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目的比较血流感染患者表皮葡萄球菌与金黄色葡萄球菌的耐药性差异,为临床合理选用抗菌药物提供参考。方法对贵州医科大学第三附属医院2011年6月至2014年11月血流感染标本中分离出的表皮葡萄球菌与金黄色葡萄球菌共140株进行比较分析,按照《全国临床检验操作规程》进行微生物鉴定,采用K-B纸片法进行药敏试验,药敏结果按美国临床和实验室标准化协会(CLSI)的标准判断,数据采用SPSS 17.0软件进行统计分析。结果血流感染标本共分离出表皮葡萄球菌与金黄色葡萄球菌140株,其中表皮葡萄球菌分离出88株,占62.86%;金黄色葡萄球菌分离出52株,占37.14%。血流感染表皮葡萄球菌与金黄色葡萄球菌对苯唑西林、头孢唑林、头孢噻肟、克林霉素、红霉素、阿奇霉素、环丙沙星、氧氟沙星、利福平、呋喃妥因、头孢噻吩、亚胺培南、左氧氟沙星、麦迪霉素、复方新诺明等耐药率分别为81.82%,45.15%;35.23%,15.38%;20.45%,5.77%;47.73%,26.92%;76.14%,51.92%;69.32%,50.00%;64.77%,9.62%;54.55%,28.85%;14.77%,0.00%;10.23%,0.00%;39.77%,3.85%;11.36%,0.00%;54.55%,28.85%;67.05%,5.77%;79.55%,32.69%;表皮葡萄球菌耐药率明显高于金黄色葡萄球菌,差异有性统计学意义(P<0.05)。结论血流感染中表皮葡萄球菌的感染率与耐药率不断上升,耐药率明显高于金黄色葡萄球菌,应引起重视。
Objective To compare the differences of drug resistance among Staphylococcus epidermidis and Staphylococcus aureus in patients with bloodstream infection and to provide a reference for the rational use of antibacterials in clinic. Methods A total of 140 Strains of Staphylococcus epidermidis and Staphylococcus aureus isolated from the bloodstream specimens of the Third Affiliated Hospital of Guizhou Medical University from June 2011 to November 2014 were compared and analyzed. According to the “National Clinical Laboratory Procedures” Microbiological identification, drug susceptibility testing using KB paper method, drug susceptibility results according to the American Society of Clinical and Laboratory Standards (CLSI) standards to determine the data using SPSS 17.0 software for statistical analysis. Results 140 strains of Staphylococcus epidermidis and Staphylococcus aureus were isolated from the bloodstream specimens, of which 88 were isolated from Staphylococcus epidermidis, accounting for 62.86%. Staphylococcus aureus isolated from 52 strains (37.14%). Staphylococcus epidermidis and Staphylococcus aureus were treated with oxacillin, cefazolin, cefotaxime, clindamycin, erythromycin, azithromycin, ciprofloxacin, ofloxacin, rifampin, , Cefalotin, imipenem, levofloxacin, midecamycin and cotrimoxazole were 81.82%, 45.15%, 35.23%, 15.38%, 20.45%, 5.77%, 47.73%, 26.92%, 76.14 %, 51.92%; 69.32%, 50.00%; 64.77%, 9.62%; 54.55%, 28.85%; 14.77%, 0.00%; 10.23%, 0.00%; 39.77%, 3.85%; 11.36%, 0.00%; 54.55% 28.85%, 67.05%, 5.77%, 79.55% and 32.69%, respectively. The resistant rate of Staphylococcus epidermidis was significantly higher than that of Staphylococcus aureus, with statistically significant difference (P <0.05). Conclusion The infection rate and drug resistance rate of Staphylococcus epidermidis in bloodstream infection are increasing, and the drug resistance rate is obviously higher than that of Staphylococcus aureus, which should be paid more attention.