中华微生物学和免疫学杂志
中華微生物學和免疫學雜誌
중화미생물학화면역학잡지
CHINESE JOURNAL OF MICROBIOLOGY AND IMMUNOLOGY
2009年
5期
468-471
,共4页
刘颖梅%曹彬%王清涛%杜小玲%曲寿山%栗方%黎斌斌%王珊珊%杨春霞%郭萍%王春雷
劉穎梅%曹彬%王清濤%杜小玲%麯壽山%慄方%黎斌斌%王珊珊%楊春霞%郭萍%王春雷
류영매%조빈%왕청도%두소령%곡수산%률방%려빈빈%왕산산%양춘하%곽평%왕춘뢰
革兰阳性球菌%耐药监测%抗菌药物%耐万占霉素肠球菌
革蘭暘性毬菌%耐藥鑑測%抗菌藥物%耐萬佔黴素腸毬菌
혁란양성구균%내약감측%항균약물%내만점매소장구균
Gram-positive cocci%Resistance surveillance%Antimicrobial agent%Vancomycin-re-sistant Enterococci
目的 探讨北京朝阳医院1999-2006年临床分离的革兰阳性球菌的耐药变迁,以指导临床合理使用抗菌药物.方法 采用MIC法进行抗菌药物敏感性试验,以WHONET5.3软件分析数据.结果 6192株临床分离的革兰阳性球菌中,前4位病原菌依次为凝同酶阴性葡萄球菌、金黄葡萄球菌、粪肠球菌、屎肠球菌.耐甲氧西林金黄葡萄球菌(MRSA)、耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)平均检出率分别为88.4%、86.9%,金黄葡萄球菌对青霉素、氨苄西林耐药率最高,8年间始终保持在90.0%以上.未发现对万古霉素耐药或中介的金黄葡萄球菌或凝固酶阴性葡萄球菌.2003年首次分离耐万古霉素肠球菌(VRE),至2006年共发现30株VRE,其中13株为耐万古霉索粪肠球菌,均为VanB基因型;17株为耐万古霉素屎肠球菌,均为VanA基因型,耐万古霉素屎肠球菌分离率呈上升趋势.对于粪肠球菌活性最高的是万古霉素、氨苄西林、青霉素,敏感率分别为98.7%、95.7%、85.6%.但是青霉素敏感性略有下降,从94.3%降至84.6%.克林霉素的耐药率8年中始终维持在99.0%以上.屎肠球菌对红霉素、克林霉素的耐药率均达95.0%以上,对青霉素、氨苄西林、环丙沙星的耐药率均大于90.0%.屎肠球菌最为敏感的药物是万古霉素,对四环素敏感性出现上升的趋势,从27.8%升到82.6%.结论 万古霉素对临床常见的革兰阳性菌保持很高的活性,发现30株耐万古霉素的肠球菌.
目的 探討北京朝暘醫院1999-2006年臨床分離的革蘭暘性毬菌的耐藥變遷,以指導臨床閤理使用抗菌藥物.方法 採用MIC法進行抗菌藥物敏感性試驗,以WHONET5.3軟件分析數據.結果 6192株臨床分離的革蘭暘性毬菌中,前4位病原菌依次為凝同酶陰性葡萄毬菌、金黃葡萄毬菌、糞腸毬菌、屎腸毬菌.耐甲氧西林金黃葡萄毬菌(MRSA)、耐甲氧西林凝固酶陰性葡萄毬菌(MRCNS)平均檢齣率分彆為88.4%、86.9%,金黃葡萄毬菌對青黴素、氨芐西林耐藥率最高,8年間始終保持在90.0%以上.未髮現對萬古黴素耐藥或中介的金黃葡萄毬菌或凝固酶陰性葡萄毬菌.2003年首次分離耐萬古黴素腸毬菌(VRE),至2006年共髮現30株VRE,其中13株為耐萬古黴索糞腸毬菌,均為VanB基因型;17株為耐萬古黴素屎腸毬菌,均為VanA基因型,耐萬古黴素屎腸毬菌分離率呈上升趨勢.對于糞腸毬菌活性最高的是萬古黴素、氨芐西林、青黴素,敏感率分彆為98.7%、95.7%、85.6%.但是青黴素敏感性略有下降,從94.3%降至84.6%.剋林黴素的耐藥率8年中始終維持在99.0%以上.屎腸毬菌對紅黴素、剋林黴素的耐藥率均達95.0%以上,對青黴素、氨芐西林、環丙沙星的耐藥率均大于90.0%.屎腸毬菌最為敏感的藥物是萬古黴素,對四環素敏感性齣現上升的趨勢,從27.8%升到82.6%.結論 萬古黴素對臨床常見的革蘭暘性菌保持很高的活性,髮現30株耐萬古黴素的腸毬菌.
