2011～2013年血液分离葡萄球菌的临床分布及耐药性分析

目的了解临床各科发热患者（怀疑细菌感染）血培养中葡萄球菌分布及耐药性，为临床治疗提供参考依据。方法血培养采用BaeT／Alert3D全自动血培养仪（梅里埃）培养5d，采用MicroScanWalk—Away-96plus全自动微生物鉴定和药敏分析系统（西门子）进行细菌鉴定和药敏试验。结果血培养共检出葡萄球菌185株，检出最多的科室是ICU，耐甲氧西林金黄色葡萄球菌（methicillin—resistant Staphylococcus aureus，MRSA）检出率为30．4％，而耐甲氧西林凝固酶阴性葡萄球菌（methicillin—resistant coagulase-negative Staphylococci，MRCNS）的检出率高达80．7％。还检出了1株万古霉素中介的凝固酶阴性葡萄球菌。结论通过血培养检出葡萄球菌的耐药性分析发现，凝固酶阴性葡萄球菌对苯唑西林、氨苄西林、青霉素、红霉素的耐药率在70％以上，而对氯霉素、利福平、四环素的耐药率在30％以下，因此这三种药物应为我院应对凝固酶阴性葡萄球菌血流感染的常用首选药物。

Distribution and drug resistance of Staphylococcus isolates from blood from 2011 to 2013

Objective To investigate the distribution and drug resistance of Staphylococci isolates in blood culture and provide basis for clinical treatment. Methods Blood cultures were cultured for 5 days by BacT/Alert 3D. All the pathogens were identified and susceptibility test done by MicroScan WalkAway-96plus Automated Microbial Sys- tem. Results A total of 185 Staphylococcus were detected, the most of which was from ICU. The detection rate of MRSA was 30.4% , while that of MRCNS was 80.7%. We also detected a vancomycln-intermediate coagulase- negative staphylococci. Conclusion This research can provide scientific basis for clinical practice and prevention and control of hospital bloodstream infections, and ensure safe and reasonable use of antimicrobial drugs.