2010—2012年万古霉素对耐甲氧西林金黄色葡萄球菌MIC值的变化

Vancomycin MIC values in methicillinresistant Staphylococcus aureus clinical isolates from 2010 to 2012

摘要:

目的了解万古霉素对不同标本来源的耐甲氧西林金黄色葡萄球菌（MRSA）最低抑菌浓度（MIC）值的变化。方法收集某院2010—2012年临床分离的MRSA菌株，测定MRSA万古霉素MIC值；并按不同标本来源，对菌株万古霉素MIC值进行分析。结果3年共收集金黄色葡萄球菌1 434株，其中分离自痰标本857株，血液标本239株，其他标本338株；2010—2012年MRSA检出率分别为41.12%（169/411）、44.96%（214/476）和48.08%（263/547）。2010—2012年血液标本分离的金黄色葡萄球菌MRSA检出率分别为29.03%、30.86%、30.21%，痰标本分离的金黄色葡萄球菌MRSA检出率分别为46.89%、51.03%、57.10%；3年间痰标本MRSA检出率均高于血液标本（χ2值分别为6.41、10.36、21.43，均P＜0.05）。血液及痰标本分离的MRSA对万古霉素均敏感。2010—2012年血液标本分离的MRSA万古霉素MIC≥1.00 μg/mL菌株分别占38.89%（7株）、40.00%（10株）及37.93%（11株）,3年间比较，差异无统计学意义（χ2=0.02，P=0.999）；痰液分离的MRSA万古霉素MIC≥1.00 μg/mL菌株分别占36.28%（41株）、40.94%（61株）及49.73%（92株），3年比较，差异亦无统计学意义（χ2=5.72，P=0.057）。结论该院2010—2012年临床MRSA检出率呈增高趋势。痰标本的MRSA检出率及万古霉素MIC值有所增高；血液标本的MRSA检出率及万古霉素MIC变化不明显。

Abstract:

ObjectiveTo analyze vancomycin minimum inhibitory concentration (MIC) in methicillinresistant Staphylococcus aureus (MRSA) isolated from different clinical specimens.MethodsFrom 2010 to 2012, MRSA were identified and vancomycin MIC in MRSA was determined by VITEK 2 COMPACT; vancomycin MIC values were analyzed.ResultsA total of 1 434 isolates of Staphylococcus aureus were detected, including 857 sputum specimens, 239 blood specimens,and 338 other specimens; MRSA isolation rate of all specimens was 41.12% (169/411), 44.96% (214/476) and 48.08% (263/547) respectively. MRSA isolation rate of blood specimens was 29.03%,30.86% and 30.21% respectively, and sputum was 46.89%,51.03% and 57.10% respectively; MRSA isolation rate of sputum was higher than that of blood specimens (χ2= 6.41, 10.36, 21.43 respectively, all P<0.05). All strains were sensitive to vancomycin. The percentage of vancomycin MIC≥1.00 μg/mL in MRSA from blood specimens was 38.89%（7 isolates）,40.00%（10 isolates）and 37.93%（11 isolates）in 2010-2012 respectively(χ2=0.02，P=0.999）,and from sputum specimens was 36.28%（41 isolates）, 40.94%（61 isolates） and 49.73% （92 isolates）respectively（χ2=5.72，P=0.057）.ConclusionThe detection rate of MRSA clinical isolates has shown an increased trend from 2010 to 2012. Detection rate of MRSA from sputum was higher than that of blood specimens; detection rate and vancomycin MIC value of MRSA from sputum specimens increased a little; detection rate and vancomycin MIC value of blood specimens didn’t change obviously.