713株金黄色葡萄球菌临床分布及耐药性分析  

Clinical distribution and drug resistance of 713 strains of Staphylococcus aureus

作　　者：陈燕[1] 董华丽[1] 张传领[1] 楚旭[1] 沈利蒙[1] 毛剑锋[1] 郭远瑜[1] 

机构地区：[1]浙江萧山医院临床检验中心,杭州311201

出　　处：《传染病信息》2013年第4期236-238,共3页Infectious Disease Information

基　　金：浙江省卫生厅科研项目(2012KYB171)

摘　　要：目的了解金黄色葡萄球菌的临床分布及耐药性,为临床合理选择抗生素提供依据。方法收集2010年1月—2011年12月我院临床分离的金黄色葡萄球菌713株,采用VITEK-60全自动微生物仪进行细菌鉴定和药物敏感性(药敏)实验,用WHONET 5.4软件分析病原菌的分布及耐药情况。结果 713株主要分离自分泌物(47.7%)和痰液(42.9%),主要分布在儿科(30.0%)、烧伤科(14.0%)、外科(13.8%)和ICU(12.2%)。其中耐甲氧西林金黄色葡萄球菌(methicillin-resistant Staphylococcus aureus,MRSA)246株,占34.5%。药敏结果显示,金黄色葡萄球菌对红霉素和青霉素的耐药率较高(>64%),对其他抗生素的耐药率较低(<35%)。MRSA与甲氧西林敏感金黄色葡萄球菌(methicillin-sensitive Staphylococcus aureus,MSSA)相比,对苯唑西林(100%vs.0)、呋喃妥因(2.4%vs.0)、红霉素(76.0%vs.57.6%)、利福平(5.7%vs.0)、莫西沙星(30.1%vs.0.4%)、青霉素(100%vs.90.4%)、庆大霉素(26.0%vs.9.9%)、四环素(36.6%vs.21.2%)和左氧氟沙星(35.4%vs.3.4%)的耐药率均较高(P均<0.05)。未发现耐万古霉素和利奈唑脘的菌株。结论金黄色葡萄球菌在分泌物和痰液中的分离率最高,儿童较易感染。MRSA对多种抗生素的耐药率明显高于MSSA,临床和实验室应加强对MRSA的监测。Objective To investigate clinical distribution and antibiotic resistance of Staphylococcus aureus （SA）, and provide evidence for rational use of antibiotics. Methods A total of 713 isolates of SA were collected from clinical specimens in our hospital from Jan. 2010 to Dec. 2011. VITEK-60 compact automatic microbial analyzer was used for bacterial identification and drug-resistance testing, and WHONET 5.4 for analyzing distribution and antibiotic resistance of SA. Results Most of the 713 SA strains were isolated from secretion （47.7%） and sputum specimens （42.9%） from the patients treated in the department of pediatrics （30.0%）, empyrosis （14.0%）, surgery （13.8%） and ICU （12.2%）. The strains of methicillin-resistant Staphylococcus aureus （MRSA） accounted for 34.5%. Antimicrobial susceptibility testing showed that the resistance rates of SA to erythromycin and penicillin were higher （more than 64%）, while the resistance rates to others antibiotics were lower （less than 35%）; as compared with methicillin- sensitive Staphylococcus aureus （MSSA）, MRSA strains had significantly higher resistance rates to oxaeillin （100% vs. 0）, nitro- furantoin （2.4% vs. 0）, erythromycin （76.0% vs. 57.6%）, rifampicin （5.7% vs. 0）, moxifloxacin （30.1% vs. 0.4%）, penicillin （100% vs. 90.4%）, gentamicin （26.0% vs. 9.9%）, tetracycline （36.6% vs. 21.2%） and levofloxacin （35.4% vs. 3.4%）（P〈0.05）; no isolate was resistant to vancomycin and linezolid. Conclusions The isolation rate of SA from secretion and sputum specimens is the highest. Children are easily affected by SA infection. MRSA shows higher resistance rates to multiple antibiotics than MSSA, so clinical and laboratory minitoring of MRSA should be strengthened.

关 键 词：金黄色葡萄球菌 抗菌药 药物耐受性 

分 类 号：R378.11[医药卫生—病原生物学] R962[医药卫生—基础医学]