门急诊患者血液分离的金黄色葡萄球菌耐药谱分析  

Drug resistance spectrum of Staphylococcus aureusisolates from blood among outpatients

作　　者：李美兰[1] 林碎钗[1] 李建凤[1] 

机构地区：[1]温州医学院附属第一医院急诊科,浙江温州325000

出　　处：《中华医院感染学杂志》2012年第22期5121-5123,共3页Chinese Journal of Nosocomiology

摘　　要：目的调查门急诊患者血液分离的金黄色葡萄球菌耐药谱,为临床治疗金黄色葡萄球菌血流感染提供指导。方法收集温州医学院附属第一医院2005-2011年门急诊患者血液分离的金黄色葡萄球菌,利用革兰染色、触酶试验、血浆凝固酶试验、SPA单克隆抗体及全自动微生物分析仪对金黄色葡萄球菌进行菌种鉴定;采用K-B纸片扩散法进行药敏试验;使用苯唑西林纸片扩散法检测耐甲氧西林金黄色葡萄球菌。结果从42例患者中共分离出42株金黄色葡萄球菌,其中有17例患者有基础性疾病,疾病的类型主要以泌尿系统疾病为主;13株金黄色葡萄球菌经鉴定为MRSA,所有金黄色葡萄球菌除对万古霉素、利奈唑胺和替考拉宁敏感,对其余抗菌药物均存在不同程度耐药;金黄色葡萄球菌对青霉素和红霉素的耐药率较高,分别为94.7%和81.1%,对庆大霉素和四环素的耐药率<10.0%。结论门急诊患者血液标本分离的金黄色葡萄球菌耐药率较低,MRSA的分离率也较低。OBJECTIVE To investigate the antimicrobial susceptibility of Staphylococcus aureus isolates from blood of outpatients.METHODS S.aureus isolates from blood among outpatients from 2005-2011 at the First Affiliated Hospital of Wenzhou Medical College were collected.S.aureus was identified by gram stain,catalase test,coagulase test,SPA monoclone antibody agglutination test and full automatic microbiology analyzer.Antimicrobial susceptibility test was determined by K-B disk diffusion test.RESULTS A total of 42 S.aureus isolates were isolated from blood among 42 outpatients,among which 17 isolates were from the patients with severe underlying diseases mainly including urinary system diseases.There were 13 strains of methicillin-resistance S.aureus（MRSA） identified.All tested isolates were susceptible to vacomycin,teicoplanin and linezolid.S.aureus showed different levels of resistance to the rest of the antimicrobials.The resistance rates of the tested isolates to penicillin and erythromycin were 94.7% and 81.1%,while the resistance rates of the tested isolates to tetracycline,gentamycin and levofloxacin were less than 10.0%.CONCLUSION S.aureus isolates from blood among outpatients show relatively high susceptibility to most of antimicrobials,the prevalence of MRSA is pretty low.

关 键 词：金黄色葡萄球菌 血液 甲氧西林 耐药性 门急诊 患者 

分 类 号：R378.11[医药卫生—病原生物学]