苍南县革兰阳性菌监测状况与耐药性分析
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摘要
目的探讨苍南县革兰阳性菌分布情况,并分析其耐药性,为临床积极预防与控制医院感染提供参考依据。方法对2016年1月—2017年12月苍南县第二人民医院分离的517株革兰阳性菌、苍南县第三人民医院分离的463株革兰阳性菌和苍南县人民医院分离的869株革兰阳性菌进行菌种鉴定和体外药物敏感性试验。结果 1 849株革兰阳性菌中,金黄色葡萄球菌718株(38.83%)、表皮葡萄球菌431株(23.31%)、溶血葡萄球菌240株(12.98%)、肺炎链球菌60株(3.24%)、无乳链球菌100株(5.41%)、粪肠球菌200株(10.82%)、屎肠球菌100株(5.41%)。718株金黄色葡萄球菌中耐甲氧西林金黄色葡萄球菌(MRSA)为481株(66.99%)。所有葡萄球菌均对替加环素和利奈唑胺敏感。粪肠球菌对万古霉素和替加环素均敏感(100.0%),对利奈唑胺的耐药率为2.0%。屎肠球菌对利奈唑胺及替加环素的耐药率均为1.0%。肺炎链球菌对替加环素和万古霉素均敏感(100.0%)。结论苍南县革兰阳性细菌中主要以金黄色葡萄球菌为主,其次为表皮葡萄球菌;且MRSA高达66.99%,肠球菌也存在不同程度的耐药性。
Objective To investigate the distribution and drug resistance of Gram-positive bacteria in Cangnan County,and to provide a reference for the clinical prevention and control of nosocomial infection. Methods A total of 517 isolates of Gram-positive bacteria from Cangnan County Second People's Hospital,463 isolates of Grampositive bacteria from Cangnan County Third People's Hospital and 869 isolates of Gram-positive bacteria from Cangnan County People's Hospital were collected from January 2016 to December 2017. Bacterial identi?cation and drug susceptibility test in vitro were performed. Results Among the 1 849 isolates of Gram-positive bacteria,there were 718 isolates of Staphylococcus aureus(38.83%),431 isolates of Staphylococcus epidermidis(23.31%),240 isolates of Staphylococcus haemolyticus(12.98%),60 isolates of Streptococcus pneumoniae(3.24%),100 isolates of Streptococcus agalactiae(5.41%),200 isolates of Enterococcus faecalis(10.82% and 100 isolates of Enterococcus faecium(5.41%). Among the 718 isolates of Staphylococcus aureus,481 isolates(66.99%) were methicillin-resistant Staphylococcus aureus(MRSA). All isolates of Staphylococcus were sensitive to tigecycline and linezolid. The isolates of Enterococcus faecalis were sensitive to vancomycin and tigecycline(100.0%),and they had different degrees of resistance to linezolid(2.0%). The isolates of Enterococcus faecium had different degrees of resistance to linezolid(1.0%) and tigecycline(1.0%). The isolates of Streptococcus pneumoniae were sensitive to tigecycline and vancomycin(100.0%). Conclusions Among the isolates of Gram-positive bacteria in Cangnan County,Staphylococcus aureus is the main one,followed by Staphylococcus epidermidis,and MRSA is as high as 66.99%. Enterococcus has different degrees of drug resistance.
Objective To investigate the distribution and drug resistance of Gram-positive bacteria in Cangnan County,and to provide a reference for the clinical prevention and control of nosocomial infection. Methods A total of 517 isolates of Gram-positive bacteria from Cangnan County Second People's Hospital,463 isolates of Grampositive bacteria from Cangnan County Third People's Hospital and 869 isolates of Gram-positive bacteria from Cangnan County People's Hospital were collected from January 2016 to December 2017. Bacterial identi?cation and drug susceptibility test in vitro were performed. Results Among the 1 849 isolates of Gram-positive bacteria,there were 718 isolates of Staphylococcus aureus(38.83%),431 isolates of Staphylococcus epidermidis(23.31%),240 isolates of Staphylococcus haemolyticus(12.98%),60 isolates of Streptococcus pneumoniae(3.24%),100 isolates of Streptococcus agalactiae(5.41%),200 isolates of Enterococcus faecalis(10.82% and 100 isolates of Enterococcus faecium(5.41%). Among the 718 isolates of Staphylococcus aureus,481 isolates(66.99%) were methicillin-resistant Staphylococcus aureus(MRSA). All isolates of Staphylococcus were sensitive to tigecycline and linezolid. The isolates of Enterococcus faecalis were sensitive to vancomycin and tigecycline(100.0%),and they had different degrees of resistance to linezolid(2.0%). The isolates of Enterococcus faecium had different degrees of resistance to linezolid(1.0%) and tigecycline(1.0%). The isolates of Streptococcus pneumoniae were sensitive to tigecycline and vancomycin(100.0%). Conclusions Among the isolates of Gram-positive bacteria in Cangnan County,Staphylococcus aureus is the main one,followed by Staphylococcus epidermidis,and MRSA is as high as 66.99%. Enterococcus has different degrees of drug resistance.
引文
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[8]陈叶红,丁洁卫,金燕,等.金黄色葡萄球菌耐药性变迁及抗菌药物应用分析[J].中华医院感染学杂志,2014,24(2):342-344.
[9]胡付品,郭燕,朱德妹,等.2016年中国CHINET细菌耐药性监测[J].中国感染与化疗杂志,2017,17(5):481-491.
[2]史翱翔,孙利花.多重耐药菌医院感染的分析与控制[J].中国冶金工业医学杂志,2016,33(5):505-507.
[3]黄丽.万古霉素联合阿奇霉素对形成生物被膜耐甲氧西林金黄色葡萄球菌的体外抗菌效果分析[J].中国现代医学杂志,2016,26(15):119-122.
[4]ETAYASHH,JIANG K,THUNDAT T,et al.Impedimetric detection of pathogenic gram-positive bacteria using an antimicrobial peptide from class IIa bacteriocins[J].Anal Chem,2014,86(3):1693-1700.
[5]胡付品,朱德妹,汪复,等.2015年CHINET细菌耐药性监测[J].中国感染与化疗杂志,2016,16(6):685-694.
[6]赵德军,胡昭宇,曹雁,等.重症监护病房患者耐甲氧西林金黄色葡萄球菌感染及耐药性研究[J].中国消毒学杂志,2014,31(8):835-837.
[7]梁毅,侯利剑,章红英.常见病原菌的耐药性与抗菌药物的应用研究[J].中华医院感染学杂志,2015,25(1):100-102.
[8]陈叶红,丁洁卫,金燕,等.金黄色葡萄球菌耐药性变迁及抗菌药物应用分析[J].中华医院感染学杂志,2014,24(2):342-344.
[9]胡付品,郭燕,朱德妹,等.2016年中国CHINET细菌耐药性监测[J].中国感染与化疗杂志,2017,17(5):481-491.