【摘要】 目的:了解浙江省湖州市中心医院住院及门诊分离的革兰阳性球菌分布特征及耐药性。方法:采用常规方法分离,用VITE-COMPACT2全自动微生物分析仪进行菌种鉴定,用K-B法进行药敏试验。结果:18557份送检标本中分离到菌株6700株,其中1253株为革兰阳性球菌。各科室菌株分离率以监护室最高(22.3%),其次为脑外科(21.4%)和呼吸科(10.2%)。各年龄段人群菌株分离率以60岁以上老年组最高(8.9%),其次为新生儿组(7.2%)和儿童组(6.6%)。分离的革兰阳性球菌以葡萄球菌(占70.5%)与肠球菌(22.5%)为主,其中金黄色葡萄球菌主要来源于痰液,为403株(占83.8%),表皮葡萄球菌主要来源于血液,为97株(占46.2%),粪肠球菌、屎肠球菌主要来源于尿液,分别为66株(占33.0%)和75株(占37.5%)。葡萄球菌和肠球菌属耐药现象严重,其中耐甲氧西林金黄色葡萄球菌、耐甲氧西林表皮葡萄球菌、耐甲氧西林溶血葡萄球菌分离率为74.3%、74.6%、93.8%。发现耐万古霉素铅黄肠球菌15株(占5.3%),但尚未发现耐万古霉素、替考拉宁葡萄球菌菌株和粪肠球菌、屎肠球菌菌株。结论:革兰阳性球菌,尤其葡萄球菌与肠球菌存在多重耐药现象,未发现耐万古霉素葡萄球菌,但已发现耐万古霉素肠球菌。临床上应加强耐甲氧西林葡萄球菌、耐万古霉素肠球菌的监测和合理使用抗生素管理。更多还原

【Abstract】 Objective:To investigate the characteristic of distribution and drug resistance of common Gram-Positive cocci isolated from clinical specimens.Methods: The specimens were cultured with routine methed of separation,the pathogenic bacteria assay were conducted with VITE-COMPACT2 and the antibiotic susceptibility was tested by K-B methord.Results: A total of 6700 strains were isolated from 18557 clinical specimens,among them 1253 strains were Gram-Positive cocci.The positive rate of Gram-Positive cocci varied from one department to another,the highest was in ICU(22.3%),followed by neurosurgery department(21.4%) and respiratory department(10.2).Among different stage of year,the positive rate was the hightest in >60 years old group(8.9%),followed by neonatal group(7.2%) and children group(6.6%).The main strains of Gram-Positive cocci isolated were Staphylococcus(70.5%) and Enterococcus(22.5%),the Staphylococcus aureus strains were mainly isolated from sputum,amount of strains were 403(83.8%),Staphylococcus epidermidis strains were mainly isolated from blood,amount of strains were 97(46.2%),Ent.Faecalis and Ent.Faecium strains were mainly isolated from urine,amount of strains were 66(33.0%) and 75(37.5%).Antibiotics resistance of Staphylococcus and Enterococci in our hospital were severe,the percentage of MRSA,MRSE and MRSH in this investigation was 74.3%,74.6%,93.8%,respectively.Fifteen vancomycin-resistant Ent.Casseliflavus strains were isolated,but no Staphylococcus,Ent.Faecalis and Ent.Faecium strain isolated was found resistant to vancomycin and teicoplanin.Conclusion: Antibiotics resistance of Gram-Positive cocci in our hospital are severe,especially with the appearance of multidrug resistant Staphylococcus and Enterococci strains,and the appearance of vancomycin-resistant Enterococci strains.Some measure should be done to reduce the antibiotics resistance and control the dissemination and outbreak of infections caused by MRS and VRE.更多还原