2008～2010年某院金黄色葡萄球菌感染现状及耐药性变迁分析  

The change of Staphylococcus aureus infection and antimicrobial resistance from 2008 to 2010

作　　者：翟如波[1] 张昊[1] 孙跃岭[1] 邱广斌[1] 

机构地区：[1]解放军第202医院检验科,沈阳市110003

出　　处：《中华实验和临床感染病杂志（电子版）》2012年第4期38-41,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

摘　　要：目的了解本院院内金黄色葡萄球菌的临床分布及耐药性变迁,为临床合理使用抗菌药物提供一定的依据。方法收集分离自2008年1月至2010年12月本院住院患者金黄色葡萄球菌共859株,采用VITEK-2Compact进行鉴定,采用K-B纸片扩散法进行药敏试验,头孢西丁纸片扩散法鉴定耐甲氧西林金黄色葡萄球菌(MRSA),采用双纸片扩散法检测诱导型克林霉素耐药情况,应用WHONET5.4软件进行数据处理。结果本研究共检出金黄色葡萄球菌859株,主要分离自痰液524株(61.0%),伤口分泌物153株(17.8%);科室分布情况为:呼吸内科291株(33.9%),肿瘤科157株(18.3%),神经内科133株(15.5%)。本研究所分离菌株中MRSA共253株(29.5%),诱导型克林霉素检测阳性菌155株(49.1%)。MRSA检出率逐年升高,MRSA对16种抗菌药物的耐药率均高于甲氧西林敏感金黄色葡萄球菌(MSSA),其中三者对头孢唑啉、头孢呋辛、环丙沙星、左氧氟沙星和利福平的耐药率比较,差异具有统计学意义(P<0.05),未检出耐万古霉素和利奈唑胺菌株。结论临床中应根据病原学药敏结果合理选择抗菌药物,减少因抗菌药物滥用而导致的耐药菌株的产生。Objective To investigate the clinical distribution of Staphylococcus aureus infection and its antimicrobial resistance change in our hospital and to provide a basis for rational use of antibiotic in clinical practice. Methods Total of 859 strains of Staphylococcus aureus isolated from various clinical samples during January 2008 to October 2010 were identified with VITEK-2 Compact microbiology analyzer, and antimicrobial susceptibility testing was performed by Kirby-Bauer disk diffusion. Methicillin-resistant Staphylococcus aureus （MRSA） were identified with cefoxitin disk diffusion method, and the inductive clindamycin resistance were tested with double disks diffusion method. The results were analyzed by WHONET 5.4. Results Among the 859 strains of Staphylococcus aureus, 524 strains （ 61.0% ） were detected out from the sample of sputum, 153 strains （ 17.8% ） were from secretion. The detection rates in respiration internal medicine, oncology and neurology were 33.9% （291 strains）, 18.3% （157 strains） and 15.5% （133 strains）, respectively. Total of 253 strains of MRSA and 155 strains of Staphylococcus aureus with inductive clindamycin resistance were detected. The detection rates of MRSA raised year by year. The drug resistance rate of MRSA was significantly higher than that of methicillin sensitive Staphylococcus aureus （MSSA）. The drug resistance rates among cefazolin, cefuroxime, ciprofloxacin, levofloxacin and rifampicin were significantly different （ P 〈 0.05 ）. No vancomycin and linezolid resistant strains were detected. Conclusions Clinicians should apply antibiotic reasonably according to the drug sensitive test so as to reduce the emergence of drug-resisitant bacteria.

关 键 词：院内感染 耐甲氧西林金黄色葡萄球菌 耐药 

分 类 号：R446.5[医药卫生—诊断学]