To investigate the strain composition and drug resistance characteristics of G+(Gram positive cocci) cocci causing bloodstream infections in the People's Hospital of Inner Mongolia Autonomous Region in recent years and provide a basis for the empirical and rational use of drugs for the prevention and treatment of bloodstream infections caused by G+cocci. The strain composition and drug-resistant characteristics of G+cocci isolated from positive blood culture specimens sent to various departments of the Inner Mongolia Autonomous Region People's Hospital from January 2015 to December 2022 were retrospectively analyzed, and the higher detection rates of Staphylococcus hominis and Staphylococcus epidermidis, Enterococcus faecium and Enterococcus faecalis, and methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA) were examined. MRSA and methicillin-sensitive Staphylococcus aureus (MSSA) were comparatively analyzed for resistance. The resistance data were analyzed by Whonet 5.6 statistical software, the significance of difference was analyzed by SPSS 22.0 software, and the resistance rate was compared by χ2 test. The results showed that 1 209 strains of G+cocci, in terms of the composition ratio, from high to low, were mainly human staphylococci (32.5%,393/1 209), Staphylococcus epidermidis (27.8%, 336/1 209), Staphylococcus aureus (14.9%,180/1 209) and Enterococcus faecalis (10.6%, 128/1 209). Among them, the detection rate of methicillin-resistant Staphylococcus aureus (MRSA) (42.8%, 77/180) was lower than that of methicillin-resistant coagulase-negative staphylococcus (MRCNS) (71.5%, 608/850); and among enterococci, the detection rate of Enterococcus faecalis (71.5%, 128/179) was much higher than that of Enterococcus faecalis (28.5%, 51/179). For drug resistance, the resistance rate to five commonly used antimicrobial drugs, ciprofloxacin, levofloxacin, moxifloxacin, clindamycin and tetracycline, was higher in Staphylococcus hominis than in Staphylococcus epidermidis (χ2=7.152-64.080, P<0.05); however, for the aminoglycoside antimicrobial drug gentamicin, the rate of resistance in Staphylococcus humanus was lower than in Staphylococcus epidermidis, and the difference was statistically significant (χ2=11.895, P<0.05); no strains resistant to linezolid and vancomycin were found in both. Comparison of the resistance rates to seven antimicrobial drugs, gentamicin, rifampicin, ciprofloxacin, levofloxacin, moxifloxacin, clindamycin and tetracycline, was significantly higher in MRSA than in MSSA (χ2=6.169-56.941, P<0.05); however, the resistance rate to cotrimoxazole, MRSA (15.6%, 12/77) was significantly lower than that of MSSA (35.3%, 36/102), and the difference was statistically significant (χ2=5.155, P<0.05); MRSA and MSSA resistant to linezolid and vancomycin were not found. The resistance rate of Enterococcus faecalis to penicillin G and ampicillin was much higher than that of Enterococcus faecalis, and the difference was statistically significant (χ2=22.965, P<0.05), and vancomycin-resistant enterococci (VRE) were not found. In conclusion, for staphylococci, except for individual antibiotics, S.hominis and MRSA were more resistant to most antimicrobial drugs than S. epidermidis and MSSA, showing a multidrug-resistant pattern. For enterococci, except for penicillin G and ampicillin resistance rate, Enterococcus faecalis is much higher than Enterococcus faecalis, the rest of the antimicrobial drugs did not see a significant difference, in addition to vancomycin-resistant enterococci were not detected. Clinicians should pay great attention to the monitoring data of multidrug-resistant G+cocci isolated from blood cultures to provide a basis for empirical and rational use of drugs in the clinic, to effectively prevent and reduce the incidence of bloodstream infections caused by G+cocci.
探讨内蒙古某医院引起血流感染革兰阳性球菌（Gram positive cocci，G+球菌）的菌种构成及耐药特点，为合理用药提供依据。对2015年1月至2022年12月内蒙古自治区人民医院各科室送检血培养阳性标本分离出的G+球菌的菌种构成和耐药情况进行回顾性分析，对检出率较高的人葡萄球菌和表皮葡萄球菌、屎肠球菌和粪肠球菌及甲氧西林耐药金黄色葡萄球菌（MRSA）和甲氧西林敏感的金黄色葡萄球菌（MSSA）的耐药性进行对比分析。耐药数据采用Whonet 5.6统计软件进行分析，差异显著性分析采用SPSS 22.0软件，耐药率比较采用χ2检验。结果显示，1 209株G+球菌，在构成比方面，从高到低主要有人葡萄球菌（32.5%，393/1 209）、表皮葡萄球菌（27.8%，336/1 209）、金黄色葡萄球菌（14.9%，180/1 209）和屎肠球菌（10.6%，128/1 209）。其中，耐甲氧西林金黄色葡萄球菌（MRSA）的检出率（42.8%，77/180）低于耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）的检出率（71.5%，608/850）；肠球菌中，屎肠球菌（71.5%，128/179）的检出率远高于粪肠球菌（28.5%，51/179）。耐药性方面，对环丙沙星、左旋氧氟沙星、莫西沙星、克林霉素和四环素5种常用抗菌药物的耐药率，人葡萄球菌高于表皮葡萄球菌（χ2=7.152~64.080，P<0.05）；但对氨基糖苷类抗菌药物庆大霉素的耐药率，人葡萄球菌低于表皮葡萄球菌，差异有统计学意义（χ2=11.895，P<0.05）；两者均未发现对利奈唑胺和万古霉素耐药的菌株。对庆大霉素、利福平、环丙沙星、左旋氧氟沙星、莫西沙星、克林霉素和四环素7种抗菌药物的耐药率比较，MRSA明显高于MSSA（χ2=6.169~56.941，P<0.05）；但对复方磺胺甲噁唑（药物的成分为磺胺甲噁唑和甲氧苄啶）的耐药率，MRSA（15.6%，12/77）明显低于MSSA（35.3%，36/102），差异有统计学意义（χ2=5.155，P<0.05）；未发现对利奈唑胺和万古霉素耐药的MRSA和MSSA。屎肠球菌对青霉素G和氨苄西林的耐药率远高于粪肠球菌，差异有统计学意义（χ2=22.965，P<0.05）；未发现对万古霉素耐药的肠球菌。综上，对于葡萄球菌，除个别抗生素外，人葡萄球菌、MRSA对大多数抗菌药物的耐药率要高于表皮葡萄球菌和MSSA，呈多重耐药的态势。对于肠球菌，只有对青霉素G和氨苄西林耐药率，屎肠球菌远高于粪肠球菌，其余抗菌药物均未见明显差异，另外未检出对万古霉素耐药的肠球菌。.