基层医院耐甲氧西林金黄色葡萄球菌临床分布与耐药性分析  

Analysis of clinical distribution and resistance of methicillin-resistant Staphylococcus aureus in primaryhospital

作　　者：向蓉[1] 杨新怀 隋洪[1] 李璐琳 徐宁[1] 

机构地区：[1]南方医科大学附属小榄人民医院检验科,广东省中山528415 [2]院办

出　　处：《中国基层医药》2013年第18期2727-2730,共4页Chinese Journal of Primary Medicine and Pharmacy

基　　金：广东省医学科学技术研究基金项目（A2011751）;广东省科技厅“广东农村安全合理用药研究基金项目”（20098040800002-2）

摘　　要：目的分析2009-2012年某基层医院临床分离的耐甲氧西林金黄色葡萄球菌（MRSA）和甲氧西林敏感金黄色葡萄球菌（MSSA）在科室的分布情况及耐药率，为临床合理用药提供有效依据。方法采用VITEK-2全自动微生物分析仪进行细菌鉴定和药敏试验。采用WHONTE5．5和SPSS13．0软件对数据进行统计分析。结果共检出金黄色葡萄球菌517株（MRSA135株、MSSA382株），4年MRSA检出率分别为24．5％、27．7％、24．8％、27．0％。MRSA感染以肿瘤科、骨科和ICU患者居多。MRSA在脓液、伤口分泌物、痰液、血液标本中分离率较高。517株金黄色葡萄球菌对万古霉素、利奈唑胺和替考拉宁的敏感率均为100．0％。结论基层医院建立较为完善的多重耐药菌监测和医院感染控制制度，治疗时根据感染细菌的药敏结果合理使用抗菌药物，可有效地预防MRSA耐药率的提高和院内传播。Objective To analyze the distribution and drug resistance rate of methicillin-resisitant Staphylo- coccus aureus（MRSA） and methicillin-susceptible Staphylococcus aureus（MSSA） isolated from different departments in a certain primary hospital during 2009 to 2012, and to provide scientific evidences for clinical application of antibi- otics. Methods Pathogens and bacterial resistance to antibiotics were identified using the VITEK 2 compact equip- ment. The data were got from WHONTES. 5 and analyzed by SPSS 13.0. Results There were 517 Staphylococcus au- reus strains were detected （ MRSA 135 strains, MSSA 382 strains）. The rate of MRSA was 24.5 %, 27.7 %, 24.8 %, 27.0% during the four years. MRSA was mainly found in the department of oncology, orthopaedicsand ICU. MRSA was mainly isolated from pus, secretion,sputum and blood. The 517 Staphylococcus aureus strains showed high sensi- tive to vancomycin, linezolid and teicoplanin, the sensitive rate was 100%. Conclusion Establishing a more compre- hensive MDRO monitoring and hospital infection control system in the primary hospital, and rational using antibacterial drugs at the based of the antibiotics susceptibility test in the treatment can be effective in preventing MRSA resistance rates increasing and hospital-borne.

关 键 词：耐甲氧西林金黄色葡萄球菌 甲氧西林敏感金黄色葡萄球菌 临床分布 耐药性 

分 类 号：R446.5[医药卫生—诊断学]