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[2008年分离出的革兰氏阳性球菌的抗生素耐药性]

[Antibiotic resistance of Gram-positive cocci isolated in 2008].

作者信息

Dorobăţ Olga Mihaela, Bădicuţ Ioana, Tălăpan Daniela, Tenea Cristina, Rafila Alexandru

机构信息

Institutul National de Boli Infecţioase Prof. Dr. Matei Balş.

出版信息

Bacteriol Virusol Parazitol Epidemiol. 2010 Apr-Jun;55(2):83-92.

PMID:21553473

Abstract

OBJECTIVE

Antibiotic resistance evaluation of Gram-positive cocci isolated in 2008.

MATERIAL AND METHODS

Antibiotic susceptibility testing was performed for 1044 strains: 610 Staphylococcus aureus (352 from patients, 258 from carriers), 203 Streptococcus pneumoniae (53 from patients, 150 from carriers), 144 Enterococcus faecalis. 57 Enterococcus faecium and 30 Streptococcus spp. using automatic systems Vitek 2 Compact. MicroScan, disc diffusion method and Etest according to 2008 CLSI. A number of 497 Streptococcus pyogenes strains were tested for eritromycin resistance.

RESULTS

There were 33.2% MRSA for strains isolated from patients and 30.0% from carriers. From MRSA strains. 35.5% were resistant to gentamicin. 33.6% to ciprofloxacin, 74.3% to erythromycin and 30.5% to rifampin. There were no S. aureus strain resistant to vancomycin and linezolid. S. aureus strains isolated from wounds were more resistant to erythromycin (43.9%) than the strains isolated from systemic infections (12.1%). From 11 S. pneumoniae strains isolated from meningitis, 4 were resistant to penicillin. Neither S. pneumoniae strain isolated from other infections, nor those from carriers had MIC to penicillin more than 4 microg/ml. S. pneumoniae strains isolated from carriers were more resistant to erythromycin. clindamycin and tetracycline than the strains isolated from patients (66.7%, 54.1%, 54.2% vs. 27.4%, 22.6%, 33.9%). E. faecium was 95.9% resistant to penicillin, 90.2% to ampicillin, 64.7% to gentamicin, 72.0% to streptomycin and 78.4% to ciprofloxacin. F. faecalis was less resistant than E. faecium at most of the antibiotics: 32.4% to gentamicin, 59.6% to streptomycin, 28.5% to ciprofloxacin. Viridans group Streptococci, all isolated from blood culture were 92% susceptible to penicillin and ampicillin. To erythromycin, 12% of viridians group Streptococci were resistant. S. pyogenes resistance to eritromycin was 5.8%.

CONCLUSIONS

S. aureus strains showed a relatively high level of resistance to oxacillin (33.2%) and resistance in the same time to several antibiotics. S. pneumoniae can not be considered resistant to penicillin administrated parenteral, with exception of the strains isolated from meningitis. E. faecium had a higher resistance rate than E. faecalis.

摘要

目的

对2008年分离出的革兰氏阳性球菌进行抗生素耐药性评估。

材料与方法

对1044株菌株进行了药敏试验：610株金黄色葡萄球菌（352株来自患者，258株来自携带者）、203株肺炎链球菌（53株来自患者，150株来自携带者）、144株粪肠球菌、57株屎肠球菌和30株链球菌属，采用Vitek 2 Compact自动系统、MicroScan、纸片扩散法和依据2008年CLSI标准的Etest法。对497株化脓性链球菌菌株进行了红霉素耐药性检测。

结果

从患者分离出的菌株中耐甲氧西林金黄色葡萄球菌（MRSA）占33.2%，从携带者分离出的占30.0%。在MRSA菌株中，35.5%对庆大霉素耐药，33.6%对环丙沙星耐药，74.3%对红霉素耐药，30.5%对利福平耐药。没有金黄色葡萄球菌菌株对万古霉素和利奈唑胺耐药。从伤口分离出的金黄色葡萄球菌菌株对红霉素的耐药性（43.9%）高于从全身感染中分离出的菌株（12.1%）。从脑膜炎分离出的11株肺炎链球菌菌株中，4株对青霉素耐药。从其他感染中分离出的肺炎链球菌菌株以及从携带者中分离出的菌株对青霉素的最低抑菌浓度均不超过4μg/ml。从携带者中分离出的肺炎链球菌菌株对红霉素、克林霉素和四环素的耐药性高于从患者中分离出的菌株（分别为66.7%、54.1%、54.2% 对比 27.4%、22.6%、33.9%）。屎肠球菌对青霉素的耐药率为95.9%，对氨苄西林为90.2%，对庆大霉素为64.7%，对链霉素为72.0%，对环丙沙星为78.4%。粪肠球菌在大多数抗生素方面的耐药性低于屎肠球菌：对庆大霉素为32.4%，对链霉素为59.6%，对环丙沙星为28.5%。均从血培养中分离出的草绿色链球菌对青霉素和氨苄西林的敏感率为92%。对红霉素，12%的草绿色链球菌耐药。化脓性链球菌对红霉素的耐药率为5.8%。