金黄色葡萄球菌致肺部感染的耐药谱分析  

Drug resistant spectrum of staphylococcus aureus causing pulmonary infection

作　　者：王良兴[1] 杨乐和[2] 余方友[3] 刘莹[2] 李挺建[2] 姚丹[2] 徐永健[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院呼吸科,湖北武汉430030 [2]温州医学院附属第一医院呼吸科,浙江温州325000 [3]温州医学院附属第一医院检验科,浙江温州325000

出　　处：《中华医院感染学杂志》2011年第4期769-771,共3页Chinese Journal of Nosocomiology

摘　　要：目的调查引起肺部感染金黄色葡萄球菌的耐药谱。方法收集确诊为金黄色葡萄球菌肺部感染病例的痰培养标本及临床资料,进行药敏试验。结果 100例由金黄色葡萄球菌引起的肺部感染患者中,70.0%为老年患者;85株为耐甲氧西林金黄色葡萄球菌(MRSA);金黄色葡萄球菌对多种抗菌药物呈普遍耐药,但所有分离株对万古霉素、利奈唑胺、替考拉宁、喹奴普汀/达福普汀及呋喃妥因均敏感,此外耐药率<20.0%的抗菌药物仅1种,为磺胺甲噁唑/甲氧苄啶;MRSA对红霉素、克林霉素等药物的耐药率显著高于MSSA(P<0.01)。结论金黄色葡萄球菌引起的肺部感染易发生于老年患者,MRSA呈多药耐药性,但对万古霉素等药仍保持较高敏感性。OBJECTIVE To investigate the clinical characteristics and resistance of Staphylococcus aureus lung infections so as to guide the treatment of S. aureus lung infections. METHODS Clinical materials of S. aureus causing lung infections and sputum culture specimen were collected and the sensitivity of isolated strains to antibacterial agents. RESULTS Among 100 cases of S. aureus causing lung infections, 70.0% were the elderly patients. One hundred strains of S. aureus were isolated,including 85 metieillin-resistant S. aureus（MRSA） and 15 meticillin-sensitive S. aureus（MSSA）. S. aureus showed multi-drug resistance to many kinds of antibiotics, while all isolates of S. aureus were sensitive to vancomycin, linezolid, teicoplanin, quinupristin/dalfopristin and furadantin. And besides, only the resistant rate to compound sulfamethoxazole was lower than 20. 0%. The resistant rates of MRSA to erythromycin, clindamycin hydrochloride, rifampicin, gentamicin, tetracycline and levofloxacin were all significantly higher than those of MSSA（P〈0.01）. CONCLUSION S. aureus causing lung infections usually occur in the elderly patients. MRSA shows multi-resistant characteristics except for vancomycin, linezolid, teicoplanin, quinupristin/dalfopristin and furadantin with high sensitivity.

关 键 词：金黄色葡萄球菌 肺部感染 耐甲氧西林金黄色葡萄球菌 耐药性 

分 类 号：R378.11[医药卫生—病原生物学]