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目的了解医院革兰阳性菌的分布及耐药性。方法回顾性分析2014年南京医科大学第一附属医院各类标本中分离的革兰阳性菌相关资料。细菌鉴定采用API系统或VITEK 2 Compact自动鉴定仪,药物敏感性检测采用纸片扩散法或VITEK 2 Compact全自动分析仪。结果共分离出各类病原菌7931株;其中,革兰阳性菌占20.7%。排名前3位的革兰阳性菌为金黄色葡萄球菌(35.4%)、凝固酶阴性的葡萄球菌(19.3%)和屎肠球菌(10.1%)。革兰阳性菌主要来源于痰液(21.9%)、伤口分泌物(17.4%)、血液(16.8%)和尿液(15.5%)。耐甲氧西林金黄色葡萄球菌和凝固酶阴性葡萄球菌的检出率分别为55.6%和68.3%。检出葡萄球菌中,16株对利奈唑胺耐药,6株对替考拉宁耐药,38株对替考拉宁中介,未发现对万古霉素耐药。耐万古霉素肠球菌的检出率为5.0%。结论该院耐甲氧西林金黄色葡萄球菌分离率逐年降低,耐万古霉素肠球菌分离率升高。
Objective To understand the distribution and drug resistance of Gram-positive bacteria in hospitals. Methods The data of Gram-positive bacteria isolated from various specimens of the First Affiliated Hospital of Nanjing Medical University in 2014 were retrospectively analyzed. Bacterial identification using API system or VITEK 2 Compact automatic identification device, drug sensitivity testing using disk diffusion method or VITEK 2 Compact automatic analyzer. Results A total of 7931 strains of pathogenic bacteria were isolated. Among them, Gram-positive bacteria accounted for 20.7%. The top three Gram-positive bacteria were Staphylococcus aureus (35.4%), coagulase-negative Staphylococcus (19.3%) and Enterococcus faecium (10.1%). Gram-positive bacteria mainly come from sputum (21.9%), wound secretions (17.4%), blood (16.8%) and urine (15.5%). The detection rates of methicillin-resistant Staphylococcus aureus and coagulase-negative staphylococcus were 55.6% and 68.3%, respectively. Sixteen strains were resistant to linezolid, six strains were resistant to teicoplanin, and 38 strains were teicoplanin agents. No resistance to vancomycin was found. The detection rate of vancomycin-resistant enterococci was 5.0%. Conclusion The isolation rate of methicillin-resistant Staphylococcus aureus in this hospital is decreasing year by year, and the isolation rate of vancomycin-resistant enterococci is increasing.