1517株金黄色葡萄球菌的临床分布及药敏结果分析  

Clinical distribution and drug resistance analysis on 1517 strains of Staphylococcus aureus

作　　者：刘晓强[1] 谢晓英[1] 曾华[1] 劳小斌[2] 

机构地区：[1]中山大学孙逸仙纪念医院,广东广州510120 [2]南方医科大学第三附属医院检验科,广东广州510630

出　　处：《中国微生态学杂志》2014年第8期944-946,共3页Chinese Journal of Microecology

摘　　要：目的了解金黄色葡萄球菌(Staphylococcus aureus,S.aureus)的分布及耐药率,为临床合理用药提供参考。方法对2008年1月至2013年12月从各类临床标本中分离的S.aureus进行统计分析。判断标准均按CLSI 2013年规定标准判定结果,以WHONET 5.6统计软件进行数据分析。结果共检出1 517株S.aureus,其中耐甲氧西林金黄色葡萄球菌(MRSA)669株,占44.1%;构成比居前的标本来源是皮肤分泌物(693株)、痰液(487株)及血液(70株),MRSA在其中检出率分别为30.9%、71.0%和37.0%,痰液来源中的MRSA分离率比其余两者高,差别有统计学意义(P<0.05);科室分布居前的有皮肤科(440株)、重症监护室(156株)、肿瘤科(118株)、耳鼻喉科(114株)及神经科(101株),MRSA检出率分别是27.7%、75.9%、40.4%、27.2%和69.1%,重症监护室及神经科检出的MRSA比例比其他三个科高,差异有统计学意义(P<0.05)。S.aureus对青霉素耐药严重,高达94.6%,对大环内酯类、四环素耐药率较高,均为50%以上,对喹诺酮类、庆大霉素为35%以下,对利福平及复方新诺明较敏感,未达到20%,未发现对万古霉素、利奈唑胺和替考拉宁耐药的S.aureus。结论 S.aureus感染的标本来源与分离科室不同,MRSA检出率有差别,耐药率有较大差异,临床医师应根据药敏结果选择使用抗菌药物。Objective To study the distribution and drug resistance of Staphylococcus aureus（S. aureus） in our hospital,and provide basis for clinical use of antimicrobial drugs. Methods 1,517 strains of clinically isolated S.aureus from Jan 2008 to Dec 2013 in Sun Yat-Sen Memorial Hospital were retrospectively analyzed. The results of antimicrobial susceptibility were determined according to CLSI 2013 criteria. All data were analyzed by WHONET5. 6 software. Results Among the 1,517 strains of S. aureus,there were 669 strains of methicillin-resistant Staphylococcus aureus（MRSA）; the detection rate was 44. 1%. Of all the S. aureus strains,693 stains were isolated from secretions,487 stains from sputum and 70 stains from blood,in which the detection rate of MRSA was30. 9%,71. 0% and 37. 0%,respectively. The detection rate of MRSA from sputum was higher than those from secretions and blood with statistically significant difference（P 0. 05）. There were 440 strains from dermatological department,156 strains from intensive care unit,118 strains from oncology department,114 strains from otolaryngology department and 101 strains from neurology department,in which the detection rate of MRSA was 27. 7%,75. 9%,40. 4%,27. 2% and 69. 1%,respectively. The detection rates of MRSA from intensive care unit and neurology department were significantly higher than those from dermatological department,oncology department and otolaryngology department（P 0. 05）. The resistance rate of S. aureus to penicillin was 94. 6%,and those to macrolides and tetracyclines kept at over 50%,while those to quinolones and gentamicin were less than 35%. The S.aureus strains were sensitive to rifampin and trimethoprim-sulfamethoxazole to which the resistance rates were less than 20%. No strains were found resistant to vancomycin,teicoplanin and linezolid. Conclusion S. aureus were isolated from different departments and specimens; the detection rates of MRSA were different,and the drug resistance was quite different. Clinicians should use antimicrobi

关 键 词：金黄色葡萄球菌 甲氧西林 耐药性 

分 类 号：R378.11[医药卫生—病原生物学]