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纸质出版:2013
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张琴,卓超,肖书念,夏淑,黄增光,林倍州,钟南山.耐甲氧西林金黄色葡萄球菌的万古霉素最低抑菌浓度漂移研究[J].陆军军医大学学报(原第三军医大学学报),2013,35(23):2513-2515.
Zhang Qin,Zhuo Chao,Xiao Shunian,Xia Shu,Huang Zengguang,Lin Beizhou,Zhong Nanshan.Vancomycin minimum inhibitory concentration creep in methicillin-resistant Staphylococcus aureus[J].J Amry Med Univ (J Third Mil Med Univ),2013,35(23):2513-2515.
张琴,卓超,肖书念,夏淑,黄增光,林倍州,钟南山.耐甲氧西林金黄色葡萄球菌的万古霉素最低抑菌浓度漂移研究[J].陆军军医大学学报(原第三军医大学学报),2013,35(23):2513-2515. DOI:
Zhang Qin,Zhuo Chao,Xiao Shunian,Xia Shu,Huang Zengguang,Lin Beizhou,Zhong Nanshan.Vancomycin minimum inhibitory concentration creep in methicillin-resistant Staphylococcus aureus[J].J Amry Med Univ (J Third Mil Med Univ),2013,35(23):2513-2515. DOI:
目的 逐年分析耐甲氧西林金黄色葡萄球菌(methicillin-resistant Staphylococcus aureus,MRSA)对万古霉素、替考拉宁及利奈唑胺的最低抑菌浓度(minimum inhibitory concentration
MIC)值变化,评估是否存在万古霉素MIC漂移。 方法 收集6家三甲医院2007-2011年临床分离的MRSA菌株,头孢西丁纸片法确认MRSA,微量肉汤稀释法测定菌株对万古霉素、替考拉宁、利奈唑胺及头孢西丁的MIC,计算MIC
50
、MIC
90
、MIC值几何均数、敏感率及耐药率。 结果 2007-2011年,共收集非重复MRSA 1 219株,所有菌株对万古霉素、替考拉宁及利奈唑胺均敏感。各年MRSA对万古霉素MIC几何均值分别为0.952、0.956、0.947、1.013、1.040 μg/mL,呈渐进性上升趋势(P0.05),MIC1 μg/mL菌株比例分别为23.5%、21.6%、27.8%、30.6%和42.8%,有逐年上升趋势(
P
0.05)。替考拉宁对MRSA菌株几何均值分别为0.739、0.749、0.743、0.768、0.973,也呈渐进性上升趋势(
P
0.05)。利奈唑胺对MRSA菌株几何均值分别为1.414、1.422、1.386、1.410、1.221,无渐进性上升趋势(
P
0.05)。 结论 我国临床分离株MRSA对万古霉素存在MIC漂移现象,呈逐年上升趋势。
Objective To assess whether there is vancomycin minimum inhibitory concentration (MIC) creep in methicillin-resistant Staphylococcus aureus (MRSA) from 6 large-scale hospitals in China by analyzing the MIC of the bacterium to vancomycin
teicoplanin and linezolid over a 5-year period. Methods MRSA isolates were collected from 6 hospitals in China during the period from 2007
to 2011. Their MIC to vancomycin
teicoplanin and linezolid was determined by broth microdilution according to the procedure by the National Committee for Clinical Laboratory Standards. MIC
50
MIC
90
and geometric-mean-MIC were calculated for all isolates in each year. Results A total of 1 219 clinical isolates of MRSA were determined in this study
All the isolates were susceptible to vancomycin
linezolid and teicoplanin. Overall
the vancomycin geometric-mean-MIC was 0.952
0.956
0.947
1.013 and 1.040 μg/mL respectively in the 5 consecutive years
with a significantly increased trend over years (
P
0.05). The percentages of MRSA isolates with a vancomycin MIC above 1 μg/mL (MIC1 μg/mL) were 23.5%
21.6%
27.8%
30.6% and 42.8% annually
and increased with time(
P
0.05). The teicoplanin geometric-mean-MIC was 0.739
0.749
0.743
0.768 and 0.973 μg/mL
and also in an increased trend over years(
P
0.05). The linezolid geometric-mean-MIC was 1.414
1.422
1.386
1.410 and 1.221 μg/mL
and MIC trend was not found (
P
0.05). Conclusion Vancomycin MIC creep in MRSA has emerged in China in this study.
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