Jarløv J O, Høiby N
Department of Clinical Microbiology, The National University Hospital (Rigshospitalet), Copenhagen, Denmark.
APMIS. 1998 Mar;106(3):411-6. doi: 10.1111/j.1699-0463.1998.tb01365.x.
Over a one-year period, all coagulase-negative staphylococci (CoNS) from blood cultures, cerebrospinal fluids and peritoneal effluents from patients in a major Danish university hospital were investigated for susceptibility to penicillin G; methicillin; gentamicin; netilmicin; amikacin; erythromycin; clindamycin; fusidic acid; rifampicin; tetracycline; chloramphenicol; ciprofloxacin; teicoplanin; and vancomycin. Among the CoNS-isolates, 56% were resistant to methicillin, 51% to gentamicin, 28% to ciprofloxacin, and 5% to teicoplanin. Blood culture CoNS-isolates from patients with a central venous catheter (CVC) were more often resistant to various antibiotics compared to CoNS-isolates from patients without a CVC, e.g. methicillin (72% vs 21%), gentamicin (65% vs 22%) (p<0.00000001). Great diversity in antibiotic resistance between the wards was found; methicillin resistance (in most cases multiple antibiotic resistance) was in particular associated with consumption of broad-spectrum beta-lactams, quinolones, and total antibiotic consumption in a ward. Thus, the antibiotic policy of a ward is an important factor for antibiotic resistance among CoNS.
在一年时间里，对丹麦一家大型大学医院患者血培养、脑脊液和腹腔积液中分离出的所有凝固酶阴性葡萄球菌（CoNS）进行了青霉素G、甲氧西林、庆大霉素、奈替米星、阿米卡星、红霉素、克林霉素、夫西地酸、利福平、四环素、氯霉素、环丙沙星、替考拉宁和万古霉素的药敏试验。在CoNS分离株中，56%对甲氧西林耐药，51%对庆大霉素耐药，28%对环丙沙星耐药，5%对替考拉宁耐药。与无中心静脉导管（CVC）患者的CoNS分离株相比，有CVC患者血培养CoNS分离株对多种抗生素的耐药性更高，例如甲氧西林（72%对21%）、庆大霉素（65%对22%）（p<0.00000001）。各病房之间抗生素耐药性存在很大差异；甲氧西林耐药（大多数情况下为多重抗生素耐药）尤其与病房中广谱β-内酰胺类、喹诺酮类的使用以及总抗生素使用量有关。因此，病房的抗生素使用策略是CoNS产生抗生素耐药性的一个重要因素。
