临床分离凝固酶阴性葡萄球菌细菌谱

目的了解玉溪市人民医院临床分离凝固酶阴性葡萄球菌（CNS）的菌种构成和耐药特征。方法对该院近6年来临床分离的808株CNS作回顾性分析。结果808株CNS共有16种;表皮葡萄球菌、腐生葡萄球菌和溶血葡萄球菌占CNS的77.2%;甲氧西林耐药（MRCNS）和甲氧西林敏感（MSCNS）各占63.3%和36.7%;β-内酰胺酶阳性检出率为84.5%,且MRCNS显著高于MSCNS（χ^2=50.88,P〈0.01）;药敏结果：MRCNS除万古霉素、呋喃妥因和利福平外,青霉素、氨苄西林等12种临床常用抗菌药物的耐药率在50.6%-100%,显示了高度的耐药性和多重耐药。结论CNS在临床标本中的检出范围广、种类多,以表皮葡萄球菌、腐生葡萄球菌和溶血葡萄球菌为主,MRCNS的高度耐药和多重耐药形势严重,加强CNS的细菌学监测非常必要。

The bacterium-spectrum of coagulase negative Staphylococcus of clinical isalates

Objective To investigate the distribution and antimicrobial resistance of coagulase negative Staphylococcus（CNS） of clinical isolates from Yuxi City People＇s Hospital. Method Retrospective analysised on a total of 808 strains of CNS of clinical isolates in the past 6 years from Yuxi City People＇s Hospital. Results 808 strains CNS had 16 kinds. Staphlococcus epidermidis,Staphlococcus saprophyticus and Staphlococcus haemolyticus accounted for 77.2% of all CNS;Methicillin-resistant（MRCNS） and methicillin-sensitive（MSCNS） strains accounted for 63.3% and 36.7% of CNS respectively. The positive detection rate of β-lactamase were 84.5%. This detection rate of MRCNS was apparent higher than MSCNS （X^2 =50.88 ,P 〈0.01 ）. The results of drug sensitive test showed high antimicrobial resistance and muhidrug resistace in MRCNS to Penicillin, Ampicillin, Clindamycin, Gentamicin, Cefazolin, Erythromycin, Ciprofloxacin, Levofloxacin,Tetaeyeline,Trime-thoprim/Sulfa etc. Their antimierobial rate were between 50.6% to 100.0%. Conclusions The detection of CNS in clinical specimen is of wide limist and many kinds. Staphlococcus epidermidis ,Staphlococcus saprophyticus and Staphlococcus haemolyticus are the major microorganisms. The situation of high antimicrobial resistance and muhidrug resistace in MRCNS is serious. It makes all the difference that increase the bacteriology monitor of CNS.