万古霉素对徐州地区2015—2019年MRSA最低抑菌浓度值飘移特征
作者:
作者单位:

1.徐州医科大学附属医院检验科, 江苏 徐州 221002;2.徐州医科大学第二附属医院检验科, 江苏 徐州 221002;3.徐州市中心医院检验科, 江苏 徐州 221009

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通讯作者:

徐萍萍  E-mail: pp2810@163.com

中图分类号:

R378.1  R446.5

基金项目:

江苏省徐州市科技计划项目(KC14SH116)


Characteristics of minimum inhibitory concentration drift of vancomycin against methicillin-resistant Staphylococcus aureus in Xuzhou in 2015-2019
Author:
Affiliation:

1.Department of Laboratory Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, China;2.Department of Laboratory Medicine, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, China;3.Department of Laboratory Medicine, Xuzhou Central Hospital, Xuzhou 221009, China

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    摘要:

    目的 回顾性分析万古霉素对耐甲氧西林金黄色葡萄球菌(MRSA)最低抑菌浓度(MIC)值变化趋势,为临床使用万古霉素治疗MRSA感染提供参考。 方法 按医院感染标准筛选2015—2019年徐州地区3所三级甲等综合性医院临床标本分离的非重复MRSA共900株,收集其MIC值,比较重症监护病房(ICU)与非ICU科室万古霉素对MRSA的MIC值,分析相关特征。 结果 900株MRSA全部对万古霉素敏感,2015—2019年万古霉素对MRSA的MIC均值分别为(1.058±0.232)、(1.100±0.272)、(1.108±0.266)、(1.122±0.273)、(1.147±0.298)μg/mL,组间整体比较,差异有统计学意义(P < 0.05);ICU科室MIC均值分别为(1.159±0.303)、(1.253 ±0.344)、(1.320±0.331)、(1.413±0.289)、(1.451±0.278)μg/mL,组间整体比较差异有统计学意义(P < 0.05);非ICU科室MIC均值分别为(0.995±0.134)、(1.005±0.135)、(1.005±0.091)、(1.016±0.155)、(1.006±0.142)μg/mL,组间整体比较,差异无统计学意义(P>0.05)。2015—2019年ICU和非ICU科室MIC均值同年份比较,差异均有统计学意义(均P < 0.05);万古霉素对MRSA的MIC≥1.5 μg/mL的比例逐年增加。 结论 2015—2019年徐州地区未发现耐万古霉素MRSA,万古霉素对MRSA的MIC值存在漂移,主要来自ICU科室。对ICU科室万古霉素MIC≥1.5 μg/mL的MRSA菌株及其感染患者应重点监控,积极治疗,防止感染暴发。

    Abstract:

    Objective To retrospectively analyze the changing trend of minimum inhibitory concentration (MIC) of vancomycin against methicillin-resistant Staphylococcus aureus (MRSA), provide reference for the clinical use of vancomycin in the treatment of MRSA infection. Methods 900 strains of non-repetitive MRSA from clinical specimens in 3 tertiary first-class general hospitals in Xuzhou City in 2015-2019 were selected according to the standard of healthcare-associated infection (HAI), MIC values were collected, MICs of vancomycin to MRSA between intensive care units (ICUs) and non-ICUs were compared, and related characteristics were analyzed. Results 900 strains of MRSA were all sensitive to vancomycin, the mean MIC values in 2015-2019 were (1.058±0.232), (1.100±0.272), (1.108±0.266), (1.122±0.273) and (1.147±0.298) μg/mL respectively, and there were significant differences among groups (P < 0.05); the mean MICs of ICU were (1.159±0.303), (1.253±0.344), (1.320±0.331), (1.413±0.289) and (1.451±0.278) μg/mL respectively, there were significant differences among groups (P < 0.05); the mean MICs of non-ICUs were (0.995±0.134), (1.005±0.135), (1.005±0.091), (1.016±0.155) and (1.006±0.142) μg/mL respectively, there were no significant differences among groups (P>0.05). The mean MICs between ICUs and non-ICUs in the same year of 2015-2019 were all significantly different (all P < 0.05); proportion of MIC ≥ 1.5 μg/mL of vancomycin against MRSA had an increasing trend year by year. Conclusion Vancomycin-resistant MRSA was not found in Xuzhou in 2015-2019; vancomycin has MIC drift to MRSA, which mainly comes from ICUs. MRSA strains with vancomycin MIC ≥ 1.5 μg/mL and infected patients in ICU should be given stress surveillance and active treatment to prevent infection outbreak.

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纵帅,徐银海,丁兴龙,等.万古霉素对徐州地区2015—2019年MRSA最低抑菌浓度值飘移特征[J]. 中国感染控制杂志,2021,(11):991-995. DOI:10.12138/j. issn.1671-9638.20211277.
Shuai ZONG, Yin-hai XU, Xing-long DING, et al. Characteristics of minimum inhibitory concentration drift of vancomycin against methicillin-resistant Staphylococcus aureus in Xuzhou in 2015-2019[J]. Chin J Infect Control, 2021,(11):991-995. DOI:10.12138/j. issn.1671-9638.20211277.

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  • 收稿日期:2021-03-26
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  • 在线发布日期: 2024-04-26
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