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目的分析医院革兰阳性菌的分布及耐药性变迁,为临床合理使用抗菌药物提供依据。方法采用VITEK-2Compact微生物分析系统进行菌株鉴定及药敏试验。使用SIMCA-P+软件建立主成分分析(principal component analysis,PCA)模型。通过构建主成分得分图,结合主成分载荷图,对革兰阳性菌耐药性的变迁进行整体评价,筛选耐药率上升趋势较显著的菌株。结果 2011—2014年共分离出5 436株革兰阳性菌,包括金黄色葡萄球菌、粪肠球菌、溶血葡萄球菌、表皮葡萄球菌、人葡萄球菌和头状葡萄球菌,分别占59.1%,12.3%,12.2%,10.3%,3.7%和2.3%。其中人葡萄球菌、金黄色葡萄球菌和溶血葡萄球菌对克林霉素耐药率的上升趋势较为显著。结论医院应加强对克林霉素使用的管理,加强葡萄球菌属对克林霉素耐药率的监测。
Objective To analyze the distribution and drug resistance changes of Gram-positive bacteria in hospitals and provide the basis for rational use of antibacterials in clinic. Methods VITEK-2Compact microbial analysis system for strain identification and susceptibility testing. The principal component analysis (PCA) model was established using SIMCA-P + software. By constructing the score chart of principal components and combining with the principal component load map, we made an overall evaluation on the change of drug resistance of Gram-positive bacteria, and screened the strains that the drug resistance rate increased significantly. Results A total of 5 436 Gram-positive bacteria, including Staphylococcus aureus, Enterococcus faecalis, Staphylococcus haemolyticus, Staphylococcus epidermidis, Staphylococcus epidermidis, Staphylococcus aureus and Staphylococcus aureus were isolated from 2011 to 2014, accounting for 59.1% and 12.3% , 12.2%, 10.3%, 3.7% and 2.3% respectively. One of the staphylococcus aureus, Staphylococcus aureus and Staphylococcus aureus resistance to clindamycin increased more significantly. Conclusion The hospital should strengthen the management of clindamycin use and strengthen the monitoring of clindamycin resistance rate in Staphylococcus.