Oteo Jesús, Cruchaga Susana, Campos José, Sáez Juan Antonio, Baquero Fernando
Centro Nacional de Microbiología. Instituto de Salud Carlos III. Majadahonda. Madrid. España.
Med Clin (Barc). 2002 Sep 28;119(10):361-5. doi: 10.1016/s0025-7753(02)73418-0.
In 1998, the European Union funded the European Antimicrobial Resistance Surveillance System. We present here Staphylococcus aureus data in 2000 in Spain.
31 hospitals were involved, covering almost 25% Spanish total population. All nosocomial blood isolates of S. aureus were included. Each laboratory carried out microbiological studies with its own usual methods. Quality control was carried out by UK National External Quality (NEQAS). A questionnaire including hospital, patient and specimen data was filled out for each isolate. Results were registered in a single database and analyzed and validated with Whonet. 5 software.
Invasive S. aureus was isolated in 903 patients. Overall incidence was 1.45/1000 admitted patients. Resistance was 28.1% (95% CI, 25.2-31.1) to oxacillin (O), 26.6% to ciprofloxacin (C), 23.8% to erythromycin (E) and 16.6% to gentamicin (G). Multiresistance was noticed in 80% oxacillin-resistant strains. More frequent multiresistance profiles were OECG (11.3% of all isolates) and OEC (6.3%). Oxacillin resistance was higher in ICU units (44.5%) than in other medical departments (27.4%) (p < 0.001). Hospitals with 500 beds or more showed 36.4% prevalence of O resistance, while in hospitals having less than 500 beds it was 18.8% (p < 0.001). A decreased susceptibility to vancomycin was not detected.
In Spain, invasive S. aureus shows a high prevalence of resistance to oxacillin, ciprofloxacin, erythromycin and gentamicin. Most oxacillin-resistant strains were resistant to three or more antibiotics. Nearly 50% oxacillin-resistant isolates were susceptible to gentamicin. Oxacillin resistance and resistance to multiple antibiotics was more frequent in ICU units and in hospitals with 500 beds or more.
1998年，欧盟资助了欧洲抗菌药物耐药性监测系统。我们在此展示2000年西班牙金黄色葡萄球菌的数据。
31家医院参与其中，覆盖了近25%的西班牙总人口。纳入了所有医院获得性金黄色葡萄球菌血培养分离株。每个实验室采用其常用方法进行微生物学研究。质量控制由英国国家外部质量评估（NEQAS）进行。为每个分离株填写一份包括医院、患者和标本数据的问卷。结果记录在一个单一数据库中，并用Whonet 5软件进行分析和验证。
903例患者分离出侵袭性金黄色葡萄球菌。总体发病率为每1000例住院患者中1.45例。对苯唑西林（O）的耐药率为28.1%（95%可信区间，25.2 - 31.1），对环丙沙星（C）为26.6%，对红霉素（E）为23.8%，对庆大霉素（G）为16.6%。在80%的苯唑西林耐药菌株中发现多重耐药。更常见的多重耐药谱为OECG（占所有分离株的11.3%）和OEC（6.3%）。重症监护病房（ICU）的苯唑西林耐药率（44.5%）高于其他医疗科室（27.4%）（p < 0.001）。拥有500张床位或更多床位的医院苯唑西林耐药率为36.4%，而床位少于500张的医院为18.8%（p < 0.001）。未检测到对万古霉素敏感性降低。
在西班牙，侵袭性金黄色葡萄球菌对苯唑西林、环丙沙星、红霉素和庆大霉素耐药率较高。大多数苯唑西林耐药菌株对三种或更多抗生素耐药。近50%的苯唑西林耐药分离株对庆大霉素敏感。苯唑西林耐药和多重抗生素耐药在ICU病房以及拥有500张床位或更多床位的医院更为常见。
