产β内酰胺酶葡萄球菌在临床标本中的检出及耐药性

Detection and drug resistance of βlactamaseproducing Staphylococcus from clinical specimens

摘要:

目的了解某院产β内酰胺酶葡萄球菌在临床标本中的检出及耐药现状，为防治葡萄球菌感染提供依据。方法回顾性分析该院2005—2010年临床各科送检标本分离的1 725株产β内酰胺酶葡萄球菌的临床和实验室资料。结果近6年产β内酰胺酶葡萄球菌总检出率为94.83%（1 725/1 819），各年度（2005—2010年）检出率分别为88.68%（94/106）、89.69%（174/194）、91.72%（155/169）、97.58%（242/248）、96.10%（591/615）、96.30%（469/487），有逐年上升趋势（χ2=51.11, P<0.01）；各菌种以松鼠葡萄球菌β内酰胺酶阳性率最高（99.50%，198/199），耳葡萄球菌最低（80.37%，86/107），种间差异有统计学意义（χ2＝58.08，P<0.01）。药敏结果显示，除万古霉素、利奈唑烷、呋喃妥因和利福平外，产β内酰胺酶葡萄球菌对青霉素、氨苄西林、氨苄西林/舒巴坦、苯唑西林、头孢唑林、环丙沙星、四环素、克林霉素、红霉素、庆大霉素和复方磺胺甲口恶唑呈高度耐药（耐药率51.74%～100.00%）和多重耐药，且产酶菌的耐药性均高于非产酶菌（χ2在7.00～485.39之间，P<0.01）。苯唑西林耐药菌株占产β内酰胺酶金黄色葡萄球菌和凝固酶阴性葡萄球菌的72.86%和78.30%，是产酶葡萄球菌的主要组成菌群。结论产β内酰胺酶葡萄球菌的高检出率和对临床常用抗菌药物的高耐药率形势严峻，加强对产酶细菌的监测，遏制其快速增长非常必要。

关键词:

&beta;内酰胺酶;葡萄球菌属;抗药性，微生物;金黄色葡萄球菌;凝固酶阴性葡萄球菌

Abstract:

ObjectiveTo realize the detection and drug resistance of βlactamaseproducing Staphylococcus isolated from clinical specimens in a hospital, so as to provide reference for preventing and treating Staphylococcus infection.MethodsClinical and laboratory data of 1 725 βlactamaseproducing Staphylococcus isolated from clinical sepcimens between 2005 and 2010 were analyzed retrospectively.ResultsThe total detection rate of βlactamaseproducing Staphylococcus was 94.83% (1 725/1 819). The detection rate of each year was 88.68%（94/106）, 89.69%（174/194）, 91.72%（155/169）,97.58%（242/248）,96.10%（591/615） and 96.30%（469/487） respectively，there was an increased tendency（χ2=51.11, P<0.01; The detection rate of βlactamase was the highest in Staphylococcus sciuri（99.50%，198/199） and the lowest in Staphylococcus auricularis (80.37%，86/107）（χ2＝58.08，P<0.01）. Antimicrobial susceptibility testing results showed that βlactamaseproducing Staphylococcus isolates were sensitive to vancomycin, linezolid, furantoin and rifampicin, but were highly and multiply resistant to penicillin, ampicillin, ampicillin/sulbactam, oxacillin, cefazolin, ciprofloxacin, tetracycline, clindamycin, erythromycin, gentamicin and sulfamethoxazole/trimethoprim, the resistant rate was between 51.74% and 100.00%, and resistant rate of βlactamaseproducing Staphylococcus was higher than nonβlactamaseproducing Staphylococcus (χ2=7.00-485.39. P<0.01). 72.86% of βlactamaseproducing Staphylococcus aureus and 78.30% of βlactamaseproducing coagulase negative Staphylococcus were oxacillinresistant strains.ConclusionThe high detection rate and high drug resistant rate of βlactamaseproducing Staphylococcus is serious, it is necessary to intensify the monitor and stop quick increase of βlactamase producing Staphylococcus.

Key words:

&beta;lactamase; Staphylococcus spp.; drug resistance, microbial; Staphylococcus aureus; coagulase negative Staphylococcus