耐甲氧西林金黄色葡萄球菌的临床分布与耐药性分析  

Clinical distribution and drug resistance of methicillin-resistant Staphylococcus aureus

作　　者：申桂娟[1] 陆军[1] 祝进[1] 

机构地区：[1]衢州市人民医院感染管理科,浙江衢州324000

出　　处：《中华医院感染学杂志》2014年第2期282-284,共3页Chinese Journal of Nosocomiology

基　　金：浙江省自然科学基金项目(LY13H200004)

摘　　要：目的了解耐甲氧西林金黄色葡萄球菌(MRSA)的临床分布及耐药性变迁,为制定医院感染预防控制措施提供依据。方法回顾性调查2007年1月-2011年12月住院患者MRSA检出结果、临床分布和耐药率。结果 2007-2011年MRSA检出率分别为38.6%、29.5%、10.3%、15.7%和23.5%;其中医院感染占77.0%、社区感染占23.0%;主要分布在ICU、神经外科、普外科、骨科、神经内科,分别占25.3%、20.7%、9.2%、8.5%、7.8%;主要检出标本为痰液、脓液/创面分泌物、血液、尿液,分别占69.6%、21.2%、5.1%、2.3%;耐药率<30.0%的只有磺胺甲噁唑/甲氧苄啶、氯霉素和喹奴普汀/达福普汀等临床不常用的药物;万古霉素、替考拉宁、利奈唑胺和呋喃妥因对MRSA仍保持高敏感性,耐药率为0。结论多药耐药菌防控应重点加强对重症医学科、神经内外科的管理,规范的医务人员手卫生、医院环境与医疗用品的清洁消毒可有效预防MRSA医院感染的发生。OBJECTIVE To investigate the prevalence and antibiotic resistance of methicillimresistant Staphylococus aureus （MRSA）, so as to provide the basis for the development of hospital infection prevention and control meas- ures. METHODS From Jan 2007 to Dec 2011, a retrospective survey was conducted for the detection rate Of MRSA isolated from hospitalized patients, clinical distribution, and drug resistance rates. RESULTS In past five years （2007-2011）, MRSA detection rates were 38.60//00, 29.5%, 10.3%, 15.7% and 23.5%, respectively; nosocomi- al infections accounted for 77 %, compared with 23 % of community-acquired. The detection cases mainly occurred in the ICU（25.3 % ）, neurosurgery（20.7 %）, followed by the department of general surge＇ry（9.2 %）, orthopedic （8.5%）, and department of neurology（7.8%）. About 69.6% of detected specimen was sputum and 21.2% pus / wound secretions while the percentage of blood was 5.1% and urine 2.3 %. Only medicine not frequently used clin- ically such as cotrimoxazole, chloramphenicol and quinupristin dalfopristin had resistance rates lower than 30.0 % ; glycopeptides vancomyein, teicoplanin, linezolid, and nitrofurantoin maintained a high level of antibacterial activity against MRSA, with the drug resistance rate of 0. CONCLUSION The prevention and control of multidrug resist- ance should focus on the management of critical care medicine, neurology and neurosurgery. In addition, effective hand hygiene of the medical staff, cleaning and disinfection of the hospital environment and medical supplies can prevent the MRSA infection to a certain degree.

关 键 词：耐甲氧西林金黄色葡萄球菌 感染 临床分布 耐药性 

分 类 号：R378.11[医药卫生—病原生物学]