CAJ | 학술논문

目的探讨医院感染革兰阳性球菌的分布和耐药性,为抗感染药物的合理使用提供依据.方法收集2009年1月至2011年12月我院分离的革兰阳性球菌125株,采用K-B法进行药敏试验,按CLSI 2009年版标准判断结果.结果检出的革兰阳性球菌依次为金黄色葡萄球菌68株(54.4％)、屎肠球菌22株(17.6％)、凝固酶阴性葡萄球菌20株(16.0％)、粪肠球菌6株(4.8％)、溶血葡萄球菌7株(5.6％),其他阳性球菌2株(1.6％).检出耐甲氧西林金黄色葡萄球菌(MRSA)40株(占金黄色葡萄球菌的58.8％),甲氧西林敏感金黄色葡萄球菌(MSSA) 28株(占金黄色葡萄球菌的41.1％).药敏试验显示,MRSA对庆大霉素、克林霉素、红霉素和环丙沙星的耐药率高达87.5％～95.0％,凝固酶阴性葡萄球菌对青霉素、红霉素、克林霉素和庆大霉素的耐药率达65.0％～95.0％,屎肠球菌和粪肠球菌对红霉素、高浓度庆大霉素和环丙沙星的耐药率为86.4％～ 100％和50.0％～ 66.7％.未检测到万古霉素、替考拉宁和利奈唑胺的耐药菌.结论金黄色葡萄球菌为医院感染革兰阳性球菌的主要菌群,革兰阳性球菌的耐药现象非常严重.临床医师应高度重视革兰阳性球菌的高耐药情况.
목적 탐토의원감염혁란양성구균적분포화내약성,위항감염약물적합리사용제공의거.방법 수집2009년1월지2011년12월아원분리적혁란양성구균125주,채용K-B법진행약민시험,안CLSI 2009년판표준판단결과.결과 검출적혁란양성구균의차위금황색포도구균68주(54.4％)、시장구균22주(17.6％)、응고매음성포도구균20주(16.0％)、분장구균6주(4.8％)、용혈포도구균7주(5.6％),기타양성구균2주(1.6％).검출내갑양서림금황색포도구균(MRSA)40주(점금황색포도구균적58.8％),갑양서림민감금황색포도구균(MSSA) 28주(점금황색포도구균적41.1％).약민시험현시,MRSA대경대매소、극림매소、홍매소화배병사성적내약솔고체87.5％～95.0％,응고매음성포도구균대청매소、홍매소、극림매소화경대매소적내약솔체65.0％～95.0％,시장구균화분장구균대홍매소、고농도경대매소화배병사성적내약솔위86.4％～ 100％화50.0％～ 66.7％.미검측도만고매소、체고랍저화리내서알적내약균.결론 금황색포도구균위의원감염혁란양성구균적주요균군,혁란양성구균적내약현상비상엄중.림상의사응고도중시혁란양성구균적고내약정황.
Objective To discuss the distributions and drug resistance of gram-positive cocci and provide scientific basis for reasonable use of antimicrobial drugs.Methods One hundred and twenty-five strains were isolated and cultured in our department from January 2009 to December 2011.The drug susceptibility was tested by K-B method and the results were judged by the criteria guideline of CLSI 2009.Results The main strains of separated cocci were Staphylococcus aureus (68,54.4％),Enterococcus faecium (22,17.6％),coagulase-negative staphylococcus (CNS) (20,16.0％),Enterococcus faecalis (6,4.8％),Staphylococcus haemolyticus(7,5.6％)and other gram-positive cocci (2,1.6％).Methicillin-resistant S.aureus (MRSA) and Methicillin-susceptible S.aureus (MSSA) detected were 40 and 28 strains(accounted for 58.8％ and 41.1％ of S.aureaus).The results of drug susceptibility tests showed that the drug resistant rate of MRSA to Gentamicin,Clidamycin,Erythromycin and Ciprofloxacin was up to 87.5％-95.0％,and the drug resistant rate of coagulasenegative staphylococcus to Penicillin,Erythromycin,Clidamycin and Gentamicin was up to 65.0％-95.0％,besides,the drug resistant rate of E.faecalis and E.faecium to Erythromycin,high level Gentamicin and Ciprofloxacin were 86.4％-100％ and 50.0％-66.7％,respectively.No strains with drug resistant to Vancomycin,Teicoplanin and Linezolid were detected.Conclusion S.aureus was the main strains of nosocomial infection of gram cocci.The resistance of gram-positive cocci is severe,so clinicians should attaches great importance to high drug resistance of gram-positive cocci.