自身免疫病病人革兰阳性球菌感染分布及耐药性
免疫系统疾病,,],免疫系统疾病；革兰阳性菌感染；药物耐受性,1资料与方法,2结果,3讨论,[参考文献]
[摘要] 目的 了解自身免疫病病人革兰阳性球菌感染种类、分布及耐药状况，为临床合理使用抗生素提供依据。方法 应用ATB Expression自动细菌鉴定系统对临床标本中分离出的革兰阳性球菌进行鉴定，用KB琼脂扩散法进行药物敏感试验。结果 428例自身免疫病病人并发细菌感染186例，感染率为43.5%。共感染285例次，例次感染率为66.6%，其中医院内感染42.8%；共分离出病原菌285株，其中革兰阳性球菌86株，占30.2%。以凝固酶阴性葡萄球菌、金黄色葡萄球菌和粪肠球菌为主。耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)分别占金黄色葡萄球菌和凝固酶阴性葡萄球菌(CNS)的63.6%和70.0%。药敏试验显示：万古霉素、替考拉宁、呋喃妥因、头孢哌酮舒巴坦及利福平对MRSA和MRCNS的抗菌活性高，对其余多种抗生素耐药，未发现万古霉素耐药株。甲氧西林敏感金黄色葡萄球菌(MSSA)和甲氧西林敏感凝固酶阴性葡萄球菌(MSCNS)对青霉素及红霉素的耐药率高，分别为87.5%~88.9%及55.6%~62.5%，对其他抗生素均敏感。粪肠球菌对替考拉宁、万古霉素、青霉素及氨苄西林等敏感性高。屎肠球菌仅对替考拉宁和万古霉素敏感，且屎肠球菌对抗菌药物的耐药率高于粪肠球菌。结论 革兰阳性球菌是自身免疫病病人感染的重要病原菌，耐药率高，细菌谱及耐药性监测对控制革兰阳性菌感染的发生有重要意义。[关键词] 免疫系统疾病；革兰阳性菌感染；药物耐受性
DISTRIBUTION OF PATHOGENS AND THEIR ANTIBIOTIC RESISTANCE IN AUTOIMMUNE DISEASE PATIENTS WITH GRAMPOSITIVE BACTERIAL INFECTIONS
LIU PENGPENG, LI WEI, ZHAI ZANLIANG, et al
(Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University Medical College, Qingdao 266003,China)
[ABSTRACT]ObjectiveTo study the distribution of pathogens and their antibiotic resistance in autoimmunedisease patients with grampositive bacterial infections, and to provide a guidance in the use antibiotics.MethodsThe identification and drug susceptibility test were analyzed by ATB Expression automatic microbiology analytical instrument system, and the bacterial susceptibility test done by KirbyBauer agar diffusion method. ResultsOf 428 patients, 186 (43.5%) had bacterial infections. The casetime of bacterial was 285, and the casetime infection rate was 66.6%, in which 42.8% were nosocomial. A total of 285 strains of pathogens had been isolated, among them, 86 strains (30.2%) were grampositive cocci, most commonly seen pathogens were coagulase negative staphylococcus, staphylococcus aureus, and enterococcus faecalis. MRSA and MRCNS accounted for 63.6% and 70.0% of staphylococcus aureus and coagulase negative staphylococci, respectively. MRSA and MRCNS were found to be most sensitive to vancomycin, teicoplanin, no vancomycin resistant strains were found. Most of them were sensitive to nitrofurantoin, cefoperazone/sulbactam and rifampin. However, most of these strains were resistant to other antibiotics. MSSA and MSCNS were highly resistant to penicillin and erythromycin, resistant rates were 87.5%-88.9% and 55.6%-62.5% respectively, while most strains were sensitive to the other 14 antibiotics. Vancomycin, teicoplanin, penicillin and ampicillin were the most active agents against Enterococcus faecalis. Enterococcus faecium was sensitive to vancomycin and teicoplanin. The resistant rates of faecalis strains to various antibiotics tested were higher than those of E. faecium strains. ConclusionGrampositive bacteria are the important bacteria infecting patients with autoimmune disease and have a high resistibility to antibiotics. Surveillance of pathogen and ant their drugresistance patterns is important for the control of infections. ......
您现在查看是摘要页，全文长 11329 字符。