综合性医院金黄色葡萄球菌分布及耐药趋势  

Distribution and drug resistance of Staphylococcus aureus in a general hospital

作　　者：郝秀红[1] 赵强元[1] 李艳君[1] 钱杨会[1] 丁毅伟[1] 刘力娟[1] 

机构地区：[1]海军总医院检验科,北京100048

出　　处：《中华医院感染学杂志》2014年第6期1342-1343,1346,共3页Chinese Journal of Nosocomiology

基　　金：国家"十二五"国际医学研究基金项目(CNSC-J2011-A330)

摘　　要：目的了解医院金黄色葡萄球菌临床分布及耐药性,为合理应用抗菌药物提供依据。方法收集2008-2011年医院临床与门诊患者送检标本分离出的金黄色葡萄球菌,细菌鉴定采用VITEK微生物分析仪,药物敏感性试验采用BIOMIC药敏测定仪,耐药性分析采用WHONET5.4软件。结果近4年医院检出金黄色葡萄球菌1 252株,其中MRSA 898株占71.7%;金黄色葡萄球菌检出以痰液标本为主占63.3%,检出病区内科36.5%、外科12.4%;内科病区除磺胺甲噁唑/甲氧苄啶和左氧氟沙星外,对其他抗菌药物耐药率均高于外科病区;金黄色葡萄球菌对利奈唑胺和万古霉素未发现耐药株,对呋喃妥因和磺胺甲噁唑/甲氧苄啶耐药率<30.0%;对青霉素耐药率>90.0%,痰标本中金黄色葡萄球菌对抗菌药物的耐药率除利奈唑胺、万古霉素、呋喃妥因、磺胺甲噁唑/甲氧苄啶外均高于总标本中金黄色葡萄球菌的耐药率。结论 MRSA耐药性高,应规范临床用药,加强MRSA耐药性监测,有效控制感染。OBJECTIVE To investigate the clinical distribution and drug resistance of Staphylococcus aureus so as to guide the reasonable use of antibiotics. METHODS The S. aureus strains, which were isolated from specimens obtained from the clinical and outpatient department patients during 2008--2011, were collected, then the strains were identified by VITEK system, the drug susceptibility testing was performed with BIOMIC, and the drug resistance was analyzed by WHONET5.4 software. RESULTS Totally 1252 strains of S. aureus have been isolated during the four years, among which there were 898 strains of MRSA; 63.3% of the S. aureus strains were isolated from the sputum specimens, 36. 5% from the department of internal medicine, 12.4G from the department of surgery. The drug resistance rates of the strains isolated from the department of internal medicine were higher than those of the strains isolated from the department of surgery except for sulfamethoxazole-trimethoprim and levofloxacin. The linezolidor vancomycin-resistant S. aureus strains have not been detected; the drug resistance rates to nitrofurantoin and sulfamethoxazole-trimethoprim were less than 30.0 %, the drug resistance rate to peni eillin was more than 90.0% ; the drug resistance rates of the S. aureus strains isolated from the sputum specimens were higher than those of the strains isolated from other specimens except for linezolid, vancomycin, nitrofuran toin, and sulfamethoxazole-trimethoprim. CONCLUSION The MRSA strains are highly resistant; it is necessary to standardize the clinical use of antibiotics and strengthen the monitoring MRSA so as to effectively control infections.

关 键 词：金黄色葡萄球菌 耐甲氧西林金黄色葡萄球菌 耐药性 

分 类 号：R378.11[医药卫生—病原生物学]