烧伤病房患者创面金葡菌分布及耐药性分析  

Distribution and drug resistance of Staphylococcus aureus isolated from wound in burn wards

作　　者：倪俊[1] 许献荣[1] 陈瑞彩[1] 孙建文[2] 顾海峰[1] 张杏梅[1] 

机构地区：[1]中国人民解放军第八五医院烧伤整形外科,上海200052 [2]中国人民解放军第八五医院检验科,上海200052

出　　处：《中国微生态学杂志》2014年第4期429-431,共3页Chinese Journal of Microecology

基　　金：上海市卫生局科研基金(20134489)

摘　　要：目的分析烧伤病房患者不同创面金葡菌的分布及耐药性,为临床合理选用抗菌药提供依据。方法对2006年1月至2013年12月间中国人民解放军第八五医院烧伤病房患者创面分离出金葡菌,采用K-B纸片扩散法进行药物敏感试验。分析金葡菌的耐药性,并对难愈性创面、非难愈性创面的耐甲氧西林金葡菌(MRSA)与甲氧西林敏感金葡菌(MSSA)的耐药性进行对比分析。结果分离出金葡菌112株,其中难愈性创面有70株MRSA和17株MSSA来自难愈性创面,16株MRSA和9株MSSA来自非难愈性创面。金葡菌对青霉素、红霉素、克林霉素的耐药率较高(分别为94.64%、81.25%和74.11%),对复方新诺明、呋喃妥因的耐药率较低(分别为16.07%和1.79%),对万古霉素、利奈唑烷的耐药率为0。MRSA的耐药率高于MSSA。来源于难愈性创面与非难愈性创面的MRSA仅在对利福平的耐药率上有明显差异,而来源于两创面的MSSA的耐药率无明显差异。结论创面金葡菌中MRSA的构成比高,难愈性创面MRSA耐药严重,应积极防控创面MRSA感染和扩散。Objective To analyze the distribution and drug resistance of Staphylococcus aureus （SA） isolated from wound in burn wards. Methods SA was isolated from wound in burn wards patients from January 2006 to Decem- ber 2013. K-B disk diffusion method was used for the sensitivity test and analysis of drug resistance rate of SA. Drug resistances of methicillin-resistant Staphylococcus aureus （ MRSA ） and methicillin-sensitive Staphylococcus aureus （MSSA） isolated from refractory wound or non-refractory wound were analyzed and compared. Results A total of 112 strains of SA were isolated, among which 70 strains of MRSA and 17 strains of MSSA were isolated from refractory wound, while 16 strains of MRSA and 9 strains of MSSA were isolated from non-refractory wound. There were higher resistance rates of SA to penicillin, erythromycin and clindamycin （94.64%, 81.25% and 74.11% respectively） and lower rates to trimethoprim-sulfamethoxazole and nitrofurantoin （ 16.07% and 1.79% respectively）. No strains were resistant to vancomycin or linezolid. The resistance rates of MRSA was much higher than those of MSSA. Comparing the drug resistance rates between MRSA isolated from refractory and non-refractory wound, the only difference was to rifampicin. There was no obvious difference in drug resistance rates between MSSA isolated from above two wounds. Conclusion MRSA was relatively prevalent among the SA isolated from wound. The drug resistance of MRSA from refractory wound is serious in hospital, and we should take appropriate control measures to prevent MRSA infection.

关 键 词：烧伤 创面 金黄色葡萄球菌 甲氧西林 耐药性 

分 类 号：R378[医药卫生—病原生物学]