耐甲氧西林葡萄球菌的耐药性分析  

Analysis of drug resistance of meticillin-resistant staphylococcus

作　　者：尚旭明[1] 王海燕[2] 

机构地区：[1]山东省立医院检验科,山东省济南250021 [2]山东省卫生厅卫生监督所

出　　处：《中国基层医药》2008年第4期623-625,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的分析临床分离的耐甲氧西林葡萄球菌（MRS）的分布和耐药性，并探讨对耐药菌感染的治疗策略。方法对临床分离的568株葡萄球菌，药敏试验及耐甲氧西林葡萄球菌的检测均采用Kirby-Bauer琼脂扩散法，操作及结果判断均按美国国家临床实验室标准委员会（NCCLS）颁布的规则（2000年版）标准执行。结果筛选出金黄色葡萄球菌（SAO）171株，检出率39．1％，凝固酶阴性葡萄球菌（CNS）397株，检出率为69．8％。其中耐甲氧西林金黄色葡萄球菌（MRSA）36．2％，耐甲氧西林凝固酶阴性葡萄球菌（MRSCON）77．5％，MRSA株对喹诺酮类耐药性（21％～48％）明显低于MRSCON株（84％～89％），MRS除对万古霉素、利复平、呋喃妥因、阿米卡星和少数青霉素类耐药外，MRSA和MRSCON株的耐药性显著高于甲氧西林敏感葡萄球菌（MSSA）和甲氧西林敏感血浆凝固酶阴性葡萄球菌（MSSCON）株（P〈0．05），未发现VRS株。结论由MRS菌株引起重症感染应首选糖肽类抗生素万古霉素治疗，葡萄球菌是造成医院感染的主要病原菌之一，MRS具有多重耐药性，应长期进行耐药性检测，提高对抗生素耐药性认识。Objective To analyze distribution and drug resistance of MRSA separated,to probe into a treat method for MRSA infection and offer scientific gist for reasonable use of clinical antibiotic. Methods 568 MRSA separated from clinic were measured and a drug sensitivity, test was performed by means of Kirby-Bautr agar diffusion method. Results 370 individual plants were filtered,the rate of inspection was 65.1%. MRSA was 36.2 % among them, MRSCON was 77.5 %, the drug resistance of MRSA to quinolones（21% --48 % ） was below MRSCON （84 % - 89 % ）. The drug resistance of MRSA and MRSCON obviously excelled MSSA and MSSCON （ P 〈 0.05 ）. VRS was undiscovered. Conclusion Severe infection caused by MRS should choose vancomycin resistant enterococci to cure at fist. Staphylococcus was one of primary pathogenic bacterium caused infection in hospital, MRS had multiple drug resistance and measure range about drug resistance should be extended, which would advance the cognition about the drug resistance of antibiotic and cut off the transmitted path, reduce the drug resistance of bacteria and the infection rate in hospital.

关 键 词：葡萄球菌 金黄色 凝固酶 甲氧西林抗药性 

分 类 号：R446[医药卫生—诊断学]