血流感染患者表皮葡萄球菌与金黄色葡萄球菌的分布与耐药性分析

目的比较血流感染患者表皮葡萄球菌与金黄色葡萄球菌的耐药性差异,为临床合理选用抗菌药物提供参考。方法对贵州医科大学第三附属医院2011年6月至2014年11月血流感染标本中分离出的表皮葡萄球菌与金黄色葡萄球菌共140株进行比较分析,按照《全国临床检验操作规程》进行微生物鉴定,采用K-B纸片法进行药敏试验,药敏结果按美国临床和实验室标准化协会(CLSI)的标准判断,数据采用SPSS 17.0软件进行统计分析。结果血流感染标本共分离出表皮葡萄球菌与金黄色葡萄球菌140株,其中表皮葡萄球菌分离出88株,占62.86%;金黄色葡萄球菌分离出52株,占37.14%。血流感染表皮葡萄球菌与金黄色葡萄球菌对苯唑西林、头孢唑林、头孢噻肟、克林霉素、红霉素、阿奇霉素、环丙沙星、氧氟沙星、利福平、呋喃妥因、头孢噻吩、亚胺培南、左氧氟沙星、麦迪霉素、复方新诺明等耐药率分别为81.82%,45.15%;35.23%,15.38%;20.45%,5.77%;47.73%,26.92%;76.14%,51.92%;69.32%,50.00%;64.77%,9.62%;54.55%,28.85%;14.77%,0.00%;10.23%,0.00%;39.77%,3.85%;11.36%,0.00%;54.55%,28.85%;67.05%,5.77%;79.55%,32.69%;表皮葡萄球菌耐药率明显高于金黄色葡萄球菌,差异有性统计学意义(P0.05)。结论血流感染中表皮葡萄球菌的感染率与耐药率不断上升,耐药率明显高于金黄色葡萄球菌,应引起重视。

Distributions and drug resistances of Staphylococcus epidermidis and Staphylococcus aureus from bloodstream infection patients

Abstract: Objective To compare the drug resistances of Staphylococcus epidermidis and Staphylococcus aureus from bloodstream infection patients, and provide reference for rational use of antimicrobial agents. Methods 140 strains of Staphylococcus epidermidis and Staphylococcus aureus isolated from the blood specimens of patients with bloodstream infection during June 2011 and November 2014 were identified in accordance with the "National Guide to Clinical Laboratory Procedures". Drug sensitivity was tested with K-B method, and the results were analyzed according to CLSI standards with SPSS 17.0 software. Results Of the 140 strains, 88 were Staphylococcus epidermidis (62.86%) and 52 were Staphylococcus aureus (37.14%). The drug resistance rates of Staphylococcus epidermidis vs Staphylococcus aureus were 81.82% vs 46.15% to Oxacillin, 35.23% vs 15.38% to Cefazolin, 20.45% vs 5.77% to Cefotaxime, 47.73% vs 26.92% to Clindamycin, 76.14% vs 51.92% to Erythromycin, 69.32% vs 50.00% to Azithromycin, 64.77% vs 9.62% to Ciprofloxacin, 54.55% vs 28.85% to Ofloxacin, 14.77% vs 0.00% to Rifampin, 10.23% vs 0.00% to Nitrofurantoin, 39.77% vs 3.85% to Cefoxitin, 11.36% vs 0.00% to Imipenem, 54.55% vs 28.85% to Levofloxacin, 67.05% vs 5.77% to Midecamycin and 79.55% vs 32.69% to Cotrimoxazole, with those of Staphylococcus epidermidis significantly higher than those of Staphylococcus aureus (P<0.05). Conclusion The rate of infection and drug resistance of Staphylococcus epidermidis are rising, to which close attention should be paid.