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In Vitro Activity of Sixteen Drugs Including Vancomycin Against Clinical Gram-positive Isolates: A Multicentre Cross-sectional Study in China
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摘要: 目的 了解万古霉素等16种药物对临床革兰阳性球菌的体外抗菌活性，为临床合理用药提供依据。 方法 2019年1月1日—12月31日，收集全国24家医院临床分离的革兰阳性球菌，采用基质辅助激光解析/电离飞行时间质谱仪进行菌种鉴定，并采用自动化仪器法对收集的菌株进行体外药物敏感性试验（简称“药敏试验”），按CLSI 2022年版标准判读药敏结果，进而对革兰阳性球菌耐药率及其影响因素进行分析。 结果 共收集革兰阳性球菌500株，主要为金黄色葡萄球菌（51.0%，255/500）和肠球菌（46.6%，233/500）。药敏试验结果显示，革兰阳性球菌对红霉素、青霉素、苯唑西林和克林霉素耐药率较高（55.5%～71.5%），但对万古霉素、利奈唑胺和替考拉宁保持较低的耐药率（0.2%～1.0%）。所有金黄色葡萄球菌和屎肠球菌均对利奈唑胺敏感，但4.4%的粪肠球菌对利奈唑胺耐药；所有金黄色葡萄球菌和粪肠球菌均对万古霉素敏感，但1.8%的屎肠球菌对万古霉素耐药。金黄色葡萄球菌对夫西地酸的耐药率较低，仅为2.7%。去甲万古霉素和万古霉素对金黄色葡萄球菌的MIC50和MIC90相同，分别为1mg/L和2mg/L。 结论 万古霉素、去甲万古霉素、利奈唑胺对金黄色葡萄球菌、肠球菌等革兰阳性球菌均具有较高的抗菌活性,夫西地酸对金黄色葡萄球菌具有较高的抗菌活性，仍存在对上述4种抗菌药物耐药的菌株。Abstract: Object To evaluate the in vitro antimicrobial activities of a total sixteen agents against clinical Gram-positive isolates to provide susceptibility data for the rational clinical use of drugs. Mechods From January 1 to December 31 in 2019, Gram-positive isolates were collected from 24 hospitals in China. All strains were identified by the MALDITOF MS apparatus. Antimicrobial susceptibility testing was performed using the CLSI broth microdilution reference method. The results were interpreted in accordance with CLSI 2022 criteria. Then the resistance rate of gram-positive isolates and their influencing factors were analyzed. Results A total of 500 Gram-positive strains were mostly Staphylococcus aureus (n=255) and Enterococcus (n=233) accounted for 51.0% and 46.6%, respectively. The drug susceptibility testing results showed that Gram-positive isolates had high resistance rates to erythromycin, penicillin, oxacillin and clindamycin(55.5-71.5%), but maintained low resistance rates to vancomycin, norvancomycin, linezolid and teicoplanin (0.2-1.0%). Linezolid could completely inhibite S. aureus and E. faecium strains, but 4.4% of E. faecalis strains were resistant. All S. aureus and E.faecalis strains were susceptible to vancomycin, but 1.8% of Enterococcus faecium was resistant. Fusidic acid maintain good activity to S. aureus strains, only 2.7% was resistant. Vancomycin and norvancomycin had the same MIC50 and MIC90 to S. aureus strains, which were 1mg/L and 2mg/L, respectively. Conclusions Vancomycin, norvancomycin and linezolid were highly active against clinical isolates of S. aureus and Enterococcus spp. Fusidic acid showed potent in vitro activity against S. aureus. However, there are still strains that are resistant to the four antimicrobials mentioned above.
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Key words:
- Staphylococcus aureus /
- Enterococcus spp. /
- vancomycin /
- norvancomycin /
- linezolid /
- fusidic acid
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