耐甲氧西林葡萄球菌的耐药性监测  

Mornitoring drug resistance of meticillin-resistant Staphylococcus aureus

作　　者：熊剑文[1] 裴云[1] 冯瑞祥[1] 李亚舒[1] 杨成芳[1] 

机构地区：[1]解放军第414医院检验科,江苏南京210015

出　　处：《南京军医学院学报》2003年第4期223-225,共3页Journal of Nanjing Military Medical College

摘　　要：目的:监测临床分离的耐甲氧西林葡萄球菌的耐药性,并探讨对耐药菌感染的治疗策略。方法:对临床分离的152株葡萄球菌用表型检测的琼脂筛选法检测耐甲氧西林葡萄球菌(MRS),用Kirby—Bauer琼脂扩散法做药敏试验。结果:筛选出MRS 79株,检出率为51.97％,其中耐甲氧西林金黄色葡萄球菌(MRSA)为60.00％,耐甲氧西林凝固酶阴性葡萄球菌(MRC-NS)为41.79％。MRS对万古霉素、利复平和阿米卡星的耐药率较低,对其他抗生素耐药率较高;甲氧西林敏感葡萄球菌(MSS)除对青霉素的耐药率较高外,对其他抗生素的耐药率显著低于MRS。结论:MRS具有多重耐药性,应长期进行耐药性检测;MRS重症感染应首选糖肽类抗生素万古霉素治疗。Objective: To mornitor the bacterial drug resistance of the clinical isolated meticillin-resistant Staphylococcus (MRS) and to explore the treatment strategy of the infection caused by resistant strains. Methods: Phenotypic surveillance test was used to detect MRS in 152 strains of Staphylococcus spp isolated from clinical patients; Kirby-Bauer agar diffusion method was used to judge the drug sensitivity. Results: Seventy-nine MRS were isolated and the detectable rate was 51.97%. Among them Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative staphylococci (MRCNS) was 60.00% and 41.79%, respectively. MRS strains had lower drug resistance to vancomycin, rifampin and aminogbycoside, however, they had higher drug resistance to other antibiotics. Apart from the higher drug resistance to penicillin, the drug resistant rate of meticillin sensitive Staphylococcus (MSS) was remarkablely lower than MRS strains. Conclusion; MRS has multi-drug resistance, and the long time bacteria drug resistance should be mornitored; Vancomycin is the first choice for the treatment of severe systemic infections caused by MRS strains.

关 键 词：耐甲氧西林葡萄球菌 抗菌药物 耐药率 

分 类 号：R446.5[医药卫生—诊断学]