摘要
目的:了解2003～2006年安徽医科大学第一附属医院血液培养293株葡萄球菌分布及敏感性变迁情况,为临床合理用药提供参考。方法:BACTEC9120全自动血培养仪进行培养,MicroScan WalkAway-40全自动微生物鉴定仪及配套阳性菌药敏复合板进行鉴定和药敏试验。结果:2003～2006年血液培养葡萄球菌属的分布主要为表皮葡萄球菌、人葡萄球菌人亚种、溶血葡萄球菌、金黄色葡萄球菌等,凝固酶阴性葡萄球菌(CNS)以及耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)比例逐年上升。病区分布主要为儿科、血液内科、消化内科、皮肤科、心内科等;所有分离株对万古霉素敏感,金黄色葡萄球菌对四环素的敏感性呈上升趋势(71.43～94.44%),对其它抗生素敏感性呈下降趋势;CNS对大多数抗生素敏感性呈下降趋势,其中甲氧苄啶/磺胺甲噁唑敏感性显著下降(P<0.05)。2006年CNS苯唑西林、庆大霉素、四环素、红霉素、甲氧苄啶/磺胺甲噁唑等敏感性显著低于金黄色葡萄球菌(P<0.05)。结论:血液培养葡萄球菌属中CNS以及MRCNS逐年升高,对临床常用抗生素的敏感性低且呈下降趋势,应根据药敏试验选择抗菌药物。合理使用抗菌药物以延缓细菌耐药性的产生非常重要。
Objective To investigate the distribution and antibiotic susceptibility change of staphylococcus isolated from blood specimens in patients in the First Affiliated Hospital of AnHui Medical University from 2003 to 2006, in order to provide some references for clinical rational drug use. Methods Blood specimens were cultured by BACTEC 9120 Fluorescent Instrument and Bacterial confirmatory and antibiotic susceptibility tests were carried out by MicroScan WalkAway-40 system with Positive Combo Panel. Results S.epidermidis, S.hominis-homin,S. hemolyticus and S.aureus were the major microorganisms in Staphylococcus in blood culture, coagulase-negative staphylococci （CNS） and methicillin-resistant coagulase-negative staphylococci （MRCNS） increased year by year. Staphylococcus strains mainly came from Department of Pediatrics, Department of Hematology, Department of Gastroenterology, Department of Dermatology and Department of Cardiovasology. Antibiotic susceptibility tests indicated that all isolates were sensitive to Vancomycin, the tendency to the tetracycline sensitivity rate of S.aureus increased （from 71.43% to 94.44% ）while other antibiotics decreased; most antibiotics sensitivity rates of CNS showed drop tendency year by year and among them, the trimethoprim-sulfamethoxazole sensitivity rate of CNS decreased significantly （P〈0.05）. Antibiotics such as oxacillin, gentamicin, tetracycline, erythromycin and trimethoprim-sulfamethox- azole showed significantly lower activity against CNS than against S.aureus in 2006 （P〈0.05）. Conclusion： CNS and MRCNS increased year by year in blood culture, there was a low sensitivity rate and a drop tendency about the antibiotics that conventionally used in clinics, antimicrobial treatment should be conducted according to the antibiotic susceptibility test. It is very important to rationally use antibiotics for delaying drug resistance occurrence.
出处
《安徽卫生职业技术学院学报》
2007年第4期71-73,77,共4页
Journal of Anhui Health Vocational & Technical College
基金
安徽省科技攻关十五二期课题资助(040130583)
关键词
血液培养
葡萄球菌
分布
药物敏感性
blood culture
staphylococcus
distribution
antibiotic susceptibility
