高　晶，　刘晓艳

(复旦大学附属妇产科医院，上海 200011)

女性泌尿生殖道无乳链球菌的耐药性分析

高晶，刘晓艳

(复旦大学附属妇产科医院，上海 200011)

摘要：目的对女性泌尿生殖道分离的无乳链球菌对常用抗菌药物的耐药情况做回顾性分析，了解常用抗菌药物的耐药趋势变化，指导临床合理使用抗菌药物。 方法对2009年1月至2012年12月送检的女性泌尿生殖道标本进行常规培养，使用VITEK32全自动细菌鉴定分析仪对分离出的细菌进行鉴定和药敏试验，同时对红霉素耐药、克林霉素敏感或中介的无乳链球菌菌株做D-抑菌圈试验。 结果妇科患者检出569株无乳链球菌，产科患者检出192株无乳链球菌，二者年龄差异有统计学意义(P<0.01)。761株无乳链球菌中无万古霉素耐药菌株，青霉素和利奈唑胺耐药率均<3%；呋喃妥因的耐药率2009年至2011年均<0.5%，2012年为7.2%；四环素耐药率>90%；红霉素、克林霉素及左氧氟沙星的耐药率较高，且呈逐年上升趋势； D-抑菌圈试验阳性率为21.7%。结论临床须根据体外药敏试验结果合理使用抗菌药物，同时须加强耐药性监测。

关键词：无乳链球菌；泌尿生殖道；耐药性

中图分类号：

文章编号：1673-8640(2015)01-0013-04R446.5

文献标志码：码：A

DOI：10.3969/j.issn.1673-8640.2015.01.004

Abstract:ObjectiveTo analyze retrospectively the drug resistance of Streptococcus agalactiae isolated from female urogenital tract, to understand the drug resistance tendency change of commonly-used antibiotics, and to guide the rational use of antibiotics in clinical application. MethodsThe routine culture was performed for female urogenital tract specimens collected from January 2009 to December 2012, and the identification and drug sensitivity test were performed for Streptococcus agalactiae by VITEK32 automatic bacterium identification analyzer. The D-inhibition zone trial was tested for isolates which were drug-resistant to erythromycin and sensitive or intermediary to clindamycin. ResultsThere was a statistical significance in age distribution among 569 specimens from Department of Gynecology and 192 specimens from Department of Obstetrics (P<0.01). Drug resistance rate was 0 to vancomycin and <3% to penicillin and linezolid. The drug resistance rate of nitrofurantoin was <0.5% from 2009 to 2011 and suddenly increased to 7.2% in 2012. The drug resistance rate of tetracycline exceeded 90%. Erythromycin, clindamycin and levofloxacin reflected high drug resistance rates and such an increasing tendency year by year. The positive rate of D-inhibition zone trial was 21.7%. ConclusionsIt is required to rationally use antibiotics in clinical application according to the drug sensitivity test results. Meanwhile, the drug resistance monitoring in clinical application should be strengthened.

作者简介：高晶，女，1982年生，学士，主管技师，主要从事临床微生物检验工作。

通讯作者：刘晓艳，联系电话：021-63455050-6394。

收稿日期：(2014-08-23)

Drug resistance analysis on the drug resistance ofStreptococcusagalactiaeisolated from female urogenital tractGAOJing,LIUXiaoyan.(ObstetricsandGynecologyHospitalofFudanUniversity,Shanghai200011,China)

Key words:Streptococcusagalactiae; Urogenital tract; Drug resistance

无乳链球菌(Streptococcusagalactiae)通常称为B群链球菌(GroupBStreptococcus, GBS)，其作为条件致病菌，常定居于妇女生殖道和直肠中，在健康人群中其带菌率高达15%~35%，是引起新生儿菌血症和脑膜炎的常见病原菌。无乳链球菌在免疫力低下、抗菌药物广泛应用时，易引起机会感染。我们对女性泌尿生殖道分离的无乳链球菌的耐药情况进行回顾性分析，以指导临床合理使用抗菌药物和预防性用药。……