목적 탐토북경조양의원1999-2006년림상분리적혁란양성구균적내약변천,이지도림상합리사용항균약물.방법 채용MIC법진행항균약물민감성시험,이WHONET5.3연건분석수거.결과 6192주림상분리적혁란양성구균중,전4위병원균의차위응동매음성포도구균、금황포도구균、분장구균、시장구균.내갑양서림금황포도구균(MRSA)、내갑양서림응고매음성포도구균(MRCNS)평균검출솔분별위88.4%、86.9%,금황포도구균대청매소、안변서림내약솔최고,8년간시종보지재90.0%이상.미발현대만고매소내약혹중개적금황포도구균혹응고매음성포도구균.2003년수차분리내만고매소장구균(VRE),지2006년공발현30주VRE,기중13주위내만고매색분장구균,균위VanB기인형;17주위내만고매소시장구균,균위VanA기인형,내만고매소시장구균분리솔정상승추세.대우분장구균활성최고적시만고매소、안변서림、청매소,민감솔분별위98.7%、95.7%、85.6%.단시청매소민감성략유하강,종94.3%강지84.6%.극림매소적내약솔8년중시종유지재99.0%이상.시장구균대홍매소、극림매소적내약솔균체95.0%이상,대청매소、안변서림、배병사성적내약솔균대우90.0%.시장구균최위민감적약물시만고매소,대사배소민감성출현상승적추세,종27.8%승도82.6%.결론 만고매소대림상상견적혁란양성균보지흔고적활성,발현30주내만고매소적장구균.
Objective To investigate the change of antimicrobial resistance among gram-positive cocci from 1999 to 2006 in Beijing Chaoyang Hospital. Methods Antimicrobial susceptibility test was car-ried out by MIC method, data were analyzed by WHONET 5.3 software. Results A total of 6192 clinical isolates were collected. The top four pathogens were Staphylococcus coagulase-negative, Staphylococcus au-reus, Enterococcus faecalis and Enterococcus faecium. The prevalence of methicillin-resistant S. aureas and coagulase-negative were identified in 88.4% and 86.9%, respectively. The resistance rates of S. aureus to penicillin G and ampicillin were more than 90.0% during 1999-2006. Neither strains of S. aureus nor strains of coagulase-negative Staphylococcus were found resistant to vancomycin. Vancomyein-resistant Enterococci (VRE) strains were firstly isolated in 2003, thirteen vancomycin-resistant E.faecalis isolates were identified as VanB genotype by PCR and sequencing. The VanA gene was confirmed by PCR and sequencing in seven-teen vancomycin-resistant E.faecium, vancomycin-resistance E.faecium rate increased sharply. The most ac-tive antibiotics against E. faecalis were vancomycin, ampicillin, penicillin with the susceptible rates of 98.7%, 95.7% and 85.6%, however, the susceptibility rate of E. faecalis to penicillin decreased from 94.3%-84.6%. The resistance rates of E.faecalis to clindamycin was 99.0%. The resistance rates of E. faecium to erythromycin and clindamycin were more than 95.0%. The resistance rates of E.faecium to ampi-cillin, penicillin, ciprofloxacin were more than 90.0%. The most active antibiotics against E. faecium was vancomycin. The susceptibility rate of E.faecium to tetracycline increased from 27.8% to 82.6%. Conclu-sion Vancomycin remains highly active against gram-positive cocci. A total of 30 Enterococci isolates were found resistant to vancomycin.
