408株凝固酶阴性葡萄球菌菌谱和耐药性分析.docVIP

408株凝固酶阴性葡萄球菌菌谱和耐药性分析 　　【摘要】 目的 分析医院感染凝固酶阴性葡萄球菌(CNS)的分布及耐药性。方法 对2007~2009年医院住院患者各类标本分离到的凝固酶阴性葡萄球菌作药敏试验和甲氧西林耐药性测定。结果 在408株CNS中,检出表皮葡萄球菌152株,占37.26%(152/408);耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)286株(70.10%),其中产β-内酰胺酶280株(产酶率97.90%);检出对甲氧西林敏感的凝固酶阴性葡萄球菌(MSCNS)122株(29.90%),其中有17株产β-内酰胺酶(产酶率13.93%),两者比较差异有显著性(P0.01)。MRCNS对13种抗菌药物耐药性明显高于MSCNS(PO.01);所有CNS对万古霉素敏感。结论 CNS已成为重要医院感染菌;CNS耐药性增高与产β-内酰胺酶有关;临床应积极进行病原学和耐药性监测,合理用药。 　　【关键词】 　　凝固酶阴性葡萄球菌;β-内酰胺酶;耐药性;增加 　　 　　Distribution and drug-resistance of 408 strains coagulase negative stapylococcuse WEI Wei-ping.The People’s Hospital of Anhua County,Hunan Province,413500,China 　　【Abstract】 Objective To study the distribution and drug resistance of coagluase negative stapylococcuse(CNS).Methods The methicillin-resistance and grug-resistance of the CNS strains isolated from the clinical specimens of the inpatient in our hospital between 2007 to 2009 were tested.Results Of all 408 CNS strains of MSCNS,there were 152 S.epidermidis strains,accounting for 37.26%(152/408),and 286 MRCNS strains in which 280 producing β-lactamase(The positive rate of β-lactamasewas 97.9%),and 122 MSCNS strains(79.90%)including 17 strains which producing β-lactamase(the rate was 13.93%).Comparing the two,the difference was significant.(P0.01).The resistance rate of MRCNS to 13 types of antibiotics were higher than those of MSCNS(P0.01).All CNS was sensitive vancomycin.Conclusion CNS is increasingly playing a significant role in nosocomial infection.The increase of drug resistance of CNS has relation with β-lactamasse;the clinic should monitor the etiology and resistance of CNS,use the drug reasonably. 　　【Key words】 　　Coagulase-negative staphylococcuse(CNS); β-lactamse; Drug-resistance; Increase 　　 　　越来越多的临床资料表明[1],凝固酶阴性葡萄球菌(Coagulase-negative Staphylococcus,CNS)在临床标本中的检出率逐年升高,已成为临床分离的主要革兰阳性球菌之一,并为细菌败血症的首要病原菌。由于抗菌药物的广泛应用,CNS耐药株日渐增多,其多重耐药使临床抗感染治疗越来越困难。笔者对近年来引起医院感染的CNS分离株的临床分布和耐药性进行了分析,结果报告如下。 　　1 资料与方法 　　1.1 菌株来源 分离自我院2007年1月至2009年12月住院患者的各类标本,主要为痰液、血液、脓及伤口分泌物、尿液等