Johnson A P, Henwood C, Mushtaq S, James D, Warner M, Livermore D M
Antibiotic Resistance Monitoring and Reference Laboratory, Central Public Health Laboratory, Colindale, London, UK.
J Hosp Infect. 2003 Jul;54(3):179-87. doi: 10.1016/s0195-6701(03)00145-2.
Microbiologists in 25 sentinel laboratories were each asked to refer up to 100 clinically-significant Gram-positive bacteria isolated from consecutive intensive care unit (ICU) patients. A total of 1595 isolates were collected from patients in 23 hospitals; these included Staphylococcus aureus (47.6%), coagulase-negative staphylococci (CNS) (30.6%), enterococci (14.3%), pneumococci (2.8%) and other streptococci (3.5%). A few coryneforms, other bacilli and a Nocardia sp. were also collected. Rates of oxacillin resistance among S. aureus and CNS isolates were 59.3 and 78.5%, respectively. Vancomycin-resistant S. aureus were not detected, although two isolates (0.3%) were resistant to teicoplanin [minimum inhibitory concentrations (MICs) 8 mg/L]. In contrast, 13.7% of CNS were teicoplanin resistant (MICs 8-32 mg/L) and 1.2% were resistant to vancomycin. Among the enterococci, 72.5% were Enterococcus faecalis and 24.5% were Enterococcus faecium, the remainder including isolates of Enterococcus casseliflavus or Enterococcus gallinarum. Eighteen percent of E. faecium isolates were vancomycin-resistant, compared with only 3% of E. faecalis isolates. Rates of high-level gentamicin resistance in E. faecalis and E. faecium were 40 and 25%, respectively. Nine percent of pneumococci and streptococci were resistant to penicillin, with 7 and 11%, respectively, resistant to erythromycin. None of the isolates showed resistance to linezolid, with the MICs for the entire study population falling in the range of 0.5-4 mg/L.
来自25个哨点实验室的微生物学家每人被要求提交从连续的重症监护病房（ICU）患者中分离出的多达100株具有临床意义的革兰氏阳性菌。共从23家医院的患者中收集到1595株分离菌；其中包括金黄色葡萄球菌（47.6%）、凝固酶阴性葡萄球菌（CNS）（30.6%）、肠球菌（14.3%）、肺炎球菌（2.8%）和其他链球菌（3.5%）。还收集到一些棒状杆菌、其他杆菌和1株诺卡氏菌。金黄色葡萄球菌和CNS分离株中苯唑西林耐药率分别为59.3%和78.5%。未检测到耐万古霉素金黄色葡萄球菌，不过有2株分离菌（0.3%）对替考拉宁耐药[最低抑菌浓度（MIC）8 mg/L]。相比之下，13.7%的CNS对替考拉宁耐药（MIC 8 - 32 mg/L），1.2%对万古霉素耐药。在肠球菌中，72.5%为粪肠球菌，24.5%为屎肠球菌，其余包括鹑鸡肠球菌或卡西菲肠球菌分离株。18%的屎肠球菌分离株对万古霉素耐药，而粪肠球菌分离株仅有3%耐药。粪肠球菌和屎肠球菌中高水平庆大霉素耐药率分别为40%和25%。9%的肺炎球菌和链球菌对青霉素耐药，对红霉素耐药的分别为7%和11%。所有分离株对利奈唑胺均无耐药，整个研究人群的MIC值在0.5 - 4 mg/L范围内。
