金黄色葡萄球菌对万古霉素MIC值变化的研究 - 中国病原生物学杂志.docVIP

万古霉素对金黄色葡萄球菌MIC值研究摘 要：目的 评价金黄色葡萄球菌的MIC）值是否存在漂移。方法 收集院2006—2011年临床分离株金黄色葡萄球菌，琼脂稀释法测定万古霉素菌株的MIC金黄色葡萄球菌的MIC值MIC值金黄色葡萄球菌 关键词：金黄色葡萄球菌；万古霉素；MIC值漂移 Study of vancomycin MIC Variance in Staphylococcus aureus isolated over 6 years LIU Hong-shu, MAO Hai-feng (Lianyungang First People’s Hospital ,Lianyugang, Jiangsu 22002,China) Abstract 0bjective To evaluate the creeping presence of vancomycin minimum inhibitory concentration (MIC) against Staphylococcus and provide a reference for clinical anti-infective therapy. Methods 288 non-duplicate Staphylococcus aureus strains were isolated from clinical specimens in our hospital from 2006 to 2011，vancomycin MIC was determined by agar dilution method, and the MIC50 and MIC90, MIC geometric mean was calculated. methicillin-resistant Staphylococcus aureus (MRSA) ??was confirmed by Oxacillin against Staphylococcus aureus MIC values, we compared the vancomycin MIC values ??differences between it and methicillin-sensitive Staphylococcus aureus (MSSA). Results All isolates were susceptible to vancomycin. From 2006 to 2011，The vancomycin geometric mean MICs were 1.169、1.118、1.042、1.019、1.019、1.086 respectively, MIC increase trends were not found. the occurrence of MRSA were 40.7％ , 43.5％ , 46％ , 60% , 29.6% , 55.4% (P0.05 )．There was a significant difference of MIC between MRSA strains and MSSA strains(p0.05)．Conclusion From 2006 to 2011，Vancomycin MIC did not increased over time , and no MIC creeping existed in the study period． Key words Staphylococcus aureus ; Vancomycin ; MIC Creep 金黄色葡萄球菌(Staphyloccoccus aureus,SAU)可以引起严重的社区和医院感染，尤其是MRSA在医院感染中占重要位置[1]，其除对甲氧西林耐药外，对其他β-内酰胺类药物，即青霉素类、β-内酰胺／β-内酰胺酶抑制剂复合物、头孢类和碳青霉烯类，可在体外实验显示活性，但临床治疗无效，对氨基糖苷类、大环内酯类、四环素类、利福平，均产生不同程度的耐药。万古霉素在治疗葡萄球菌感染中具有重要的作用，也是治疗MRSA感染的最经典药物。随着万古霉素使用时间的增加，其对金黄色葡萄球菌的敏感性也出现下降趋势，有报道称万古霉素金对黄色葡萄球菌的MIC值有逐渐增高的趋势（万古霉素MIC漂移）[2]。为了解万古霉素对本地区金黄色葡萄球菌MIC值的变化情况，本文对2006-2011年从临床标本中分离的金黄色葡萄球菌万古霉素MIC值进行了检测和分析，对本地区金黄色葡萄球菌是否存在万古霉素MIC漂移现象作初步探讨。 1 材料和方法 1.1 试验菌株 收集本院微生物室分离的金黄色葡萄球菌非重复菌株共288株，