132株MRSA的临床分布情况和耐药性分析  

The resistance drug analysis and clcnical Constribution of 132 strains MRSA

作　　者：钟海英[1] 周贞学[1] 王旭明[1] 

机构地区：[1]海南省人民医院检验科,海南海口570311

出　　处：《中国实验诊断学》2011年第6期1079-1082,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的分析耐甲氧西林金黄色葡萄球菌(Methicillin—resistant Staphylococcus aureus,MRSA)的临床分布情况和耐药性分析,指导临床合理使用抗生素。方法本院2009年10月-2010年5月临床分离的耐甲氧西林金黄色葡萄球菌(MRSA)132株,利用天地人微生物分析系统进行细菌鉴定和药敏实验,分析其感染分布和耐药性。结果共分离出MRSA132株,占金黄色葡萄球菌的40.49%,主要分布在门诊(18.98%),ICU病房(14.39%),神经内科(13.64%),呼吸内科(12.88%),而感染标本以痰液(59.54%)为主;所有的分离株对万古霉素都敏感,所有菌株对苯唑西林、青霉素、美罗培南、拉氧头孢、哌拉西林/他唑巴坦都耐药,对红霉素、环丙沙星、诺氟沙星、克林霉素、四环素、庆大霉素、利福平、呋喃妥因耐药率分别为91.70%、81.10%、80.30%、78.80%、69.70%、68.90%、53.00%、19.70%。结论 MSRA的的感染率高,耐药现象严重,具有多重耐药的特点,应长期进行耐药性监测,临床应根据药敏结果合理选用抗茵药物治疗感染,首选药物为万古霉素。Objective To analyze the clinical distribution and resistance to antibiotics of Methicillin—resistant Staphylococcus aureus（MRSA） for guiding rational of antibiotics.Methods Isolates of 132 Methicillin—resistant Staphylococcus aureus（MRSA） in Hainan Hospital from clinical cases from October 2009 to May 2010.To identity MRSA and drug sensitivity test were examined by DGR-96 analysis system.To study the infection distribution and resistance to antibiotics.Results A total of MRSA is 132,which is Proportion of 40.85% of Staphylococcus aureus Separated.All the Strains Distribute mainly from Outpatient department,ICU ward,Neurology ward and Respiratory ward.The rates of the above are as follows,18.98%,14.39%,13.64%,12.88%.Sputum is the Major type of the sample where MRSA isolated,which takes up the Proportion of 59.54%.All isolates were sensitive to vancomycin.However,All strains were all resistant to oxacillin,penicillin,meropenem,pulling oxygen cephalosporins,piperacillin/tazobactam.Resistance rates for other antimicrobial agents were as follows：erythromycin,91.7%;ciprofloxacin, 81.1%;norfloxacin,80.3%;clindamycin,78.8%;tetracycline,69.7%;gentamicin,68.9%;rifampicin,53%;nitrofurantoin,19.7%.Conclusion The infection and drug resistance of MRSA and serious,and the strain can resist multiple antibiotics.So we should have surveillances for MRSA for a long time,and be based on the results of clinical drug sensitivity to use antibiotic drugs in the treatment of infections.The first option of antibiotics for MRSA is vancomycin.

关 键 词：MRSA 感染 耐药性 

分 类 号：R446.5[医药卫生—诊断学]