均耐藥;所有肺炎鏈毬菌塒大環內酯類、甲氧芐啶/磺胺甲噁(噁)唑(TMPCo)和四環素的敏感率均小于35%.金黃色葡萄毬菌和凝固酶陰性葡萄毬菌(SCON)中耐甲氧西林菌株分彆佔48%(33%～84%)和81%(69%～94%).耐甲氧西林金黃色葡萄毬菌(MRSA)對TMPCo、氯黴素和利福平敏感率分彆為72%、66%和45%;對大環內脂類、氨基糖苷類、四環素和氟喹諾酮類的敏感率低于18%.糞腸毬菌和屎腸毬菌對高濃度慶大黴素耐藥率分彆為56%(30%～86%)和80%(50%～100%).未髮現對萬古黴素和替攷拉寧耐藥的葡萄毬菌和糞腸毬菌;但在杭州髮現對該2種抗菌藥物同時耐藥的屎腸毬菌.除氯黴素和四環素外,糞腸毬菌對其他所測抗菌藥物的敏感率均高于屎腸毬菌.結論 各地區革蘭暘件耐藥性有所差異,且對大部分抗菌藥物的耐藥率較2005年本項目的 鑑測結果有所升高.替攷拉寧和萬古黴素對革蘭暘性毬菌仍保持很高的抗菌活性.
목적 조사2006년아국혁란양성구균적내약성.방법 수집2006년6-12월전국7가교학의원분리적비중복혁란양건균674주,이경지희석법측정항균약물적MIC.결과 100주폐염련구균중,청매소내약적폐염련구균(PRSP)화청매소중개적폐염련구균(PISP)분별점1%화19%.소유폐염련구균균대만고매소화체고랍저고도민감;대좌양불사성화막서사성적민감솔분별위97%화98%;대아막서림/극랍유산、두포곡송화록매소적민감솔의차위96%、87%화73%;청매소민감적폐염련구균(PSSP)전부대두포병희화두포극라적민감솔분별위62.0%화55.7%,이PISP화PRSP대저2충항균약물균내약;소유폐염련구균시대배내지류、갑양변정/광알갑악(오)서(TMPCo)화사배소적민감솔균소우35%.금황색포도구균화응고매음성포도구균(SCON)중내갑양서림균주분별점48%(33%～84%)화81%(69%～94%).내갑양서림금황색포도구균(MRSA)대TMPCo、록매소화리복평민감솔분별위72%、66%화45%;대대배내지류、안기당감류、사배소화불규낙동류적민감솔저우18%.분장구균화시장구균대고농도경대매소내약솔분별위56%(30%～86%)화80%(50%～100%).미발현대만고매소화체고랍저내약적포도구균화분장구균;단재항주발현대해2충항균약물동시내약적시장구균.제록매소화사배소외,분장구균대기타소측항균약물적민감솔균고우시장구균.결론 각지구혁란양건내약성유소차이,차대대부분항균약물적내약솔교2005년본항목적 감측결과유소승고.체고랍저화만고매소대혁란양성구균잉보지흔고적항균활성.
Objective To investigate antimicrobial resistance among gram-positive cocci in China in 2006.Methods From Jun 2006 to Dec 2006,674 consecutive and non-repetitive gram-positive bacteria were collected from 7 teaching hospitals.The minimal inhibitory concentration(MICs)of antibacterial agents were determined by agar dilution method.Results The prevalence of penicillin.resistant(ease)and pemcllhn. intermediate S.pneumoniae(PISP)among 100 isolates was l%and 19%,respectively.Teicoplanin and vancomycin were the most active agents against S.pneumoniae.97% and 98% S.pneumoniae isolates were susceptible to levofloxacin and moxifloxacin,respectively.The susceptibility of amoxicillin/clavulanic acid, ceftriaxone and chloramphenicol are 96%,87% and 73%,respectively.The susceptible rates of penicillin. susceptible S.pneumoniae(PSSP)to cefprozil and cefaclor were 62% and 55.7%,respectively.All the PISP and PRSP isolates were resistance to the two antibiotics.The susceptibility to macrolides,trimethoprim/ sulfamethoxazole and tetracycline was lower than 35%.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA)and methicillin.resistant coagulase-negative Staphylococci(MRSCON)was 48%(33%-84%)and 81%(69%-94%),respectively.The susceptible rates of MRSA to trimethoprim/ sulfamethoxazole,chloramphenicol,rifampin,and the other antibiotics in this study were 72%,66%and 45%,respectively.The susceptible rate of MRSA to marcrolides,aminoglycosides,tetracyclines and quinolones were not more than 18%.56%(30%-86%)of E.faecalis and 80%(50%.100%)of E.faecium were highly resistant to gentamicin.The susceptibility of E.faecalis to all the antibiotics except chloramphenicol and tetracycline were higher than E.faecium.All isolates of S.aureus,CoNS and E.faecalis tested were susceptible to vacomycin and teicoplanin.There were two vacomycin.resistant E.faecium strains isolated from Hangzhou.Conclusions Antimicrobial resistance patterns of gram.positive cocci differed in different regions.The resistance of gram-positive cocci to the antibiotics in this study this year was a little higher than the data of the year of 2005.Teicoplanin and vancomycin remained very high activity to gram-positive cocci.
